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https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#1
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#2
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#3
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29299101/rib-head-dislocation-causing-spinal-canal-stenosis-in-a-child-with-neurofibromatosis-type-1
#4
Alan M Chen, Jeffrey B Neustadt, Jennifer Neville Kucera
A 10-year-old female with neurofibromatosis type 1 and severe dystrophic scoliosis presented with a two-month history of difficulty ambulating due to low back pain. The patient did not have any neurological symptoms. MRI of the thoracolumbar spine demonstrated subluxation of the right posterior tenth and eleventh ribs through their respective neural foramina, with mild mass effect on the thecal sac without abnormal cord signal or cord compression. Groups of neurofibromas were present along the right ribs and paravertebral soft tissues around these levels...
August 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29299097/paravertebral-calcification-as-a-potential-indicator-for-nonaccidental-trauma
#5
Katsuaki Kojima, Jennifer Nimtz, Steven W Martin, Stephen R Guertin, Ellen C Cavenagh
We report a case of nonaccidental trauma (NAT) involving a 23-month-old boy who presented with seizures, acute subarachnoid hemorrhage, and acute subdural hemorrhage. Ophthalmologic examination showed bilateral intraretinal hemorrhages. Further evaluation revealed that he had bilateral thoracolumbar paravertebral calcifications. The Children's Protective Services agency was involved in the case. The child was discharged to an inpatient rehabilitation facility. Vertebral fracture associated with paravertebral calcification has been reported as a sign of NAT...
July 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29297990/video-assisted-thoracoscopic-surgery-can-help-enable-the-complete-resection-of-a-mediastinal-tumor-caused-by-immunoglobulin-g4-related-disease-and-avoid-the-need-for-postoperative-medication-a-case-report
#6
Tsuyoshi Uchida, Hirochika Matsubara, Satoshi Nagasaka, Satsuki Kina, Tomofumi Ichihara, Hiroyasu Matsuoka, Hiroyuki Nakajima
Immunoglobulin (Ig) G4-related disease has various clinical signs and symptoms, and steroidal therapy with corticosteroids has been found to be effective for treatment. Few cases of IgG4-related disease associated with paravertebral tumor have been reported, and there have been no reports on complete resection of such a tumor. Here, we report a case of IgG4-related disease associated with a paravertebral tumor that was successfully resected without the need for postoperative medication. An 84-year-old woman was admitted to our hospital with a paravertebral tumor...
January 3, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29297566/immunohistochemical-characteristics-of-neurons-in-the-ganglia-of-the-greater-splanchnic-nerve-of-the-pig
#7
Jamal Nourinezhad, Piotr Podlasz, Krzysztof Wasowicz
INTRODUCTION: Greater splanchnic nerve (GSN) is by far the largest of the splanchnic nerves and connects the paravertebral and prevertebral ganglia to transmit the majority of nociceptive information from the viscera. Despite its importance, the immunohistochemical features of the porcine GSN neurons have not yet been examined. Therefore, the aim of the study was to investigate the neurochemistry of the porcine GSN neurons and to compare their neurochemical coding with those of the paravertebral and prevertebral ganglia...
January 3, 2018: Folia Histochemica et Cytobiologica
https://www.readbyqxmd.com/read/29284840/effect-of-clonidine-as-adjuvant-in-thoracic-paravertebral-block-for-patients-undergoing-breast-cancer-surgery-a-prospective-randomized-placebo-controlled-double-blind-study
#8
Nairita Mayur, Anjan Das, Hirak Biswas, Subinay Chhaule, Surajit Chattopadhyay, Tapobrata Mitra, Sandip Roybasunia, Subrata Kumar Mandal
Background and Aims: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29278605/erector-spinae-plane-block-for-surgery-of-the-posterior-thoracic-wall-in-a-pediatric-patient
#9
Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29260419/comparative-effectiveness-of-preoperative-paravertebral-block-for-post-mastectomy-reconstruction-a-systematic-review-of-the-literature
#10
Anaeze C Offodile, Mario A Aycart, Jodi B Segal
INTRODUCTION: Paravertebral block (PVB) has emerged as a viable strategy for improving postoperative outcomes in breast surgery; however, it is unclear whether these benefits extend to recipients of post-mastectomy reconstruction (PMR). METHODS: A systematic search of the PubMed, EMBASE, Web of Science and Cochrane Library electronic databases was conducted for all studies matching the a priori inclusion criteria (inception to 1 March 2017). Independent assessment by two reviewers, in stages, of the title/abstract and full text was performed...
December 19, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29249491/laparoscopic-transdiaphragmatic-chest-surgery-early-experience
#11
Rafael Santiago Andrade, Ilitch Diaz-Gutierrez, Jacob Hutchins, Alexander Kaizer, Joseph Small, Madhuri Rao
OBJECTIVE: We describe laparoscopic transdiaphragmatic (LTD) chest surgery without intercostal incisions and focus on technique and safety. The goal of LTD is to minimize postoperative pain. METHODS: We reviewed all patients undergoing LTD chest surgery (September 8, 2010-April 4, 2017). We place 4 abdominal ports with the patient in semilateral decubitus, make 2 diaphragmatic openings, and advance 2 ports into the chest. The intrathoracic operation is standard video-assisted thoracoscopic surgery (VATS), and diaphragmatic openings are closed at the end...
November 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29248776/spinal-epidural-cavernous-hemangioma-a-clinical-series-of-seven-patients
#12
Chuanping Gao, Wenjian Xu, Ji Qing Lian, Duan Feng, Jiu Fa Cui, Hua Liu
OBJECTIVE: The aim of this study was to investigate the imaging characteristics of spinal epidural cavernous hemangiomas (ECH) and improve the understanding of this rare disease. METHODS: This retrospective study included seven cases of ECH, confirmed with surgical pathology and imaging. All patients underwent computed tomographic and conventional magnetic resonance imaging. One of the seven patients underwent diffusion-weighted imaging. RESULTS: The ECH originated from vertebrae with coarsened trabeculae in five patients...
December 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29248305/state-of-the-art-transforaminal-percutaneous-endoscopic-lumbar-surgery-under-local-anesthesia-discectomy-foraminoplasty-and-ventral-facetectomy
#13
REVIEW
Koichi Sairyo, Takashi Chikawa, Akihiro Nagamachi
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided...
December 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29242655/evaluation-of-the-role-of-dexmedetomidine-in-improvement-of-the-analgesic-profile-of-thoracic-paravertebral-block-in-thoracic-surgeries-a-randomised-prospective-clinical-trial
#14
Mohamed Elsayed Hassan, Essam Mahran
Background and Aims: Thoracic paravertebral block (TPB) is one of the effective methods for management of post-operative pain in thoracic surgeries. The aim of the study was to evaluate effectiveness of addition of dexmedetomidine to paravertebral block with bupivacaine in improving the postoperative pain relief and pulmonary functions in patients undergoing thoracic surgeries. Methods: A prospective randomized double-blinded study was performed on forty patients scheduled for thoracic surgery...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29240031/thoracic-actinomycosis-with-infiltration-of-the-spine-an-oncological-pitfall
#15
Leila Ronceray, Waltraud Friesenbichler, Caroline Hutter, Karoly Lakatos, Wolfgang Krizmanich, Gabriele Amann, Kaan Boztug, Leo Kager, Georg Mann, Andishe Attarbaschi
Thoracic actinomycosis with involvement of the vertebral column and chest wall is rare in children and may resemble malignant tumors. A 12-year-old girl was admitted to our clinic having B-symptoms, cachexia, and painful scoliosis (Karnofsky index 20%). Imaging showed a large thoracic left-sided paravertebral tumor with infiltration of the vertebrae, destruction of the chest wall and multiple intrapulmonary nodules. Initially, Ewing sarcoma was suspected and chemotherapy started without previous biopsies. Definite diagnosis of actinomycosis was established later upon histopathologic examination and successfully treated by β-lactam antibiotics...
December 12, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29239241/tuberculous-spondylitis-after-vertebral-augmentation-a-case-report-with-a-literature-review
#16
Sun Jia-Jia, Sun Zhi-Yong, Qian Zhong-Lai, Yang Hui-Lin, Zhu Xiao-Yu
Tuberculous spondylitis of vertebral augmentation following percutaneous vertebroplasty or kyphoplasty is rare. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous kyphoplasty (PKP). A 54-year-old woman presented to hospital complaining of back pain following a fall 20 days prior. Radiology showed an acute osteoporotic compression (L3 fracture). The patient denied a history of pulmonary tuberculosis and there were no signs of infection. The patient was discharged from hospital 2 days after undergoing L3 PKP with a dramatic improvement in her back pain...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29226148/transition-from-deep-regional-blocks-toward-deep-nerve-hydrodissection-in-the-upper-body-and-torso-method-description-and-results-from-a-retrospective-chart-review-of-the-analgesic-effect-of-5-dextrose-water-as-the-primary-hydrodissection-injectate-to-enhance
#17
Stanley K H Lam, Kenneth Dean Reeves, An-Lin Cheng
Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29218392/unusual-circumstances-to-diagnose-cervical-pott-s-disease
#18
Mohamed Ali Kedous, Ahmed Msakni, Wael Chebbi, Mourad Zaraa, Mohsen Trabelsi
Tuberculous spondylodiscitis usually affects the dorso-lumbar spine, and its cervical location is a rare condition that can mimic other diseases and consequently cause treatment delays. We report a case of tuberculous spondylodiscitis of the lower cervical spine discovered under unusual circumstances in a patient with severe polytrauma involving a cranio-cerebral trauma, a non-displaced fracture of the two laminæ and the spinous process of the C6 vertebrae as well as fibular and tibial shaft fractures. The patient underwent static tibial nailing, and a collar with occipital and chin supports was applied...
December 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29218230/spondylodiscitis-revisited
#19
Andreas F Mavrogenis, Panayiotis D Megaloikonomos, Vasileios G Igoumenou, Georgios N Panagopoulos, Efthymia Giannitsioti, Antonios Papadopoulos, Panayiotis J Papagelopoulos
Spondylodiscitis may involve the vertebral bodies, intervertebral discs, paravertebral structures and spinal canal, with potentially high morbidity and mortality rates.A rise in the susceptible population and improved diagnosis have increased the reported incidence of the disease in recent years.Blood cultures, appropriate imaging and biopsy are essential for diagnosis and treatment.Most patients are successfully treated by conservative means; however, some patients may require surgical treatment.Surgical indications include doubtful diagnosis, progressive neurological deficits, progressive spinal deformity, failure to respond to treatment, and unresolved pain...
November 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29204290/meningeal-carcinomatosis-and-spinal-cord-infiltration-caused-by-a-locally-invasive-pulmonary-adenocarcinoma-in-a-cat
#20
Christoforos Posporis, Llorenç Grau-Roma, Olga Travetti, Maria Oliveira, Laura Polledo, Annette Wessmann
Case summary: A 12-year-old domestic shorthair cat was presented with acute non-painful hindlimb proprioceptive ataxia localising to T3-L3 spinal cord segments. MRI revealed paravertebral muscular hyperintensity on T2-weighted images at the level of T7-T8 vertebrae. The cat improved on conservative management but deteriorated 3 months later. Repeated MRI showed meningeal enhancement at the same level and hyperintensity of the paravertebral musculature extending to the right thoracic wall and pleural space on short tau inversion recovery images...
July 2017: JFMS Open Reports
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