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https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#1
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#2
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#3
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28532673/-neuraxial-anesthesia-in-patients-with-multiple-sclerosis-a-systematic-review
#4
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...
May 19, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#5
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28527780/-youtube-as-a-source-of-spinal-anesthesia-epidural-anesthesia-and-combined-spinal-and-epidural-anesthesia
#6
Serkan Tulgar, Onur Selvi, Talat Ercan Serifsoy, Ozgur Senturk, Zeliha Ozer
INTRODUCTION: Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information. MATERIAL AND METHOD: A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#7
Pelin Şen, Havva Gül Gültekin, İsmail Caymaz, Ömer Özel, Ayda Türköz
A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#8
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28520566/essential-thrombocytosis-and-labor-epidural-placement-while-on-aspirin-assessing-hemorrhagic-risks-a-case-report
#9
Paul Martin Kempen
Essential thrombocytosis (ET) is a rare disease with known thrombotic and bleeding complications. We encountered a patient with a diagnosis of longstanding Janus kinase-2 gene-negative ET on aspirin therapy presenting for labor epidural. Evaluation of platelet function with pointof-care analysis using Plateletworks in a community hospital setting allowed confirmation of adequate numbers of functional platelets to support safe epidural placement. The relevant issues of ET for anesthesia management with labor epidurals are discussed...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28511794/application-of-end-tidal-carbon-dioxide-monitoring-via-distal-gas-samples-in-ventilated-neonates
#10
Ziying Jin, Maoying Yang, Ru Lin, Wenfang Huang, Jiangmei Wang, Zhiyong Hu, Qiang Shu
BACKGROUND: Previous research has suggested correlations between the end-tidal partial pressure of carbon dioxide (PETCO2) and the partial pressure of arterial carbon dioxide (PaCO2) in mechanically ventilated patients, but both the relationship between PETCO2 and PaCO2 and whether PETCO2 accurately reflects PaCO2 in neonates and infants are still controversial. This study evaluated remote sampling of PETCO2 via an epidural catheter within an endotracheal tube to determine the procedure's clinical safety and efficacy in the perioperative management of neonates...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28508148/thermographic-skin-temperature-measurement-compared-with-cold-sensation-in-predicting-the-efficacy-and-distribution-of-epidural-anesthesia
#11
Arnoud A Bruins, Kay R J Kistemaker, Annemieke Boom, John H G M Klaessens, Rudolf M Verdaasdonk, Christa Boer
Due to the high rates of epidural failure (3-32%), novel techniques are required to objectively assess the successfulness of an epidural block. In this study we therefore investigated whether thermographic temperature measurements have a higher predictive value for a successful epidural block when compared to the cold sensation test as gold standard. Epidural anesthesia was induced in 61 patients undergoing elective abdominal, thoracic or orthopedic surgery. A thermographic picture was recorded at 5, 10 and 15 min following epidural anesthesia induction...
May 15, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#12
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#13
I Gruzman, I Shelef, A Y Weintraub, A Zlotnik, O Erez
Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment...
March 31, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28496360/epidural-anesthesia-for-labor-and-delivery-in-a-patient-with-may-hegglin-anomaly-a-case-report
#14
Annas Muhammad Muzannar, Mohammed Al Harbi, Raza Rathore, Nasser Tawfeeq, Freddie Wambi, Nasir Mahmood, Sonia Albrechtova, Vassilios Dimitriou
We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28492436/continuous-regional-anesthesia-and-inpatient-rehabilitation-for-pediatric-complex-regional-pain-syndrome
#15
Carolina Donado, Kimberly Lobo, María Fe Velarde-Álvarez, Joseph Kim, Anne Kenney, Deirdre Logan, Charles B Berde
BACKGROUND: Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy and cognitive-behavioral therapy. Some patients have persistent pain and/or limb dysfunction despite these treatments. We performed a retrospective study of pediatric patients with CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along with inpatient rehabilitation at Boston Children's Hospital. METHODS: After approval from the institutional review board, electronic medical records were reviewed for patients treated between September 2003 and September 2014...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#16
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489779/epidural-hematoma-after-total-hip-arthroplasty-in-ankylosing-spondylitis-patient-a-case-report-and-review-of-the-literature
#17
Jia Li, Ke Qi, Yongjin Zhang, Chenchen Xue, Weidong Xu
RATIONALE: Ankylosing spondylitis (AS) can affect the hip joint, causing deformity and disability. Total hip arthroplasty can obviously relieve the pain of the hip joint, and reconstruct the function of hip joint. Epidural anesthesia in this patient population has high risk of epidural hematoma, but the reason is unclear. PATIENT CONCERNS: A 44-year-old man diagnosed with AS underwent total hip arthroplasty. DIAGNOSES: Six days after operation, he was diagnosed epidural hematoma...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489765/anesthetic-management-of-cesarean-delivery-in-parturients-with-ruptured-sinus-of-valsalva-aneurysm-care-compliant-2-case-reports-and-literature-review
#18
Gang Fang, Man Li, Jian Li, Li Lin, Wei Mei
RATIONALE: Ruptured sinus of Valsalva aneurysm is rare and dangerous in parturients. Few cases of ruptured SVA in pregnancy are reported, and the anesthetic management for cesarean delivery has scarcely been described. PATIENT CONCERNS: A parturient at 37-week gestation complained of a sore throat and cough that started 3 days before admission, followed 1 day later by fever, dizziness, breathlessness, and palpitation on exertion. Case two at 36-week gestation complained of a 1-day history of bloating in the lower abdomen...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28485386/monitoring-rate-and-predictability-of-intraoperative-monitoring-in-patients-with-intradural-extramedullary-and-epidural-metastatic-spinal-tumors
#19
H Kang, H S Gwak, S H Shin, M K Woo, I H Jeong, H Yoo, J W Kwon, S H Lee
STUDY DESIGN: Single-center retrospective study. OBJECTIVES: To evaluate the monitoring rate, sensitivity and specificity of intraoperative monitoring (IOM) during removal of intradural extramedullary (IDEM) or epidural metastatic spinal tumors. Also, to assess the efficacy of monitoring somatosensory-evoked potentials (SSEP) when motor-evoked potentials (MEP) are not measurable. SETTING: The Neuro-Oncology Clinic, National Cancer Center, Korea...
May 9, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28471968/spinal-anesthesia-increases-the-risk-of-venous-thromboembolism-in-total-arthroplasty-secondary-analysis-of-a-j-psvt-cohort-study-on-anesthesia
#20
Mashio Nakamura, Masataka Kamei, Seiji Bito, Kiyoshi Migita, Shigeki Miyata, Kenji Kumagai, Isao Abe, Yasuaki Nakagawa, Yuichiro Nakayama, Masanobu Saito, Takaaki Tanaka, Satoru Motokawa
Clinical guidance on the choice of anesthetic modality vis-à-vis the risk of perioperative venous thromboembolism (VTE) is largely lacking because of a paucity of recent evidence. A comparative effect of general anesthesia and neuraxial blockade on the perioperative incidence of VTE has not been well-investigated.We compared the effects of different types of anesthetic modalities on the risk of VTE after total hip arthroplasty (THA) and total knee arthroplasty (TKA).This is a secondary analysis of the Japanese Study of Prevention and Actual Situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT)...
May 2017: Medicine (Baltimore)
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