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Peridural analgesia

Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
November 2017: Wiener Medizinische Wochenschrift
Helmar Bornemann-Cimenti, Nikki Sivro, Frederike Toft, Larissa Halb, Andreas Sandner-Kiesling
BACKGROUND AND OBJECTIVES: Current guidelines for neuraxial analgesia in patients with multiple sclerosis are ambiguous and offer the clinician only a limited basis for decision making. This systematic review examines the number of cases in which multiple sclerosis has been exacerbated after central neuraxial analgesia in order to rationally evaluate the safety of these procedures. METHODS: A systematic literature search with the keywords "anesthesia or analgesia" and "epidural, peridural, caudal, spinal, subarachnoid or intrathecal" in combination with "multiple sclerosis" was performed in the databases PubMed and Embase, looking for clinical data on the effect of central neuraxial analgesia on the course of multiple sclerosis...
July 2017: Revista Brasileira de Anestesiologia
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
P Kranke, T Annecke, D H Bremerich, R Hanß, L Kaufner, C Klapp, H Ohnesorge, U Schwemmer, T Standl, S Weber, T Volk
Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology...
January 2016: Der Anaesthesist
Félix Manuel Juárez-Adame, Yolanda Ruiz-Rubio, Ana Bertha Zavalza-Gómez
BACKGROUND: Cerebrospinal fluid cutaneous fistula following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. CLINICAL CASE: Female aged 50 with a stage IIB cervical carcinoma; a peridural catheter was passed at lumbar level; three days after surgery, refers severe headache and to corroborate leakage cerebrospinal fluid through the puncture. The prescription was antibiotics and acetazolamide 250mg every 8hours for five days with favorable evolution...
January 2015: Cirugia y Cirujanos
Nicole Viana Leal, Alex Sandro Rolland Souza, Leila Katz, Carlos Noronha-Neto, Sabina Bastos Maia, Antonio Henriques Franca-Neto, Melania Maria Ramos Amorim
OBJECTIVES: To determine the factors associated with vaginal delivery in hypertensive and normotensive pregnant women submitted to induction of labor with misoprostol. METHODS: We conducted a cohort study, with pregnant women submitted to induction of labor with misoprostol, evaluating normotensive and hypertensive gestation. All pregnancies had a live fetus. The main outcomes analyzed were: age, parity, number of pregnancies, gestational age, index of amniotic fluid, Bishop score, fetus weight estimated by ultrasound, premature rupture of membranes, diabetes, peridural analgesia, presence of meconium in the amniotic liquid, cervical modifications, time of induction, time of labor and time between induction and labor, need of oxytocin, route of misoprostol administration and size of cervix by ultrasound...
January 2015: Pregnancy Hypertension
Hiromi Kako, Ralph J Beltran, Senthil G Krishna, Tarun Bhalla, Joseph D Tobias
The use of local anesthesia combined with general anesthesia to provide effective perioperative analgesia continues to increase in the pediatric population. Although neurological complications resulting from peridural hemorrhage following placement of neuraxial blockade is extremely rare in the absence of co-morbid conditions, the consequences can be devastating. Therefore, caution should be exercised, especially in patients receiving antithrombotic or thrombolytic therapy. We present two patients who received unplanned anticoagulation therapy perioperatively following placement of an epidural catheter for postoperative analgesia...
2015: International Journal of Clinical and Experimental Medicine
J P N Holler, J Ahlbrandt, M Gruß, A Hecker, M A Weigand, W Padberg, R Röhrig
BACKGROUND: The results of recent clinical studies suggest a potential benefit of peridural analgesia (PDA) during general anesthesia on long-term survival in patients after surgery for colorectal cancer. In order to test the hypothesis a meta-analysis was performed. OBJECTIVES: To determine the prognostic impact of perioperative PDA on long-term survival in patients with colorectal cancer who underwent surgical resection. MATERIAL AND METHODS: By searching the relevant literature (up to May 2014) a total of 5 studies were identified from a total of 608 publications and a meta-analysis was carried out...
July 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Marcela Amparo Osuna-Zazueta, Francisco Javier Jaime-Alejo, Iván Pérez-Neri
Pain during labor alters the well-being of the mother and fetus. Peridural analgesia may prevent pain, but some physicians prefer to administrate this until labor has progressed in order to avoid blocking labor so a cesarean surgery would be required. In this case, the mother suffers pain until labor has progressed enough to apply analgesia. Thus, the mother suffers pain while labor has progressed enough. Cesarean surgery increases maternal morbidity, thus it is important to evaluate labor progression when analgesia is applied at an early or advanced stage of labor...
November 2013: Gaceta Médica de México
Julia P N Holler, Janko Ahlbrandt, Ernst Burkhardt, Marco Gruss, Rainer Röhrig, Julia Knapheide, Andreas Hecker, Winfried Padberg, Markus A Weigand
OBJECTIVE: To determine the effect of peridural analgesia on long-term survival in patients who underwent surgical treatment of colorectal carcinoma. BACKGROUND: Clinical and animal studies suggest a potential benefit of peridural analgesia on morbidity and mortality after cancer surgery. The effect of peridural analgesia on long-term outcome after surgery for colorectal cancer remains undefined. METHODS: From 2003 to 2009, there were 749 patients who underwent surgery for colorectal carcinoma under general anesthesia with or without peridural analgesia...
December 2013: Annals of Surgery
Thomas J Luger, Christian Kammerlander, Maureen Benz, Markus F Luger, Ivo Garoscio
PURPOSE: The aim of our study was to investigate the clinical relevance of preoperative acute pain management and cardiovascular stability by ultrasound-guided continuous 3-in-1 nerve block in very elderly patients with hip fracture when compared to epidural anesthesia (PDA). METHODS: To study the analgesic effect, we enrolled 37 very elderly patients with hip fractures, of whom 3 patients with dementia had to be excluded. Thus, 34 patients were randomized to 1 of the 3 groups: group A (ultrasound-guided continuous 3-in-1 block, bupivacaine; n = 10, dropout rate: 0), group B (PDA, bupivacaine; n = 14, dropout rate: 8), and group C (systemic pain therapy, piritramide/paracetamol; n = 10, dropout rate: 0)...
September 2012: Geriatric Orthopaedic Surgery & Rehabilitation
M N D Di Minno, M Milone, A Russolillo, R Lupoli, A Di Minno, P Maietta, C Iacovazzo, G Salvatore, F Milone
BACKGROUND: Peripheral arterial disease (PAD) predicts cardiovascular and cerebrovascular ischemic events. PAD treatment is aimed at reducing clinical symptoms, local tissue loss and at preventing complications. AIMS: To evaluated the effect of peridural analgesia on peripheral perfusion and pain control. METHODS: In 280 diabetic subjects with severe limb ischemia (65.7% males and 34.3% females, mean age 59.3±14.4 years) with a failure of medical treatment and contraindications to endovascular and/or surgical reperfusion, we performed a 30-day long peridural ropivacaine infusion, monitoring blood pressure, VAS and ABI periodically...
February 2013: Experimental and Clinical Endocrinology & Diabetes
Paolo Franci, Elizabeth A Leece, Federico Corletto
OBJECTIVE: To describe a technique for insertion of a thoracic epidural catheter. STUDY DESIGN: Clinical report. ANIMALS: Dogs (n = 3) undergoing thoracic wall resection and thoracotomy. METHODS: A paramedian approach with cephalic angulation was used to place a 24-g epidural catheter in 3 dogs. Dogs 1 and 2 had left caudal thoracic wall resection and dog 3 had left thoracotomy. In dog 1, the epidural catheter was inserted at L2-L3 intervertebral space and the tip of the catheter advanced to the level of T13 vertebral body...
October 2012: Veterinary Surgery: VS
J-L Hanouz, T Simonet, C Marliot, A Mayaud, A Girard, N Rakotnirina, J-L Fellahi, J-L Gérard
OBJECTIVES: The last French survey on alternatives to neuraxial anaesthesia for labour pain was published in 1997. However, intravenous remifentanil has become increasingly used as an option for labour analgesia. We evaluated the use of remifentanil as an alternative to epidural analgesia in level 2 and 3 French maternities in 2009. STUDY DESIGN: This was an internet-based French survey performed in 2009 including all level 2 and 3 maternities. Data recorded were maternity unit characteristic, alternatives to neuraxial analgesia used, and remifentanil administration protocols...
September 2012: Annales Françaises D'anesthèsie et de Rèanimation
A De Jong, L Benayoun, Y Bekrar, S Forget, A Wernet
Prevalence of cerebral cavernous malformations is comprised in between 0.4 to 0.8% of the people. Anesthetic management of pregnant women suffering from this disease is often difficult. We have witnessed two cases of delivery concerning two patients suffering from a cerebral cavernous malformation, one with vaginal delivery under peridural analgesia and the other one with cesarean delivery under rachianesthesia. We recommend the realization of a magnetic resonance imaging the year before delivery. Without medullar cavernous malformations, perimedullar analgesia seems to be the preferred method of choice...
July 2012: Annales Françaises D'anesthèsie et de Rèanimation
Stefan Endres
PURPOSE: To compare mid-term outcomes of a high-flexion prosthesis with a conventional prosthesis. METHODS: Records of 107 consecutive patients who underwent total knee arthroplasty (TKA) for primary osteoarthritis by a single surgeon were reviewed. 21 men and 36 women (mean age, 65 years) used a high-flexion prosthesis (NexGen CR-Flex Mobile, Zimmer), whereas 38 men and 12 women (mean age, 67 years) used a conventional prosthesis (Genesis II, Smith & Nephew) that preserves the posterior cruciate ligament, with mobile-bearing polyethylene inlay...
August 2011: Journal of Orthopaedic Surgery
P Deruelle
Obesity during pregnancy increases the risk of complications for both the mother (gestational hypertension, diabetes mellitus) and the newborn (malformations and macrosomia). Deliveries are also more difficult with more c-section and failure in peridural analgesia. A specific organization supported by the perinatal network should improve the management of these women, especially for morbid obesity.
February 2011: Gynécologie, Obstétrique & Fertilité
No abstract text is available yet for this article.
October 1946: Journal of the Royal Army Medical Corps
Monika Becker
Compared to patient controlled intravenous analgesia (PCIA) peridural analgesia is considered as more effective but more expensive for the treatment of postoperative pain after major abdominal surgery. The aim of the analysis was to assess the incremental cost-effectiveness ratio and to relate the cost to time (per 1 day) and pain reduction (per 1 step on a pain scale). Systematic literature research on Medline and the Cochrane library were conducted. Clinical data were primary extracted from randomized controlled trials...
March 2010: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Mark Hartel, Peter Illing, James B Mercer, Jürgen Lademann, Georg Daeschlein, Gerd Hoffmann
Water-filtered infrared-A (wIRA) as a special form of heat radiation with a high tissue penetration and with a low thermal load to the skin surface acts both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA produces a therapeutically usable field of heat in the tissue and increases tissue temperature, tissue oxygen partial pressure, and tissue perfusion. These three factors are decisive for a sufficient tissue supply with energy and oxygen and consequently as well for wound healing and infection defense...
2007: GMS Krankenhaushygiene Interdisziplinär
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