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Spinal and epidural anesthesia

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https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#1
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28815271/the-prolidase-activity-oxidative-stress-and-nitric-oxide-levels-of-bladder-tissues-with-or-without-tumor-in-patients-with-bladder-cancer
#2
İlhan Gecit, Recep Eryılmaz, Servet Kavak, İsmail Meral, Halit Demir, Necip Pirinççi, Mustafa Güneş, Kerem Taken
This study was designed to evaluate the malondialdehyde (MDA), glutathione (GSH) and nitric oxide (NO) levels, and also prolidase, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) enzyme activities in malignant and benign cancers of bladder tissue. A total of 59 patients admitted to our clinic due to microscopic or macroscopic haematuria, were prospectively included in the study. Because of some reasons (no request to participate in the study, the inability to reach, other malignancies, alcohol consumption, metabolic disease), eight patients were excluded from study...
August 16, 2017: Journal of Membrane Biology
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#3
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#4
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28767640/efficacy-and-safety-of-3-different-anesthesia-techniques-used-in-total-hip-arthroplasty
#5
Chengwei Liang, Jionglin Wei, Xiaoxi Cai, Weilong Lin, Yongqian Fan, Fengjian Yang
BACKGROUND This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). MATERIAL AND METHODS We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients...
August 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#6
REVIEW
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...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#7
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28716031/a-rare-case-of-intradural-and-extramedullary-epidermoid-cyst-after-repetitive-epidural-anesthesia-case-report-and-review-of-the-literature
#8
Haruki Funao, Norihiro Isogai, Kenshi Daimon, Yuichiro Mima, Hitoshi Sugiura, Takahiro Koyanagi, Masaya Nakamura, Morio Matsumoto, Ken Ishii
BACKGROUND: Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28687146/intravenous-dexmedetomidine-for-cesarean-delivery-and-its-concentration-in-colostrum
#9
M Yoshimura, T Kunisawa, M Suno, A Sugawara, A Kurosawa, R Nakanishi, K Aoki, T Toriumi
BACKGROUND: Dexmedetomidine is a sedative agent with high α2-adrenoreceptor selectivity. We investigated intravenous Dexmedetomidine administration during scheduled cesarean delivery under neuraxial anesthesia; and concentration in the colostrum. METHODS: Twenty-seven participants having elective cesarean delivery under combined spinal-epidural anesthesia were enrolled. After delivery and cord clamping, 6μg/kg/h of intravenous dexmedetomidine was administered for 10minutes, followed by a dose of 0...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#10
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28684142/neuraxial-anesthesia-in-a-patient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-in-pregnancy-management-for-cesarean-delivery-and-oophorectomy
#11
L Demma, S Norris, J Dolak
We describe the neuraxial anesthetic management of a 28-year-old primigravid patient with severe, treatment-refractory anti-N-methyl-D-aspartate receptor encephalitis undergoing cesarean delivery. The presence of an ovarian teratoma was suspected although not confirmed by imaging. The severity of symptoms, ineffective immunotherapy and the need for chemotherapy necessitated cesarean delivery and resection of a suspected teratoma at 28weeks estimated gestational age. A combined spinal-epidural technique was used...
May 11, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28678882/insertion-of-an-intrathecal-catheter-in-parturients-reduces-the-risk-of-post-dural-puncture-headache-a-retrospective-study-and-meta-analysis
#12
Jiali Deng, Lizhong Wang, Yinfa Zhang, Xiangyang Chang, Xingjie Ma
This study aimed to determine whether insertion of an intrathecal catheter following accidental dural puncture (ADP) in obstetric patients can reduce the incidence of post-dural puncture headache (PDPH) and the requirement of a therapeutic epidural blood patch (TEBP). This was also compared with relocating the epidural catheter at a different vertebral interspace. A retrospective study was performed, as well as a meta-analysis of the literature to further validate our findings. We reviewed the records of 86 obstetric patients who suffered from ADP during epidural anesthesia or combined spinal-epidural anesthesia from October 2015 to November 2016 at our institution...
2017: PloS One
https://www.readbyqxmd.com/read/28663650/comparison-of-epidural-clonidine-and-dexmedetomidine-for-perioperative-analgesia-in-combined-spinal-epidural-anesthesia-with-intrathecal-levobupivacaine-a-randomized-controlled-double-blind-study
#13
Safiya I Shaikh, Laksmi R Revur, Marutheesh Mallappa
BACKGROUND: Epidural administrations of α2 agonists are being used as adjuvants as they lead to anxiolysis, sedation, analgesia, and hypnosis. AIM: This study aims to evaluate the analgesic effects of epidural α2 agonists-dexmedetomidine and clonidine in conjunction with intrathecal levobupivacaine in combined spinal epidural anesthesia (CSEA). METHODS: A prospective, randomized controlled study was done to assess and compare the efficacy and clinical profile of two α2 adrenergic agonists, clonidine, and dexmedetomidine administered epidurally in combination with intrathecal levobupivacaine in CSEA...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663641/the-postdural-puncture-headache-and-back-pain-the-comparison-of-26-gauge-atraucan-and-26-gauge-quincke-spinal-needles-in-obstetric-patients
#14
Mehmet Salim Akdemir, Ayhan Kaydu, Yonca Yanlı, Mehtap Özdemir, Erhan Gökçek, Haktan Karaman
BACKGROUND: The postdural puncture headache (PDPH) and postdural puncture backache (PDPB) are well-known complications of spinal anesthesia. There are some attempts to reduce the frequency of complication such as different design of the spinal needles. AIMS: The primary outcome of this study is to compare the incidence of PDPH between 26-gauge Atraucan and 26-gauge Quincke spinal needles in elective cesarean operations. The severity of symptoms, the incidence of backache, technical issues, and comparison of cost of needles are secondary outcomes...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658142/use-of-neuromuscular-blockers-and-neostigmine-for-general-anesthesia-and-its-association-with-neuraxial-blockade-a-retrospective-study
#15
Filipe Nadir Caparica Santos, Angélica de Fátima de Assunção Braga, Fernando Eduardo Feres Junqueira, Rafaela Menezes Bezerra, Felipe Ferreira de Almeida, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho
This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28652804/success-with-neurotropin-in-treating-pediatric-lower-extremity-pain-induced-by-spinal-cord-injury-after-epidural-anesthesia
#16
Mengye Zhu, Fuqing Zhou, Lingchao Li, Qin Yin, Mizhen Qiu, Yong Zhang
Spinal cord injury (SCI) complicated by epidural anesthesia, though rare, can result in neuropathic pain. However, the treatment for this kind of life-altering injury remains a challenge. A 7-year-old girl was referred with dyskinesia and severe pain in her right lower extremity due to an accidental SCI following lumbar puncture. After treatment with analgesics such as gabapentin, mecobalamin, and dexamethasone/methylprednisolone for 1 week, the myodynamia had improved, but progressive pain persisted. After treatment with neurotropin, a gradual decrease in visual analog scale score from 7 to 0 was observed...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#17
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28640100/level-of-sensory-block-after-spinal-anesthesia-as-a-predictor-of-hypotension-in-parturient
#18
Ning Zhang, Liangliang He, Jia-Xiang Ni
When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthesia-induced hypotension remains unclear.After placement in the left lateral position, combined epidural-spinal anesthesia was performed on 140 parturients undergoing caesarean section using the following procedure: no volume preloading, injection site of L3-4 or L4-5, injection rate of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28633155/regional-anesthesia-and-pain-medicine-us-anesthesiology-resident-training-the-year-2015
#19
Joseph M Neal, Anne Gravel Sullivan, Richard W Rosenquist, Dan J Kopacz
BACKGROUND AND OBJECTIVES: The Anesthesiology Review Committee of the Accreditation Council for Graduate Medical Education sets core requirements for residency program accreditation. We periodically report and analyze the US anesthesiology residents' training experience in regional anesthesia and pain medicine. METHODS: Resident caseload, procedure, and pain medicine evaluation data were aggregated for the resident cohort who graduated in 2015. These data were analyzed for present-day experience and compared with previous reports from years 1980, 1990, and 2000 graduates...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#20
REVIEW
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
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