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Anesthesia spine surgery

Abirami Kumaresan, Robert Gerber, Ariel Mueller, Stephen H Loring, Daniel Talmor
BACKGROUND: The effects of prone positioning on esophageal pressures have not been investigated in mechanically ventilated patients. Our objective was to characterize effects of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby assessing the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. METHODS: We studied 16 patients undergoing spine surgery during general anesthesia and neuromuscular blockade...
March 9, 2018: Anesthesiology
Narender Kaloria, Pooja Bihani, Pradeep Bhatia, Bharat Paliwal, Ankur Sharma
No abstract text is available yet for this article.
February 28, 2018: Journal of Neurosurgical Anesthesiology
Ankur S Narain, Fady Y Hijji, Gabriel Duhancioglu, Brittany E Haws, Benjamin Khechen, Blaine T Manning, Matthew W Colman, Kern Singh
STUDY DESIGN: Prospective questionnaire. OBJECTIVE: To describe patient perceptions of minimally invasive spine (MIS) versus open surgery, and to determine which factors are most heavily considered by the patient when choosing between approaches. SUMMARY OF BACKGROUND DATA: MIS surgery has increased in popularity due to proposed advantages in the perioperative and immediate postoperative periods. However, patient preferences and understanding with regard to the differences between MIS and open surgery have not been elucidated...
February 20, 2018: Clinical Spine Surgery
Yogita Patil, Suyog Bagade, Nilesh Patil, Nalini Jadhav
Background and Aims: Desflurane and sevoflurane are inhalational anesthetics which provide stable intraoperative hemodynamics and rapid emergence from anesthesia. Dexmedetomidine is an α2-agonist with sedative and hypnotic effects. We compared recovery following anesthesia with a combination of a continuous intravenous infusion of dexmedetomidine and desflurane or sevoflurane in cases of spine surgeries because no such data are available from India. Material and Methods: It was a single-blind, prospective, randomized study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Sheng-Hua Tsai, Hsuan-Han Wu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: Endoscopic surgery has been successfully applied in the treatment of degenerative spinal disease, but few studies have assessed its use in treating sacral metastasis. Herein, a successful full endoscopic interlaminar approach for sacral nerve root decompression of a sacral metastatic tumor was presented. CASE DESCRIPTION: An 80-year-old man with history of hepatocellular carcinoma suffered from buttock pain with radiation to the right lower leg for one week...
January 17, 2018: World Neurosurgery
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Vrushali C Ponde, Vinit V Bedekar, Dilip Chavan, Anuya Gursale, Dipal Shah
BACKGROUND: Children that have had a meningomyelocele repair often present for hip and bilateral lower limb surgeries. Due to vertebral, epidural, and nerve root abnormalities, placement of epidural catheter is difficult. AIMS: We aim to describe the potential role of ultrasound in delineating the most appropriate intervertebral space for central neuroaxial blocks in these patients. METHODS: Twelve children with previous meningomyelocele repair, in the age group of 6-12 years posted for hip or bilateral lower limb surgeries were included...
March 2018: Paediatric Anaesthesia
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Regional anesthesia in the form of combined cervical plexus block is gaining popularity as a technique of choice for cervical spine surgeries, especially for urgent ones. An important advantage is that it allows continuous monitoring of patient's neurological status. The success of the block often depends on accurate placement of the local anesthetic. Landmarks for the block are therefore of great importance. In this case, we aimed to present a 74-year-old man with C4-5 odontoid fracture. We planned to perform a unilateral combined cervical plexus block for anterior cervical instrumentation and fusion (ACIF) operation because of his associated high-risk comorbid disorders...
October 2017: Anesthesia, Essays and Researches
Koichi Sairyo, Takashi Chikawa, Akihiro Nagamachi
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided...
December 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
David J Kim, Raheel Bengali, T Anthony Anderson
No abstract text is available yet for this article.
December 2017: Korean Journal of Anesthesiology
Jorge Luiz Amorim Correa, Marcus André Acioly
BACKGROUND: Perioperative visual loss after spinal surgery is a devastating complication for the patient and the surgical team. Two known major causes are ischemic optic neuropathy and central retinal artery occlusion (CRAO). Traditional understanding of CRAO has been consistently related to occurrence of periocular trauma and signs of increased intraorbital pressure in addition to visual loss. However, such orbital signs are not a feature of any common perioperative visual loss syndrome...
February 2018: World Neurosurgery
Brian T Sullivan, Adam Margalit, Vaibhav S Garg, Dolores B Njoku, Paul D Sponseller
BACKGROUND: Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI. METHODS: We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center...
November 16, 2017: Journal of Pediatric Orthopedics
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)
A Piirainen, M Kokki, H M Lidsle, M Lehtonen, V P Ranta, H Kokki
OBJECTIVE: Patient-controlled oral analgesia has gained popularity in postoperative pain management. Anesthesia and surgery delay gastrointestinal tract function and this may therefore decrease bioavailability of drugs taken by mouth. To hasten absorption, an orodispersible ibuprofen tablet has been developed. In this study, we evaluated the pharmacokinetics and feasibility of orodispersible ibuprofen tablets in spine surgery patients. METHODS: The study design was a prospective clinical trial where each patient served as her/his own control...
October 18, 2017: Current Medical Research and Opinion
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Kei Yamada, Michio Hongo, Hirosuke Nishimura, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori
STUDY DESIGN: Retrospective study of registry data. OBJECTIVES: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions...
October 2017: Global Spine Journal
Manuel Wenk, Ulf Liljenqvist, Thomas Kaulingfrecks, Simone Gurlit, Thomas Ermert, Daniel M Pöpping, Michael Möllmann
BACKGROUND: Thoracic epidural anesthesia (TEC) is one of the pillars of preoperative pain care. Particularly for spine surgery which causes significant postoperative pain TEC seems like an appealing option. However, beneficial effects of a TEC are questionable when the catheter is not used intraoperatively, a decision that is usually based on the surgeon's wish to perform immediate neurological examination postoperatively. METHODS: 40 patients undergoing transforaminal lumbar interbody fusion surgery (TLIF) were randomized in two groups...
October 4, 2017: Minerva Anestesiologica
Angelique Sao-Mai Do, Joseph Kapurch, Ravi Kumar, John Port, Jeffrey W Miller, Jamie J Van Gompel
OBJECTIVES: Spinal dural arteriovenous fistulas (DAVFs) have diverse presentations. Magnetic resonance imaging (MRI) reveals spinal cord swelling in only 45% to 74% of cases. We present an unusual case of a 57-year old man with a craniocervical junction DAVF in which the edema appeared in the thoracolumbar region, skipping the cervical spinal cord. METHODS: A case report and literature review from a tertiary referral center are provided. RESULTS: In our patient, symptoms progressed over 3 months from low back and radicular pain to weakness, saddle anesthesia, and urinary retention...
December 2017: World Neurosurgery
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
December 2017: Journal of Neurosurgery. Spine
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