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Anesthesia epidural

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https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#1
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29773486/labor-analgesia-in-czech-republic-and-slovakia-a-2015-national-survey
#2
J Bláha, P Štourač, M Grochová, R Klozová, S Richterová, P Nosková, D Seidlová, V Zenkner, A Novotný, D Schwarz, J Ščamburová, M Kosinová, Ch Kufa, M Kirchnerová, J Macková, L Várošová, R Toboláková, J Cepák, J Firment
BACKGROUND: The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK). METHODS: All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE)...
April 7, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29771608/paced-breathing-and-phrenic-nerve-responses-evoked-by-epidural-stimulation-following-complete-high-cervical-spinal-cord-injury-in-rats
#3
Tatiana Bezdudnaya, Michael A Lane, Vitaliy Marchenko
Spinal cord injury (SCI) at the level of cervical segments often results in life-threatening respiratory complications and requires long-term mechanical ventilator assistance. Thus, restoring diaphragm activity and regaining voluntary control of breathing are the primary clinical goals for patients with respiratory dysfunction following cervical SCI. Epidural stimulation (EDS) is a promising strategy that has been explored extensively for non-respiratory functions, and to a limited extent within the respiratory system...
May 17, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29769140/local-infiltration-anesthesia-versus-epidural-analgesia-for-postoperative-pain-control-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#4
Chen Li, Ji Qu, Su Pan, Yang Qu
BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA). METHODS: In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared LIA versus EPA for postoperative pain control in TKA were retrieved...
May 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#5
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29756696/preliminary-experience-with-epidural-and-perineural-catheter-localization-with-pulsed-wave-doppler-ultrasonography
#6
Hesham Elsharkawy, Theresa Barnes, Rovnat Babazade, Maria Huarte, Wael Ali Sakr Esa, Brian M Ilfeld
BACKGROUND: Various methods for peripheral nerve and epidural catheter location assessment exist, with varying degrees of ease of use, utility, and accuracy. Pulsed wave Doppler (PWD) evaluates the presence of fluid flow and is possible modality to assess the location of a percutaneously inserted perineural catheter. METHODS: A retrospective chart review was conducted in which PWD ultrasonography was used to confirm the position of nerve catheters for regional anesthesia...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29752149/tourniquet-pressure-settings-based-on-limb-occlusion-pressure-determination-or-arterial-occlusion-pressure-estimation-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#7
Bahattin Tuncali, Hakan Boya, Zeynep Kayhan, Sukru Arac
OBJECTIVE: The aim of this study was to compare the limb occlusion pressure (LOP) determination and arterial occlusion pressure (AOP) estimation methods for tourniquet pressure setting in adult patients undergoing knee arthroplasty under combined spinal-epidural anesthesia. METHODS: Ninety-three patients were randomized into two groups. Pneumatic tourniquet inflation pressures were adjusted based either on LOP determination or AOP estimation in Group 1 (46 patients, 38 female and 8 male; mean age: 67...
May 8, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29751229/endoscopy-mediated-intratubal-insemination-in-the-cow-development-of-a-novel-minimally-invasive-ai-technique
#8
Karina Radefeld, Sophie Papp, Vitezslav Havlicek, Jane M Morrell, Gottfried Brem, Urban Besenfelder
Conventionally inseminated spermatozoa suffer a dramatic reduction in numbers during their long journey until fertilization. In addition sperm survival seems to be strongly affected by the reconstitution of the female reproductive tract in the post partum period. The purpose of this study was to develop a novel AI technique for cattle that allows the deposition of spermatozoa directly into the ampulla in the immediate vicinity of the fertilization site. This new reproductive biotechnique was investigated with focus on semen origin, sperm dosage, semen preparation and time of insemination...
April 27, 2018: Theriogenology
https://www.readbyqxmd.com/read/29750691/propensity-score-methods-theory-and-practice-for-anesthesia-research
#9
Phillip J Schulte, Edward J Mascha
Observational data are often readily available or less costly to obtain than conducting a randomized controlled trial. With observational data, investigators may statistically evaluate the relationship between a treatment or therapy and outcomes. However, inherent in observational data is the potential for confounding arising from the nonrandom assignment of treatment. In this statistical grand rounds, we describe the use of propensity score methods (ie, using the probability of receiving treatment given covariates) to reduce bias due to measured confounders in anesthesia and perioperative medicine research...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29742667/total-laparoscopic-hysterectomy-under-regional-anesthesia
#10
Nash S Moawad, Estefania Santamaria Flores, Linda Le-Wendling, Martina T Sumner, F Kayser Enneking
BACKGROUND: Laparoscopic hysterectomies comprise a large proportion of all hysterectomies in the United States. Procedures completed under regional anesthesia pose a number of benefits to patients, but laparoscopic hysterectomies traditionally have been performed under general anesthesia. We describe a case of total laparoscopic hysterectomy under epidural anesthesia with the patient fully awake. CASE: A 51-year-old woman with abnormal uterine bleeding underwent an uncomplicated total laparoscopic hysterectomy, bilateral salpingectomy, and excision of endometriosis...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29732150/efficacy-of-prophylactic-epidural-ketamine-for-reducing-shivering-in-patients-undergoing-caesarean-section-with-combined-spinal-epidural-anesthesia
#11
Xing Xue, Ying Lv, Youhong Zhao, Yufang Leng, Yan Zhang
Intravenous ketamine is known to inhibit postoperative shivering; however, at present, there has been little research on whether this effect may be achieved with epidural application. The aim of the present study was to evaluate the efficacy and safety of epidural ketamine as a prophylactic agent to prevent shivering in patients undergoing caesarean section during combined spinal-epidural anesthesia. A prospective, randomized, double-blind study was performed. A total of 60 patients who were undergoing elective caesarean section under combined spinal-epidural anesthesia and had an American Society of Anesthesiologists physical status of I or II were recruited...
May 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29721359/acute-cauda-equina-syndrome-following-orthopedic-procedures-as-a-result-of-epidural-anesthesia
#12
Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields
Background: Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction. Case Description: The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#13
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29703025/association-between-perioperative-hypothermia-and-patient-outcomes-after-thoracic-surgery-a-single-center-retrospective-analysis
#14
Alexander Emmert, Gereon Gries, Saskia Wand, Judith Buentzel, Anselm Bräuer, Michael Quintel, Ivo F Brandes
Hypothermia due to anaesthetic-induced impairment of thermoregulatory control and exposure to a cool environment is common in surgical patients. Peripheral vasodilation due to neuroaxial blockade may aggravate hypothermia. There is few data on perioperative hypothermia in patients undergoing thoracic surgery under combined general and regional anesthesia. We reviewed all thoracic surgical patients between 2006 and 2011 to determine the incidence and extent of hypothermia with or without an epidural anesthesia and evaluated its effect...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29696301/-radical-cystectomy-and-urinary-diversion-what-is-important
#15
REVIEW
J Noldus, G Niegisch, A Pycha, A Karl
BACKGROUND: In Germany, radical cystectomy with urinary diversion is the primary therapeutic option for localized muscle invasive urothelial bladder cancer. Modifications in the pre-, peri-, and postoperative phase have significantly improved outcomes. OBJECTIVES: Different factors and parameters are directly associated with patients' outcome. An overview on how to best approach this procedure is provided in this article. MATERIALS AND METHODS: The data regarding preparation and the procedure for the radical cystectomy followed by urinary diversion are separately analyzed...
April 25, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29696112/epidural-anesthesia-combined-with-light-general-anesthesia-for-a-juvenile-with-charcot-marie-tooth-disease-undergoing-corrective-spine-surgery-a-case-report
#16
Amir Poya Zanjani, Azam Ghorbani, Babak Eslami, Babak Mirzashahi
General anesthesia (GA) is associated with serious concerns in advanced cases of Charcot-Marie-Tooth (CMT). Despite several benefits of applying regional anesthesia (RA), recommendation for RA is controversial in CMT due to insufficient supporting documents and trials. We report combined epidural/general anesthesia for a 12-year-old boy with CMT disease undergoing major spine corrective surgery. This manuscript is presented not only to evaluate the costs and benefits of RA, but also to highlight the safety of neuraxial anesthesia and emphasis on the broad potential role of RA to reduce risks of GA in CMT patients...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29693947/use-of-sugammadex-in-a-patient-with-myotonic-dystrophy-undergoing-laparoscopic-cholecystectomy
#17
Rieko Uno, Shoko Matsuda, Kohei Murao, Kumiko Nakamura, Michiyo Shirakawa, Koh Shingu
A 37-year-old female patient with myotonic dystrophy was scheduled for laparoscopic cholecystectomy for gall stone under general anesthesia with continuous propofol infusion. Rocuronium was administered with careful monitoring using TOF- Watch®, measuring train-of-four count (Tc), TOF ratio (Tr), and posttetanic count The total amount of rocuronium was 70 mg ; 0.6 mg .kg⁻1 for anesthetic induction and 0.3 mg .kg⁻1 when Tc exceeded 1. When the operation was completed, Tc was 4, Tr was uncountable and she showed reaction to calling her name...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29693946/a-case-of-sudden-shock-during-caesarean-section-in-whi-ch-amniotic-fluid-embolism-is-suspected
#18
Hiroo Shimono, Satoko Haraguchi, Yuko Minoda, Mari Beppu, Naomi Shinmura, Yuki Suzuki, Mikiko Higashi, Yuichi Kanmura
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29686989/enhanced-recovery-after-surgery-protocols-in-major-urologic-surgery
#19
REVIEW
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29681955/ropivacaine-has-no-advantage-over-bupivacaine-in-thoracic-epidural-analgesia-for-patients-with-pectus-excavatum-undergoing-the-nuss-procedure-a-single-blind-randomized-clinical-trial-comparing-efficacy-and-safety
#20
Małgorzata Walaszczyk, Rafał Wiench, Maja Copik, Jacek Karpe, Małgorzata Łowicka, Anna Pióro, Piotr Knapik, Hanna Misiołek
Introduction: Pectus excavatum repair (Nuss procedure) is a painful procedure requiring effective postoperative analgesia. Aim: To establish whether thoracic epidural analgesia with ropivacaine is non-inferior to epidural analgesia with bupivacaine following the Nuss procedure in children. Material and methods: The prospective, randomized, controlled, single blind study included 81 children. Computer-generated random numbers were used to allocate treatment...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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