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epidural anesthesia

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https://www.readbyqxmd.com/read/28341956/improvement-on-the-neo-umbilicoplasty-technique-and-review-of-the-literature
#1
Valderi Vieira da Silva Júnior, Francis Régis Soares de Sousa
INTRODUCTION: The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341129/optimal-hand-washing-technique-to-minimize-bacterial-contamination-before-neuraxial-anesthesia-a-randomized-control-trial
#2
N Siddiqui, Z Friedman, A McGeer, A Yousefzadeh, J C Carvalho, S Davies
INTRODUCTION: Infectious complications related to neuraxial anesthesia may result in adverse outcomes. There are no best practice guidelines regarding hand-sanitizing measures specifically for these procedures. The objective of this study was to compare the growth of microbial organisms on the operator's forearm between five common techniques of hand washing for labor epidurals. METHODS: In this single blind randomized controlled trial, all anesthesiologists performing labor epidurals in a tertiary care hospital were randomized into five study groups: hand washing with alcohol gel only up to elbows (Group A); hand washing with soap up to elbows, sterile towel to dry, followed by alcohol gel (Group B); hand washing with soap up to elbows, non-sterile towel to dry, followed by alcohol gel (Group C); hand washing with soap up to elbows, non-sterile towel to dry (Group D) or hand washing with soap up to elbows, sterile towel to dry (Group E)...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#3
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337460/caudal-epidural-block-an-updated-review-of-anatomy-and-techniques
#4
REVIEW
Sheng-Chin Kao, Chia-Shiang Lin
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#5
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#6
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#7
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320344/risk-factors-associated-with-adverse-perinatal-outcome-in-planned-vaginal-breech-labors-at-term-a-retrospective-population-based-case-control-study
#8
Georg Macharey, Mika Gissler, Veli-Matti Ulander, Leena Rahkonen, Mervi Väisänen-Tommiska, Mika Nuutila, Seppo Heinonen
BACKGROUND: Vaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position. METHODS: We conducted a retrospective, nationwide, Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#9
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28315629/oxidative-stress-in-newborns-by-different-modes-of-delivery
#10
Milos Veleminsky, Antonin Ambroz, Pavel Rossner, Andrea Rossnerova, Vlasta Svecova, Alena Milcova, Miroslav Dostal, Anna Pastorkova, Jana Pulkrabova, Jana Hajslova, Ivo Solansky, Milan Hanzl, Radim J Sram
OBJECTIVES: The aim of our study is to investigate the impact of the type of delivery - vaginal vs. cesarean section on oxidative damage determined as the lipid peroxidation (15-F2t-isoprostane (15-F2t-IsoP) in the cord blood of newborns and venous blood from mothers in two localities with different levels of air pollution: Ceske Budejovice (CB), a locality with a clean air, and Karvina, a locality with high air pollution. RESUTLS: In Karvina, the concentration of PM2...
November 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28303086/anesthesia-provision-in-disasters-and-armed-conflicts
#11
REVIEW
Miguel Trelles Centurion, Rafael Van Den Bergh, Henry Gray
PURPOSE OF REVIEW: Disasters and armed conflicts are characterized by high numbers of trauma cases, and occur mainly in developing countries where the healthcare response is already impaired, resulting in an inadequate response. Aside of the trauma cases, other surgical health conditions are also still present and require urgent care. Surgical care needs are different from context to context and depend on local means and capabilities. RECENT FINDINGS: Doctors without Borders (MSF) has proven that even in precarious situations, safe administration of anesthesia is possible, and the "do no harm" principle can and must be upheld...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/28298800/a-case-of-subclavian-artery-aneurysm-with-history-of-ischemic-heart-disease-operated-under-cervical-epidural-anesthesia
#12
Amrita Rath, J Abhinay, Sandeep Loha, Atul Kumar Singh
Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298766/comparison-of-perioperative-thoracic-epidural-fentanyl-with-bupivacaine-and-intravenous-fentanyl-for-analgesia-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#13
Amitabh Chanchal Sen, Sunil Rajan, Rakhi Balachandran, Lakshmi Kumar, Suresh Gangadharan Nair
CONTEXT: Two-thirds of patients undergoing coronary artery bypass grafting (CABG) surgery report moderate to severe pain, particularly with ambulatory or respiratory effort. AIMS: The aim of this study is to compare the analgesic effect of perioperative thoracic epidural fentanyl with bupivacaine and intravenous fentanyl in patients undergoing CABG surgery. SETTINGS AND DESIGN: The study was a prospective, randomized, nonblinded comparative study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298756/comparison-of-postoperative-pain-after-epidural-anesthesia-using-0-5-0-75-ropivacaine-and-0-5-bupivacaine-in-patients-undergoing-lower-limb-surgery-a-double-blind-study
#14
Tripat Kaur Bindra, Rajvinder Singh, Ruchi Gupta
BACKGROUND: Ropivacaine (S (-)-1-propyl-2", 6"; pipecoloxylidide hydrochloride) a newer long-acting amide local anesthetic has various clinical and pharmacokinetic advantages over bupivacaine. AIMS: The aim of this study is to compare the onset as well as the duration of sensory block, hemodynamic variables, and postoperative analgesia with 0.5%, 0.75% ropivacaine and 0.5% bupivacaine after epidural anesthesia for lower limb orthopedic surgery. PATIENTS AND METHODS: Sixty American Society of Anesthesiologists I and II patients scheduled for lower limb orthopedic surgery were enrolled into this randomized, double-blind study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#15
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28272202/effects-of-combined-epidural-and-general-anesthesia-on-intraoperative-hemodynamic-responses-postoperative-cellular-immunity-and-prognosis-in-patients-with-gallbladder-cancer-a-randomized-controlled-trial
#16
Jun Zhu, Xue-Rong Zhang, Hu Yang
BACKGROUND: This study is supposed to investigate the effects of combined epidural and general anesthesia on intraoperative hemodynamic responses, postoperative cellular immunity, and prognosis in patients with gallbladder cancer (GBC). METHODS: One hundred forty-four GBC patients were selected and randomly divided into the general anesthesia (GA) group and the combined epidural-general anesthesia (CEGA) group. Before anesthesia induction (t0), at intubation (t1), at the beginning of surgery (t2), 5 minutes after pneumoperitoneum (t3), at the end of surgery (t4), after recovery of spontaneous breathing (t5), after regaining consciousness (t6), and after extubation (t7), the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the depth of anesthesia (bispectral index [BIS]) were detected...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28269182/development-of-a-real-time-lumbar-ultrasound-image-processing-system-for-epidural-needle-entry-site-localization
#17
Yusong Leng, Shuang Yu, Kok Kiong Tan, Philip Tildsley, Alex Tiong Heng Sia, Ban Leong Sng
A fully-automatic ultrasound image processing system that can determine the needle entry site for epidural anesthesia (EA) in real time is presented in this paper. Neither the knowledge of anesthetists nor additional hardware is required to operate the system, which firstly directs the anesthetists to reach the desired insertion region in the longitudinal view, i.e., lumbar level L3-L4, and then locates the ideal puncture site by instructing the anesthetists to rotate and slightly adjust the position of ultrasound probe...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268745/development-of-artificial-tissue-like-structures-for-a-hybrid-epidural-anesthesia-simulator
#18
Benjamin Esterer, Johannes Razenbock, Marianne Hollensteiner, David Fuerst, Andreas Schrempf
Puncturing the epidural space and lumbar puncture are common procedures in anesthesia. They are carried out blind, where a needle is advanced from posterior between two adjacent vertebrae. Two different approaches are common practice for this technique, the midline and the paramedian one. The learning curve characteristics of both approaches significantly depends on the number of punctures carried out by a medical novice. For the training of these blind procedures a hybrid simulator requires artificial structures imitating the tissues which are penetrated by the needle...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#19
Jelliffe Jeganathan, Yanick Baribeau, Jeffrey Bortman, Feroze Mahmood, Marc Shnider, Muneeb Ahmed, Azad Mashari, Rabia Amir, Yannis Amador, Robina Matyal
BACKGROUND AND OBJECTIVES: Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model. METHODS: We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#20
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
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