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Lumbar plexus catheter

Sylvia H Wilson, Bethany J Wolf, Abdalrahman A Algendy, Clark Sealy, Harry A Demos, Julie R McSwain
BACKGROUND: Total hip arthroplasty (THA) is associated with significant postoperative pain. Both lumbar epidurals and lumbar plexus nerve blocks have been described for postoperative pain control, but it is unclear if one technique is more beneficial. METHODS: Using electronic medical records, a randomly selected, cohort of 58 patients with lumbar epidurals were compared with 58 patients with lumbar plexus nerve blocks following primary THA. The primary end point was 48-hour postoperative opiate consumption...
August 10, 2016: Journal of Arthroplasty
Andrea Tognù, Veronica Cauli, Nicola de Simone, Lucia Aurini, Marco Manfrini, Stefano Bonarelli
This case report details the feasibility of a continuous lumbar plexus block obtained with a paramedian transverse scan of the lumbar paravertebral region, using a catheter-over-needle system, as a main postoperative orthopedic analgesia, in a 14-month-old patient undergoing surgical treatment of a localized Ewing family tumor of the right proximal femur. After surgery, the patient remained in the intensive care unit for 3 days; pain was assessed regularly using the Children's and Infants' Postoperative Pain Scale, and comfort was monitored...
July 2016: Regional Anesthesia and Pain Medicine
Monika Lachowska, Krzysztof Lachowski, Barbara Królak-Olejnik
INTRODUCTION: Percutaneously inserted central venous catheters (epicutaneo-cava-catheter - ECC) are widely used in neonatal intensive care, facilitating the parenteral nutrition and the treatment of critically ill newborns. This invasive procedure is regarded as safe and associated with low complication rate. Possible life-threatening complications may result from malpositioning of ECC. Paraspinal misplacement of ECC is one of the most serious complications. CASE PRESENTATION: The authors report a case of misplacement of ECC inserted via left saphenous vein for intravenous feeding...
July 12, 2016: Journal of Vascular Access
Mariano Paiva Souza, Edno Magalhães, Elialba de Farias Cascudo, Marco Antonio Dias Jogaib, Marcelo Carneiro da Silva
BACKGROUND AND OBJECTIVES: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. CASE REPORT: A female patient in her sixties, physical status II (ASA), underwent conventional cholecystectomy under balanced general anesthesia and an epidural with catheter for postoperative analgesia...
March 2016: Brazilian Journal of Anesthesiology
Paolo Monticelli, Maja Drożdżyńska, Thaleia Stathopoulou, David Neilson, Tommaso Gregori, Jaime Viscasillas
OBJECTIVE: To describe an ultrasound-guided approach for lumbar plexus catheter placement in dogs. STUDY DESIGN: Prospective experimental cadaveric study. ANIMALS: Eleven thawed canine cadavers (13 ± 2 kg). MATERIAL AND METHODS: A technique to place a catheter in the psoas compartment at the level of the lumbar plexus under ultrasound guidance was described. Ultrasonographic landmarks for the placement of a lumbar plexus catheter were identified as the body of the sixth lumbar vertebrae, the psoas muscle and the femoral nerve...
July 2016: Veterinary Anaesthesia and Analgesia
Alexander Amir, Vynka Lash, Albert Moore, Pramod Rao, Carlos Torres, Ian Kaufman
Intravascular, subdural, intrathecal, and subcutaneous placement of epidural catheters are known complications and common causes of anesthesia and analgesia failure. Because the epidural space is located near the retroperitoneum and catheters are placed blindly, it is possible that misplacement could involve other structures, including the inferior vena cava, the aorta, and the lumbar plexus. We report a case of an obese laterally positioned parturient who presented with an epidural catheter lodged in the retroperitoneum...
November 2015: Regional Anesthesia and Pain Medicine
Huanwei Jiang, Benchao Shi, Shiyuan Xu
BACKGROUND: We herein provide an analysis of lumbar epidural catheterization, which outlines a detailed anatomical description of the epidural anatomy, and may improve the success rate of neuraxial cannulation. METHODS: Lumbar epidural catheters were placed in 50 adult embalmed cadavers. After catheterization, the lumbar dura and connecting structures between the epidural space and the vertebral body were separated. The positional relationship between the catheter and the posterior epidural space were observed and photographed...
2015: BMC Anesthesiology
G Cappelleri, D Ghisi, E Ceravola, L Guzzetti, A L Ambrosoli, M Gemma, G Cornaggia
The aim of this randomised, prospective, blinded study was to evaluate if stimulating catheters can decrease the minimum effective anaesthetic volume in 50% of patients during lumbar plexus block using mepivacaine 1.5% compared with standard catheters. Fifty-eight patients of ASA physical status 1-3 were randomly allocated to receive a lumbar plexus block via a stimulating or standard catheter, with 29 in each group. The first dose was 30 ml and subsequent doses were determined using the up-and-down staircase method...
August 2015: Anaesthesia
K Bouattour, G Moyano-Tidou, A Le Gouez, S Martel-Jacob, F-J Mercier
Anaesthetists often stand in the front line to manage postpartum neurological deficits, although epidural analgesia is rarely responsible for these complications. An epidural analgesia was performed to relieve pain during spontaneous labor in a 34-year-old parturient. An emergency C-section was subsequently required due to fetal heart rate abnormalities. Twelve hours after catheter removal, the parturient developed a severe right leg motor and sensory neurological deficit, predominant on L5 and S1 roots and diagnosed by a neurologist as a central nerve root injury...
December 2014: Annales Françaises D'anesthèsie et de Rèanimation
Mihaela Visoiu, Lendi N Joy, Jan S Grudziak, Jacques E Chelly
BACKGROUND: Ambulatory continuous peripheral nerve blocks (CPNBs) are feasible for pediatric patients. We sought to evaluate the efficacy of CPNBs in a pediatric population. METHODS: This retrospective report of 33-month prospectively collected data investigates patient, parent, and nurse pain control satisfaction score (PCSS), the incidence and severity of pain, daily analgesic consumption following discharge home with various CPNBs and On-Q pumps, and any complications and side effects related to CPNBs...
November 2014: Paediatric Anaesthesia
Luiz Eduardo Imbelloni, Douglas M P Teixeira, Thatiany Monteiro Coelho, Danielly Gomes, Rafaela Lopes Braga, Geraldo Borges de Morais Filho, Alberto da Silva
OBJECTIVE: To evaluate the initial results after the implementation of perioperative protocol in patients over 60 years of age undergoing surgical treatment for femur fractures. METHODS: We conducted a prospective study of patients older than 60 years who were hospitalized with femur fracture. They were operated under spinal anesthesia and analgesia by lumbar plexus blockade. Data evaluation was performed before arrival in the operating room during surgery, in the post-anesthesia recovery room and in the ward the next morning of the operation...
May 2014: Revista do Colégio Brasileiro de Cirurgiões
Sylvia H Wilson, Anne-Sophie M Auroux, Jean D Eloy, Rita B Merman, Jacques E Chelly
OBJECTIVE: Continuous lumbar plexus blocks provide excellent analgesia for total hip arthroplasty (THA), but their utility has been questioned as they may increase motor weakness. The aim of this study was to compare the efficacy of two different concentrations of ropivacaine on both postoperative analgesia and motor function. METHODS: Thirty patients were examined in this prospective, single center, double-blinded, parallel group, comparative, randomized controlled trial in patients undergoing primary THA...
March 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Xuezheng Zhang, Ying Zhou, Limei Chen, Quanguang Wang, Jianwu Ni, Le Liu, Chenggang Hu, Xuzhong Xu
OBJECTIVE: To compare the clinical effects of anesthesia and postoperative analgesia for patients with unilateral lower-extremity fracture between multiple injections through catheters beside the lumbar plexus or sciatic nerve and continuous epidural analgesia. METHODS: Seventy patients with unilateral lower-extremity fracture scheduled for internal fixation were randomly divided into group N (n = 35) and group E (n = 35). Patients in group N received combined lumbar plexus and sciatic nerve block, then a catheter was inserted into the psoas compartment or beside the sciatic nerve, according to the surgical site, and 25 mL 0...
2013: Therapeutics and Clinical Risk Management
Garet C Comer, Micah W Smith, Eric L Hurwitz, Kyle A Mitsunaga, Robert Kessler, Eugene J Carragee
BACKGROUND CONTEXT: Retrograde ejaculation (RE) is a complication of anterior lumbar interbody fusion (ALIF) techniques. Most commonly, this results from mechanical or inflammatory injury to the superior hypogastric plexus near the aortic bifurcation. Bone morphogenetic protein-2 (BMP-2) has been used in spinal fusions and has been associated with inflammatory and neuroinflammatory adverse reactions, which may contribute to RE development after anterior lumbar surgery. PURPOSE: While controlling for anterior approach technique, we compared the incidence of RE with and without rhBMP-2 exposure, in large, matched cohorts of patients after ALIF...
October 2012: Spine Journal: Official Journal of the North American Spine Society
Morgan Roth Goldberg, Dorothy Gilbertson-Dahdal
Properly placed central venous catheters have been effective in establishing prolonged access for total parenteral nutrition infusion in ill neonates. However, malposition of the catheter may lead to lethal complications. Malposition and infusion into the epidural venous plexus is most commonly diagnosed on the basis of radiographs and has been confirmed by lumbar puncture. Several studies describe catheter malposition and associated complications. None, however, demonstrate head ultrasound features. We present sonographic findings in a patient who received hyperalimentation for 15 days through a malpositioned lower extremity peripherally inserted central venous catheter...
2009: Journal of Radiology Case Reports
Ji Seok Baik, Eun Joo Choi, Pyung Bok Lee, Francis Sahngun Nahm
The superior hypogastric plexus block (SHPB) is used for treating pelvic pain, especially in patients with gynecological malignancies. Various approaches to this procedure have been reported due to the anatomic obstacles of a high iliac crest or large transverse process of the 5(th) lumbar vertebra. Here, we report a new technique of superior hypogastric plexus block using a unilateral single-needle approach to block the bilateral superior hypogastric plexus with a Tuohy needle and epidural catheter. We have confidence that this new technique can be another option in performing the SHPB when the conventional bilateral approach is difficult to perform...
January 2012: Korean Journal of Pain
G Danelli, D Ghisi, F Bellinghieri, B Borghi, G Fanelli, J Chelly
BACKGROUND: This prospective, randomized, observer-blinded, pilot study compares the effects of the nerve stimulation guidance technique (NS) with the loss of resistance technique (LOR) on readiness for surgery during the posterior approach to lumbar plexus block. METHODS: Thirty ASA status I-III patients who were 18-85 years old and who were undergoing hip fracture repair were enrolled. After parasacral sciatic nerve block, patients were randomly allocated to receive a continuous posterior lumbar plexus block using nerve stimulation (n=15) or a continuous psoas compartment block using the loss of resistance technique (n=15) with 20 ml of 1...
October 2011: Minerva Anestesiologica
Gianluca Cappelleri, Daniela Ghisi, Andrea Fanelli, Andrea Albertin, Francesco Somalvico, Giorgio Aldegheri
INTRODUCTION: The aim of this prospective, randomized, double-blind study was to evaluate whether continuous sciatic nerve block can improve postoperative pain relief and early rehabilitation compared with single-injection sciatic nerve block in patients undergoing total knee arthroplasty (TKA) and lumbar plexus block. METHODS: After ethical committee approval and written informed consent, 38 patients with ASA physical status I to II were enrolled. The first group received continuous sciatic and continuous lumbar plexus blocks (group regional or R, n = 19), whereas the second group received a single sciatic nerve block followed by saline infusion through the sciatic catheter and continuous lumbar plexus block (group control or C, n = 19)...
September 2011: Regional Anesthesia and Pain Medicine
Luiz Eduardo Imbelloni, Eneida Maria Vieira, Fábio Stuchhi Devito, Eliana Marisa Ganem
BACKGROUND AND OBJECTIVES: The number of bilateral total hip arthroplasties (THA) has been increasing every year. Postoperative analgesia by continuous perineural infusion of local anesthetic has been shown favorable results when compared to systemic analgesia. The use of elastomeric pumps has increased patient satisfaction when compared to electronic models. The objective of this report was to describe a case of continuous bilateral posterior lumbar plexus block with an elastomeric infusion pump in a patient submitted to bilateral hip arthroplasty...
March 2011: Revista Brasileira de Anestesiologia
Brian M Ilfeld, Edward R Mariano, Sarah J Madison, Vanessa J Loland, NavParkash S Sandhu, Preetham J Suresh, Michael L Bishop, T Edward Kim, Michael C Donohue, Anna A Kulidjian, Scott T Ball
BACKGROUND: Hip arthroplasty frequently requires potent postoperative analgesia, often provided with an epidural or posterior lumbar plexus local anesthetic infusion. However, American Society of Regional Anesthesia guidelines now recommend against epidural and continuous posterior lumbar plexus blocks during administration of various perioperative anticoagulants often administered after hip arthroplasty. A continuous femoral nerve block is a possible analgesic alternative, but whether it provides comparable analgesia to a continuous posterior lumbar plexus block after hip arthroplasty remains unclear...
October 2011: Anesthesia and Analgesia
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