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Neuraxial anesthesia

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https://www.readbyqxmd.com/read/27903338/-ultrasound-imaging-increases-first-attempt-success-rate-of-neuraxial-block-in-elderly-patients
#1
J Geng, X L Chen, X D Wang, X Y Guo, M Li
Objective: To verify whether preprocedural ultrasound of the lumbar spine could improve first-attempt success rate (defined as a successful neuraxial anesthesia with only one skin puncture) of neuraxial block in elderly patients. Methods: From septemble 2015 to February 2016, 200 elderly patients undergoing lower-limb surgery with neuraxial block at the Peking Universty Third Hospital were enrolled in this study.RandA 1.0 software was used to randomize patients into two groups: conventional surface landmark-guided group (group LM) and ultrasound-assisted group (group US)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27884666/anesthetic-considerations-in-a-parturient-with-congenital-insensitivity-to-pain-with-anhidrosis
#2
Z Pirani, F Qasem, S Katsiris
Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery...
October 21, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27884665/airway-management-for-cesarean-delivery-performed-under-general-anesthesia
#3
S Rajagopalan, M Suresh, S L Clark, B Serratos, S Chandrasekhar
BACKGROUND: With the increasing popularity of neuraxial anesthesia, there has been a decline in the use of general anesthesia for cesarean delivery. We sought to examine the incidence, outcome and characteristics associated with a failed airway in patients undergoing cesarean delivery under general anesthesia. METHODS: A retrospective review of airway management in women undergoing cesarean delivery under general anesthesia over an eight-year period from 2006-2013 at an academic medical center was conducted...
October 27, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27871590/does-nitrous-oxide-labor-analgesia-influence-the-pattern-of-neuraxial-analgesia-usage-an-impact-study-at-an-academic-medical-center
#4
Lesley E Bobb, Michaela K Farber, Catherine McGovern, William Camann
STUDY OBJECTIVE: To compare the rate of epidural use before and after the implementation of nitrous oxide (N2O). DESIGN: Data were obtained from a nursing database of N2O usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of N2O. It was available 24 h/d, 7 d/wk, consistent with neuraxial analgesia availability. Epidural utilization before and after introduction of N2O was compared using χ(2) analysis. SETTING: Labor and delivery floor...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867960/is-a-short-anesthetic-exposure-in-children-safe-time-will-tell-a-focused-commentary-of-the-gas-and-panda-trials
#5
COMMENT
Gregory A Chinn, Jennifer M Sasaki Russell, Jeffrey W Sall
Early life exposure to general anesthesia in preclinical studies has consistently led to permanent cognitive deficits later in life. However, the extent to which this finding is translatable to humans is the subject of much debate as the results from clinical studies have been mixed. Recently two well-designed clinical trials have attempted to add clarity to our murky understanding. The General Anesthesia compared to Spinal anesthesia (GAS) trial, was an international, prospective, randomized, multicenter, equivalence trial comparing infants undergoing herniorrhaphy receiving general anesthesia vs...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27843773/effect-of-position-during-spinal-anesthesia-on-postdural-puncture-headache-after-cesarean-section-a-prospective-single-blind-randomized-clinical-trial
#6
Maryam Davoudi, Masoud Tarbiat, Mohammad Reza Ebadian, Puran Hajian
BACKGROUND: The most common method of anesthesia for cesarean section is spinal anesthesia, and postdural puncture headache (PDPH) remains a major complication of this procedure. Nowadays, PDPH is a major cause of morbidity in parturients after spinal anesthesia. This headache is the third most popular reason for claims against anesthesiologists in obstetrics. The position after spinal anesthesia has been evaluated as a contributory factor in the occurrence of PDPH, but the position before spinal anesthesia has not yet been evaluated...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27836523/-why-and-how-to-perform-an-ultrasound-guided-transversus-abdominis-plane-block-a-step-by-step-approach
#7
E Nohuz, B El Drayi, A Triki, K Grossmannova, B Boudier, K Koffi, M Albaut, C Dualé
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#8
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833488/vibration-sensation-as-an-indicator-of-surgical-anesthesia-following-brachial-plexus-block
#9
Seema Jindal, Gurkaran Kaur Sidhu, Dinesh Sood, Anju Grewal
BACKGROUND: Local anesthetic instillation in close vicinity to nerves anywhere in body blocks sensations in the same order as in central neuraxial blockade. The main purpose of this study was to evaluate the efficacy of vibration sense as criteria to determine the onset of surgical anesthesia following brachial plexus block and its correlation with loss of sensory and motor power. MATERIALS AND METHODS: This prospective study included fifty patients of American Society of Anaesthesiologist physical status I and II, aged between 18 and 45 years, undergoing elective upper limb surgery under brachial plexus block by supraclavicular approach...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27828783/transversus-abdominis-plane-block-for-inguinal-hernia-repair-in-a-premature-infant-a-low-risk-high-benefit-technique
#10
Rashmi Ramachandran, Sumit Bansal, Preeti Yadav, Vimi Rewari
In this report, we describe the case of a premature infant (36 weeks' postgestational age) who underwent left inguinal hernia repair under general anesthesia without the use of any airway device. Anesthesia was induced and maintained with sevoflurane in oxygen and nitrous oxide. An ultrasound-guided transversus abdominis plane block was performed that provided effective analgesia, obviating the need for opioids in the intraoperative period. The infant's hemodynamics remained stable throughout the surgery. This report also briefly explains the advantages of using a transversus abdominis plane block, compared with neuraxial blockade, for hernia repair surgery...
November 8, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27827521/ultrasonography-for-neuraxial-blocks-a-review-of-the-evidence
#11
Maria F Elgueta, Silvia Duong, Roderick J Finlayson, De Qh Tran
INTRODUCTION: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) pertaining to the use of adjunctive ultrasonography (US) for neuraxial blocks. EVIDENCE ACQUISITION: The literature search was conducted using the MEDLINE, EMBASE and PUBMED databases. For the MEDLINE and EMBASE searches, the MESH terms "ultrasonography" and key word "ultrasound" were queried; using the operator "and", they were combined with the MESH terms "neuraxial block", "epidural anesthesia", "epidural analgesia", "spinal anesthesia", "spinal analgesia", "intrathecal anesthesia", "intrathecal analgesia", "caudal anesthesia", and "caudal analgesia"...
November 9, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27793238/pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#12
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27746553/prevention-of-hypotension-induced-by-combined-spinal-epidural-anesthesia-using-continuous-infusion-of-vasopressin-a-randomized-trial
#13
Chetna Shamshery, Ashish Kannaujia, Rajashree Madabushi, Dinesh Singh, Divya Srivastava, Shobhana Jafa
BACKGROUND: Central neuraxial blockade (CNB) is an established technique of providing anesthesia for surgeries of the lower limb and abdomen. Hypotension is the most common side effect of CNB. It was hypothesized that by supplementing the initial burst of vasopressin following hypovolemia, hypotension following combined spinal epidural anesthesia (CSEA) could be avoided. MATERIALS AND METHODS: A total of 122 patients undergoing lower limb and abdomen surgeries were included in the study, with 61 patients randomized into two groups - I and II...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746542/a-randomized-controlled-study-between-fentanyl-and-butorphanol-with-low-dose-intrathecal-bupivacaine-to-facilitate-early-postoperative-ambulation-in-urological-procedures
#14
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746531/effect-of-adding-clonidine-to-intrathecal-bupivacaine-on-the-quality-of-subarachnoid-block-a-prospective-randomized-double-blind-study
#15
Srivishnu Vardhan Yallapragada, Nagendra Nath Vemuri, Mastan Saheb Shaik
CONTEXT: The purpose of adding an adjuvant to local anesthetic in a central neuraxial blockade is to augment the desirable pharmacological actions of the agent and/or to minimize its undesirable pharmacological effects. Clonidine is an alfa-2 receptor agonist which has gained popularity in recent times as an adjuvant in spinal anesthesia. AIMS: To evaluate the influence of clonidine on the hemodynamic stability and the duration of anesthesia when added to intrathecal hyperbaric bupivacaine...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27720520/three-dimensional-ultrasound-guided-real-time-midline-epidural-needle-placement-with-epiguide-a-prospective-feasibility-study
#16
Parmida Beigi, Paul Malenfant, Abtin Rasoulian, Robert Rohling, Alison Dube, Vit Gunka
Current 2-D ultrasound technology is unable to perform a midline neuraxial needle insertion under real-time ultrasound guidance using a standard needle and without an assistant. The aim of the work described here was to determine the feasibility of a new technology providing such capability, starting with a study evaluating the selected puncture site. A novel 3-D ultrasound imaging technique was designed using thick-slice rendering in conjunction with a custom needle guide (3DUS + Epiguide). A clinical feasibility study evaluated the ability of 3DUS + Epiguide to identify the epidural needle puncture site for a midline insertion in the lumbar spine...
October 6, 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#17
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27687460/survey-of-external-cephalic-version-for-breech-presentation-and-neuraxial-blockade-use
#18
Carolyn F Weiniger, Pervez Sultan, Ashley Dunn, Brendan Carvalho
STUDY OBJECTIVE: Neuraxial blockade may increase external cephalic version (ECV) success rates. This survey aimed to assess the frequency and characteristics of neuraxial blockade used to facilitate ECV. SETTING AND DESIGN: We surveyed Society for Obstetric Anesthesia and Perinatology members regarding ECV practice using a 15-item survey developed by 3 obstetric anesthesiologists and tested for face validity. The survey was e-mailed in January 2015 and again in February 2015 to the 1056 Society of Obstetric Anesthesiology and Perinatology members...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687419/myoclonus-like-involuntary-movements-following-cesarean-delivery-epidural-anesthesia
#19
Hee Yong Kang, Sang Wook Lee, Eun Pyo Hong, Yeo Hae Sim, Su-Mi Lee, Sung Wook Park, Jong-Man Kang
Spinal myoclonus following neuraxial anesthesia is rare. This report describes a case of myoclonus-like involuntary movement that occurred during the recovery from epidural anesthesia for a cesarean delivery. The patient's symptom improved with the administration of benzodiazepine, and the patient recovered with no neurological sequelae. In conclusion, epidural anesthesia can cause spinal myoclonus, which can be treated with a benzodiazepine.
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687372/transnasal-sphenopalatine-ganglion-block-for-the-treatment-of-postdural-puncture-headache-in-obstetric-patients
#20
Sheffield Kent, Gregory Mehaffey
STUDY OBJECTIVE: To demonstrate a possible alternative treatment for postdural puncture headache (PDPH). DESIGN: Postdural puncture headache is a common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood patch (EBP) is the standard therapy for PDPH but has risks including pain, dural puncture, and infection. Transnasal sphenopalatine ganglion block (SPGB) has been successfully used to treat migraine, cluster headache, and trigeminal neuralgia...
November 2016: Journal of Clinical Anesthesia
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