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Epidural

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https://www.readbyqxmd.com/read/28820803/perioperative-breast-analgesia-a-qualitative-review-of-anatomy-and-regional-techniques
#1
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28820759/thromboprophylaxis-in-spinal-surgery
#2
William P Mosenthal, David C Landy, Haroutioun H Boyajian, Olumuyiwa A Idowu, Lewis L Shi, Edwin Ramos, Michael J Lee
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: Determine the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery patients receiving no thromboprophylaxis, mechanoprophylaxis, and chemoprophylaxis. SUMMARY OF BACKGROUND DATA: The incidence of thromboembolic complications after spinal surgery is not well established. While a variety of effective mechanical and chemical thromboprophylaxis interventions exist, their role in spinal surgery remains unclear...
August 17, 2017: Spine
https://www.readbyqxmd.com/read/28819591/aggressive-vertebral-body-hemangioma-causing-compressive-myelopathy-two-case-reports
#3
Denver Steven Pinto, V Ravi Hoisala, Pavan Gupta, Parthasarathy Sarkar
INTRODUCTION: Hemangiomas are benign tumors characterized by proliferation of blood vessels. A few hemangiomas are aggressive, characterized by bone expansion and extraosseous extension. These benign tumors may be mistaken for metatasis resulting in unnecessary biopsies, which have a high risk of hemorrhage. These hemangiomas can spread not just into the paraspinal soft tissues but also into the epidural region of the spinal canal causing cord compression and paraparesis. These clinical symptoms can be relieved by surgical decompression of the posterior elements, embolization or radiotherapy...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28818570/prevalence-and-risk-factors-of-deep-vein-thrombosis-in-patients-undergoing-lumbar-spine-surgery
#4
Koji Yamasaki, Masahiro Hoshino, Keita Omori, Hidetoshi Igarashi, Takashi Tsuruta, Hiroyuki Miyakata, Yasuhiro Nemoto, Hiromi Matsuzaki, Takanori Iriuchishima
BACKGROUND: Spinal surgery is classified as a moderate risk for DVT. The occurrence of DVT after various spinal surgical procedures was reviewed retrospectively, and the perioperative risk factors in the high-risk group were identified. In addition, the administration of the factor Xa inhibitor to DVT subjects with unstable thrombosis was evaluated to reveal its effectiveness in the prevention of PTE and postoperative complications. METHODS: This study included 588 subjects who underwent lumbar spine surgery...
August 14, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28816943/spinal-cord-compression-syndrome-caused-by-intraspinal-epidural-fibrous-cord-three-case-reports
#5
Yingjie Zhou, Xubin Chai, Huailiang Zheng, Renqian Song, Xiaofei Qin
RATIONALE: The spinal cord compression caused by intraspinal epidural fibrous cord. PATIENT CONCERNS: All patients in this study had spinal cord compression syndrome caused by an intraspinal epidural fibrous cord, manifested as abnormally increased epidural adipose tissue by imaging. DIAGNOSE: These abnormal fibrous connective tissue strips were not identical to the known pathological tissue such as "meningovertebral ligament." Instead, it might be a novel pathogenic cause for the spinal cord compression...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816824/analysis-of-the-relationship-between-the-epidural-spinal-cord-compression-escc-scale-and-paralysis-caused-by-metastatic-spine-tumors
#6
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda
STUDY DESIGN: A retrospective, single-institute, and radiographic study. OBJECTIVE: To evaluate the relationship between the epidural spinal cord compression (ESCC) scale and the severity of metastatic spine tumor-induced paralysis. SUMMARY OF BACKGROUND DATA: The ESCC scale is used to evaluate the grade of spinal cord compression on T2-weighted magnetic resonance imaging (MRI). However, few studies have investigated the relationship between such MRI findings and paralysis...
August 14, 2017: Spine
https://www.readbyqxmd.com/read/28816690/complications-of-the-middle-cranial-fossa-approach-for-acoustic-neuroma-removal
#7
Matthias Scheich, Christian Ginzkey, Desiree Ehrmann Müller, Wafaa Shehata Dieler, Rudolf Hagen
OBJECTIVE: To analyze postoperative complications after microsurgery for acoustic neuroma (AN) via the middle fossa approach (MFA). MATERIALS AND METHODS: In total, 203 consecutive patients of a tertiary skull base referral center at a university hospital were included in this retrospective chart and database analysis. All patients had undergone primary microsurgery at the Otorhinolaryngology department via MFA between December 2005 and October 2014. Postoperative complications were documented during the inpatient stay and outpatient follow-up...
August 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28816240/rodent-mismatch-negativity-mmn-theta-neuro-oscillatory-response-as-a-translational-neurophysiological-biomarker-for-n-methyl-d-aspartate-receptor-based-new-treatment-development-in-schizophrenia
#8
Migyung Lee, Andrea Balla, Henry Sershen, Pejman Sehatpour, Peter Lakatos, Daniel C Javitt
Deficits in the generation of auditory mismatch negativity (MMN) generation are among the most widely replicated neurophysiological abnormalities in schizophrenia and linked to underlying dysfunction of N-methyl-D-aspartate receptor (NMDAR)-mediated neurotransmission. Here, we evaluate physiological properties of rodent MMN, along with sensitivity to NMDAR agonist and antagonist treatment, relative to known patterns of dysfunction in schizophrenia. Epidural neurophysiological responses to frequency- and duration-deviants, along with responses to standard stimuli, were obtained at baseline and following 2 and 4 weeks treatment from rats treated with saline, phencyclidine (PCP, 15 mg/kg/d by osmotic minipump), or PCP+glycine (16% by weight diet) interventions...
August 17, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#9
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28815271/the-prolidase-activity-oxidative-stress-and-nitric-oxide-levels-of-bladder-tissues-with-or-without-tumor-in-patients-with-bladder-cancer
#10
İlhan Gecit, Recep Eryılmaz, Servet Kavak, İsmail Meral, Halit Demir, Necip Pirinççi, Mustafa Güneş, Kerem Taken
This study was designed to evaluate the malondialdehyde (MDA), glutathione (GSH) and nitric oxide (NO) levels, and also prolidase, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) enzyme activities in malignant and benign cancers of bladder tissue. A total of 59 patients admitted to our clinic due to microscopic or macroscopic haematuria, were prospectively included in the study. Because of some reasons (no request to participate in the study, the inability to reach, other malignancies, alcohol consumption, metabolic disease), eight patients were excluded from study...
August 16, 2017: Journal of Membrane Biology
https://www.readbyqxmd.com/read/28814094/the-role-of-pegaptanib-sodium-in-the-suppression-of-epidural-fibrosis-in-a-postlaminectomy-rat-model
#11
I Sertbas, A Yilmaz, T Yildirim, M Karatay, H Celik, M A Bayar
OBJECTIVE: Spinal epidural fibrosis is a clinical condition that develops after laminectomy and can compress the spine. Many agents have been tried for the treatment, but none has entered clinical use at present. Pegaptanib sodium is an antiangiogenetic drug that prevents the development of new vessels and thus adhesion by inhibiting the effect of VEGF. MATERIAL AND METHOD: 20 Wistar rats were used in this study. The rats were divided into 2 different groups as the control and pegaptanib sodium group...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28814093/role-of-ischemic-modified-albumin-in-the-early-diagnosis-of-increased-intracranial-pressure-and-brain-death
#12
I Kara, H K Pampal, F Yildirim, E Dilekoz, G Emmez, F P U, M Kocabiyik, C B Demirel
AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modified albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6)...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28812113/-pathophysiology-of-intracranial-injuries
#13
REVIEW
D Lahner, G Fritsch
Traumatic brain injury (TBI) constitutes a heterogeneous condition that affects the most complex organ of the human body. It is commonly classified by its location as focal injury (e.g. epidural hematoma) and diffuse injury (e.g. diffuse axonal shearing injury) as well as by primary and secondary tissue injury. Accordingly, direct mechanical force causes the primary insult. The tissue damage occurring afterwards is subsumed under the term secondary brain damage. Some of these processes are overlapping and include in the early phase local cerebral ischemia resulting in excitotoxicity, which together with the triggered neuroinflammatory cascade causes the formation of cerebral edema and ultimately increased intracranial pressure once the intracranial compliance is exhausted...
August 15, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28809679/automatic-localization-of-the-needle-target-for-ultrasound-guided-epidural-injections
#14
Mehran Pesteie, Victoria Lessoway, Purang Abolmaesumi, Robert N Rohling
Accurate identification of the needle target is crucial for effective epidural anesthesia. Currently, epidural needle placement is administered by a manual technique, relying on the sense of feel, which has a significant failure rate. Moreover, misleading the needle may lead to inadequate anesthesia, post dural puncture headaches and other potential complications. Ultrasound offers guidance to the physician for identification of the needle target, but accurate interpretation and localization remain challenges...
August 11, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#15
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28808583/successful-spinal-cord-stimulation-for-neuropathic-below-level-spinal-cord-injury-pain-following-complete-paraplegia-a-case-report
#16
Tim A Reck, Gunther Landmann
INTRODUCTION: Neuropathic pain is common in patients with spinal cord injury (SCI) and often difficult to treat. We report a case where epidural spinal cord stimulation (SCS) below the level of injury has been successfully applied in a patient with a complete spinal cord lesion. CASE PRESENTATION: A 53-year-old female presented with neuropathic below-level SCI pain of both lower legs and feet due to complete SCI below T5. Time and pain duration since injury was 2 years...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28807894/advances-in-the-diagnosis-and-management-of-neck-pain
#17
REVIEW
Steven P Cohen, W Michael Hooten
Neck pain imposes a considerable personal and socioeconomic burden-it is one of the top five chronic pain conditions in terms of prevalence and years lost to disability-yet it receives a fraction of the research funding given to low back pain. Although most acute episodes resolve spontaneously, more than a third of affected people still have low grade symptoms or recurrences more than one year later, with genetics and psychosocial factors being risk factors for persistence. Nearly half of people with chronic neck pain have mixed neuropathic-nociceptive symptoms or predominantly neuropathic symptoms...
August 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28806489/characteristics-of-spontaneous-births-attended-by-midwives-and-physicians-in-us-hospitals-in-2014
#18
Patrick Thornton
INTRODUCTION: This study compares characteristics and birth outcomes of women attended by certified nurse-midwives/certified midwives (midwives) and physicians in US hospitals in 2014. METHODS: Data reported in 2014 on the 2003 version of the US birth certificate were examined. Spontaneous vaginal births attributed to midwives and physicians and occurring in hospitals were included. Demographic and risk profiles and adjusted odds ratios for maternal and newborn outcomes were compared by provider type...
August 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28806249/epidural-metastases-from-follicular-thyroid-cancer-mimicking-meningiomas-in-68ga-dotatate-pet
#19
Marcus Unterrainer, Harun Ilhan, Andrei Todica, Peter Bartenstein, Nathalie Lisa Albert
We report a woman with multifocal lesions suggestive of meningiomas in MRI, which also presented with high Ga-DOTATATE uptake in PET, a finding characteristic for meningioma. A whole-body staging due to a pathological fracture revealed multiple neoplastic lesions throughout the body without detection of a primary site. Subsequent pathological workup of a lung lesion revealed multifocal metastases from follicular thyroid cancer despite thyroidectomy 10 years ago (without pathological finding), and posttreatment scans after radioiodine therapy confirmed the multiple brain lesions to be metastases as well...
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28805780/-regional-and-peripheral-blockades-for-prevention-of-chronic-post-thoracotomy-pain-syndrome-in-oncosurgical-practice
#20
V E Khoronenko, A S Malanova, D S Baskakov, A B Ryabov, O V Pikin
AIM: To compare an effectiveness of thoracic epidural anesthesia/analgesia, paravertebral and intercostal blockades in prevention of chronic post-thoracotomy pain syndrome (CPTPS) in oncosurgery. MATERIAL AND METHODS: There were 300 patients who underwent open surgery including lobectomy or pneumonectomy. Patients were randomized into 3 groups depending on type of anesthesia: TEA (n=100) - combined general and epidural anesthesia; PVB (n=50) - combined general and paravertebral anesthesia; ICB (n=50) - general anesthesia was supplemented by intercostal blockade after removal of the drug...
2017: Khirurgiia
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