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epidural injections

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https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#1
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29138074/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-cervical-foraminal-stenosis
#2
Min Son Kim, Dong Gyu Lee, Min Cheol Chang
BACKGROUND CONTEXT: Cervical transforaminal epidural steroid injection (TFESI) is considered one of the most effective treatments for radicular pain induced by cervical foraminal stenosis. PURPOSE: To evaluate the treatment outcome of TFESI according to the severity of cervical foraminal stenosis DESIGN: Retrospective study. PATIENT SAMPLE: Fifty-three patients with cervical radiculopathy due to cervical foraminal stenosis. OUTCOME MEASURES: Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, 2 weeks, and 1, 2, and 3 months after TFESI...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#3
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29130237/in-situ-forming-oxidised-hyaluronic-acid-adipic-acid-dihydrazide-hydrogel-for-prevention-of-epidural-fibrosis-after-laminectomy
#4
M H Hu, K C Yang, Y H Sun, Y C Chen, S H Yang, F H Lin
Post-operative epidural fibrosis is a biological response after laminectomy that may lead to clinical symptoms, such as radicular pain. An ideal material for prevention of epidural fibrosis should be able to inhibit fibroblast adhesions and reduce formation of scar tissue. An injectable hydrogel would be the material of choice for this purpose, since it could fill an irregular surgical defect completely, gelate in situ and be delivered in a minimally-invasive manner. The objective of this study was to evaluate, in vitro and in vivo, the cytocompatibility and anti-adhesive effect of an oxidised hyaluronic acid/adipic acid dihydrazide (oxi-HA/ADH) hydrogel...
November 13, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/29123623/effect-of-epidural-corticosteroid-injection-on-magnetic-resonance-imaging-findings
#5
Min Soo Kim, Tae Yoon Jeong, Yu Seon Cheong, Young Wook Jeon, So Young Lim, Seong Sik Kang, In Nam Kim, Tsong Bin Chang, Hyun Ho Seong, Byeong Mun Hwang
Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29121291/pectoral-nerve-block1-versus-modified-pectoral-nerve-block2-for-postoperative-pain-relief-in-patients-undergoing-modified-radical-mastectomy-a-randomized-clinical-trial
#6
S Goswami, P Kundra, J Bhattacharyya
Background: Pectoral nerve block1 (PEC1) given between pectoralis major and minor, and modified pectoral nerve block2 (mPEC2) performed between pectoralis minor and serratus anterior, can provide continuous analgesia after modified radical mastectomy (MRM) when catheters are placed before skin closure. This study was designed to compare PEC1 and mPEC2 block for providing postoperative pain relief after MRM. Methods: Sixty-two physically fit patients undergoing MRM were assigned into two groups (Group PEC1, n=31 and Group mPEC2, n=31)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#7
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#8
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29099886/risk-of-osteoporotic-fracture-after-steroid-injections-in-patients-with-medicare
#9
Leah Y Carreon, Kevin L Ong, Edmund Lau, Steven M Kurtz, Steven D Glassman
To further evaluate the relationship between steroid injections and osteoporotic fracture risk, we analyzed Medicare administrative claims data on both large-joint steroid injections (LJSIs) into knee and hip and transforaminal steroid injections (TSIs), as well as osteoporotic hip and wrist fractures. Our hypothesis was that a systemic effect of steroid injections would increase fracture risk in all skeletal locations regardless of injection site, whereas a local effect would produce a disproportionate increased risk of spine fracture with spine injection...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29098646/failed-back-surgery-syndrome-a-new-strategy-by-the-epidural-injection-of-mesna
#10
M Carassiti, A Di Martino, A Centonze, C C Quattrocchi, A Caldaria, F Agrò, V Denaro
PURPOSE: Evaluate the efficacy and safety of MESNA (sodium 2-mercaptoethanesulfonate) injection into the epidural space in the FBSS. METHODS: We designed a prospective phase II longitudinal study. Six consecutive patients were enrolled. Patients underwent one peridural injection per week for 3 weeks. NRS and ODI were investigated before and 48 h after injections, and at 1 week, 1 month and 2 months after the last procedures. Opioids intake is investigated before procedures and 1 week, 1 month and 3 months after the last procedures...
November 2, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#11
Wangping Zhang, Hanbin Wu
BACKGROUND: Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS: Sixty parturient women were allocated into 2 groups in this prospective study. Group P received 0.5 mL kg h of phenylephrine (5 mg/50 mL) at the start of intrathecal injection, and Group C (control group) received the same volume of saline...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#12
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29074369/transient-hypokalemic-quadriplegia-following-a-lumbar-transforaminal-epidural-dexamethasone-injection-a-case-report
#13
Maryam Tahmasbi Sohi, William J Sullivan, Dustin J M Anderson
A 30-year-old male with no significant past medical history presented with hypokalemic quadriplegia four hours after he received a lumbar transforaminal epidural steroid injection (TFESI) containing dexamethasone and lidocaine. A comprehensive work up ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Paralysis after TFESI is uncommon, but has been associated with particulate steroids that can coalesce into aggregates and occlude vessels...
October 23, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29074363/ultrasound-guided-femoral-and-obturator-nerves-block-in-the-psoas-compartment-in-dogs-anatomical-and-randomized-clinical-study
#14
Hamaseh Tayari, Giulio Tazioli, Gloria Breghi, Angela Briganti
OBJECTIVE: To evaluate intraoperative and postoperative efficacy of ultrasound (US)-guided femoral (FN) and obturator (ON) nerves block, in the iliopsoas muscle compartment (IPM), using an in-plane technique. STUDY DESIGN: Anatomical research and randomized, prospective, 'blinded' clinical study. ANIMALS: Six dog cadavers and 20 client-owned dogs undergoing tibial plateau levelling osteotomy (TPLO) surgery. METHODS: In phase 1, anatomical dissections and US imaging of the IPM were performed to design an US-guided nerve block involving the FN and ON simultaneously...
April 29, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29072177/effects-of-intradermal-sterile-water-injections-in-women-with-low-back-pain-in-labor-a-randomized-controlled-clinical-trial
#15
Refika Genç Koyucu, Nurdan Demirci, Ayşe Ender Yumru, Süleyman Salman, Yavuz Tahsin Ayanoğlu, Yıldız Tosun, Cihangir Tayfur
BACKGROUND: In addition to pain caused by uterine contractions in labor, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered to be an alternative method for nonpharmacological management. AIM: The aim of this study was to assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labor...
October 26, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/29071370/determination-of-the-median-effective-dose-ed50-of-bupivacaine-and-ropivacaine-unilateral-spinal-anesthesia-prospective-double-blinded-randomized-dose-response-trial
#16
WeiBing Wang, YuanHai Li, AiJiao Sun, HongPing Yu, JingChun Dong, Huang Xu
BACKGROUND: Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED50) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery. METHODS: A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study...
October 25, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29059983/ex-vivo-animal-model-assessment-of-a-non-invasive-system-for-loss-of-resistance-detection-during-epidural-blockade
#17
M Carassiti, R Quarta, A Mattei, M Tesei, P Saccomandi, C Massaroni, R Setola, E Schena
During recent decades epidural analgesia has gained widespread recognition in many applications. In this complex procedure, anaesthetist uses a specific needle to inject anesthetic into the epidural space. It is crucial the appropriate insertion of the needle through inhomogeneous tissues placed between the skin and the epidural space to minimize anesthetic-related complications (e.g., nausea, headache, and dural puncture). Usually, anaesthetists perform the procedure without any supporting tools, and stop pushing the syringe when they sense a loss of resistance (LOR)...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29053132/-neurotropic-effect-of-b-vitamins-in-the-complex-treatment-of-pain-syndrome
#18
O A Shavlovskaya
Combined vitamin preparations in therapeutic doses are used, along with simple analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle and epidural blockade, for the relief of acute pain. It is recommended to use the B vitamin preparation neuromultivit. The tablet form of this preparation contains vitamin thiamine hydrochloride (100 mg), pyridoxine hydrochloride (200 mg), cyanocobalamin (0.2 mg), and injectable form includes thiamine hydrochloride (100mg), pyridoxine hydrochloride (100 mg), cyanocobalamin (1 mg)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29051967/clinical-efficacy-of-transforaminal-epidural-injection-for-management-of-zoster-associated-pain-a-retrospective-analysis
#19
Eung Don Kim, Ha Hyeon Bak, Dae Hyun Jo, Hue Jung Park
OBJECTIVES: Transforaminal epidural injection (TFEI) has superior accessibility to the dorsal root ganglion, which is an essential location of pain signaling in herpes zoster. However, the effectiveness of TFEI for herpes zoster patients has not previously been studied. We retrospectively analyzed the efficacy of TFEI for pain control and prevention of PHN in patients with acute and subacute herpes zoster. METHODS: Medical records of 137 patients who underwent TFEI for zoster-associated pain (ZAP) were reviewed...
October 19, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29049070/noninfectious-fever-in-the-near-term-pregnant-rat-induces-fetal-brain-inflammation-a-model-for-the-consequences-of-epidural-associated-maternal-fever
#20
Scott Segal, Carlo Pancaro, Iwona Bonney, James E Marchand
BACKGROUND: Women laboring with epidural analgesia experience fever much more frequently than do women who chose other forms of analgesia, and maternal intrapartum fever is associated with numerous adverse consequences, including brain injury in the fetus. We developed a model of noninfectious inflammatory fever in the near-term pregnant rat to simulate the pathophysiology of epidural-associated fever and hypothesized that it would produce fetal brain inflammation. METHODS: Twenty-four pregnant Sprague-Dawley rats were studied at 20 days gestation (term: 22 days)...
October 17, 2017: Anesthesia and Analgesia
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