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Spinal and epidural anesthesia

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https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#1
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#2
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#3
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29284849/comparison-of-the-efficacy-and-safety-of-morphine-and-fentanyl-as-adjuvants-to-bupivacaine-in-providing-operative-anesthesia-and-postoperative-analgesia-in-subumblical-surgeries-using-combined-spinal-epidural-technique
#4
Owais Mushtaq Shah, Kharat Mohammad Bhat
Introduction: The combined spinal epidural (CSE) technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure to combine their individual best features, to reduce the total drug dosage and avoid their respective disadvantages. The addition of opioids to local anesthetics (bupivacaine) for CSE anesthesia (CSEA) is increasingly common to enhance the block. Neuraxial fentanyl is more potent and has shorter duration of action than morphine which provides prolonged anesthesia and analgesia, however at the cost of increased incidence of adverse effects like delayed respiratory depression...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29206803/clinical-indicators-of-the-need-for-telemetry-postoperative-monitoring-in-patients-with-suspected-obstructive-sleep-apnea-undergoing-total-knee-arthroplasty
#5
Kethy M Jules-Elysée, Natasha A Desai, Yan Ma, Wei Zhang, Thuyvan H Luu, Stavros G Memtsoudis, Gregory A Liguori
BACKGROUND AND OBJECTIVES: Obstructive sleep apnea is associated with increased complication rates postoperatively. Current literature does not provide adequate guidance on management of these patients. This study used the STOP-Bang questionnaire to diagnose patients with possible obstructive sleep apnea (score ≥3). We hypothesized that a STOP-Bang score of 3 or greater would significantly correlate with the number of oxygen desaturation episodes during the first 48 hours after total knee arthroscopy...
December 4, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#6
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29135475/using-activity-trackers-to-quantify-postpartum-ambulation-a-prospective-observational-study-of-ambulation-after-regional-anesthesia-and-analgesia-interventions
#7
Julia Ma, Rachel Martin, Bokman Chan, Michael Gofeld, Michael P Geary, John G Laffey, Faraj W Abdallah
BACKGROUND: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery...
November 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29109653/combined-spinal-epidural-anesthesia-for-cesarean-section-in-a-parturient-with-congenitally-corrected-transposition-of-the-great-arteries
#8
Mohamed Mohamed Tawfik, Helmi Hafez, Mostafa Abdelkhalek, Nasser Sameh Allakkany
No abstract text is available yet for this article.
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29108403/epidemiology-of-septic-meningitis-associated-with-neuraxial-anesthesia-a-historical-review-and-meta-analysis
#9
Andres Zorrilla-Vaca, Ryan J Healy, Lucia Rivera-Lara, Michael C Grant, Lisa L Maragakis, Kevin Escandón-Vargas, Marek A Mirski
BACKGROUND: Neuraxial anesthesia in the form of spinal and epidural are two of the most frequent forms of regional anesthesia. We aimed to describe and compare the relevant epidemiological, clinical and microbiological characteristics of all reported cases of septic meningitis associated with the use of spinal and epidural anesthetics. METHODS: We performed a systematic review of septic meningitis associated with neuraxial anesthesia. We included all relevant case-reports and observational studies in which authors described septic meningitis in association with spinal, epidural or combined neuraxial anesthesia using local anesthetics...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29107311/the-use-of-remifentanil-as-the-primary-agent-for-analgesia-in-parturients
#10
REVIEW
Bryan Anderson
Pain control in parturients can be particularly challenging for the hospital staff. To achieve optimal outcomes in anesthesia patients, it is important to consider multiple options for pain control, especially when traditional options pose a problem or are not options. In particular, there are parturient clients for whom the use of neuraxial anesthesia (epidural and spinal blockade) is not an option. One option that warrants consideration for patient centered anesthesia practice is the use of remifentanil.
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#11
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29095302/spontaneous-spinal-epidural-hematomas-one-case-report-and-rehabilitation-outcome
#12
Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#13
RANDOMIZED CONTROLLED TRIAL
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
#14
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/29080306/retrospective-analysis-of-obstetric-and-anesthetic-management-of-patients-with-placenta-accreta-spectrum-disorders
#15
Efrain Riveros-Perez, Cristina Wood
OBJECTIVE: To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. METHODS: A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. RESULTS: A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%)...
October 28, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29077615/the-effect-of-adding-subarachnoid-epinephrine-to-hyperbaric-bupivacaine-and-morphine-for-repeat-cesarean-delivery-a-double-blind-prospective-randomized-control-trial
#16
Daniel Katz, Joshua Hamburger, David Gutman, Ryan Wang, Hung-Mo Lin, Michael Marotta, Jeffrey Zahn, Yaakov Beilin
BACKGROUND: Spinal anesthesia has become the most common type of anesthetic for cesarean delivery. The major limitation to spinal anesthesia is that the duration of the anesthetic may not be adequate in the event of a prolonged surgery. Some practitioners add epinephrine to hyperbaric bupivacaine to increase the duration, although its effect has not been fully studied. We therefore aimed to evaluate whether adding epinephrine to the spinal medication prolongs the duration of action of the resultant block in women presenting for repeat cesarean delivery...
October 26, 2017: Anesthesia and Analgesia
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
#17
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/29062459/comparison-of-the-effects-of-spinal-epidural-and-general-anesthesia-on-coagulation-and-fibrinolysis-in-laparoscopic-cholecystectomy-a-randomized-controlled-trial-vsj-competition-2-nd-place
#18
Suleyman Demiryas, Turgut Donmez, Vuslat Muslu Erdem, Duygu Ayfer Erdem, Engin Hatipoglu, Sina Ferahman, Oguzhan Sunamak, Lale Yoldas Zengin, Ahmet Kocakusak
INTRODUCTION: Laparoscopic cholecystectomy (LC) is usually performed under general anesthesia. Recently, laparoscopic cholecystectomy under regional anesthesia has become popular, but this creates a serious risk of thromboembolism because of pneumoperitoneum, anesthesia technique, operative positioning, and patient-specific risk factors. AIM: This randomized controlled trial compares the effects of two different anesthesia techniques in laparoscopic cholecystectomy on coagulation and fibrinolysis...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29060565/gabor-based-automatic-spinal-level-identification-in-ultrasound
#19
Mohammad Ikhsan, Kok Kiong Tan, Ting Ting Oh, John Paul Lew, Ban Leong Sng
This paper presents an automatic lumbar spine level identification system based on image processing of ultrasound images. The goal is to aid anesthetists in identifying the correct spinal level during epidural anesthesia. Spine level identification is initiated by detecting the location of the sacrum using a classifier based on a support vector machine. Image stitching is then conducted to produce a panorama image of the spinal area. During this process, the location of spinal processes are enhanced using a Gabor filter and detected through template matching...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059806/a-hybrid-low-cost-tissue-like-epidural-needle-insertion-simulator
#20
B Esterer, S Gabauer, R Pichler, D Wirthl, M Drack, M Hollensteiner, G Kettlgruber, M Kaltenbrunner, S Bauer, D Furst, R Merwa, J Meier, P Augat, A Schrempf
Epidural and spinal anesthesia are mostly performed "blind" without any medical imaging. Currently, training of these procedures is performed on human specimens, virtual reality systems, manikins and mostly in clinical practice supervised by a professional. In this study a novel hybrid, low-cost patient simulator for the training of needle insertion into the epidural space was designed. The patient phantom provides a realistic force feedback comparable with biological tissue and enables sensing of the needle tip position during insertion...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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