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https://www.readbyqxmd.com/read/29351097/effect-of-epidural-infusion-bolus-delivery-rate-on-the-duration-of-labor-analgesia-a-randomized-clinical-trial
#1
Elizabeth M S Lange, Cynthia A Wong, Paul C Fitzgerald, Wilmer F Davila, Suman Rao, Robert J McCarthy, Paloma Toledo
BACKGROUND: Programmed intermittent boluses of local anesthetic have been shown to be superior to continuous infusions for maintenance of labor analgesia. High-rate epidural boluses increase delivery pressure at the catheter orifice and may improve drug distribution in the epidural space. We hypothesized that high-rate drug delivery would improve labor analgesia and reduce the requirement for provider-administered supplemental boluses for breakthrough pain. METHODS: Nulliparous women with a singleton pregnancy at a cervical dilation of less than or equal to 5 cm at request for neuraxial analgesia were eligible for this superiority-design, double-blind, randomized controlled trial...
January 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29349999/-percutaneous-endoscopic-lumbar-discectomy-combined-with-epidural-injection-for-prolapsed-lumbar-disc-herniation
#2
Hai-Hao Wu, Tao Tang, Qing-Jiang Pang, Yun Wang, Zong-Kai Zhang
OBJECTIVE: To assess the effect of percutaneous endoscopic lumbar discectomy (PELD) combined with epidural injection for prolapsed lumbar disc herniation(PLDH). METHODS: In this prospective randomized controlled study, the clinical data of 126 patients who had undergone a PELD because of a single-level PLDH from March 2014 to June 2015 were analyzed. There were 67 males and 59 females, ranging in age from 17 to 75 years old with an average of(41.0±13.5) years old, 9 cases were L₃,₄, 76 cases were L₄,₅ and 41 cases were L₅S₁...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29347855/low-power-bipolar-radiofrequency-ablation-and-vertebral-augmentation-for-the-palliative-treatment-of-spinal-malignancies
#3
Roberto Luigi Cazzato, Julien Garnon, Jean Caudrelier, Pramod Prabhakar Rao, Guillaume Koch, Afshin Gangi
AIM: To investigate the analgesic properties and the safety of low power bipolar radiofrequency ablation (RFA) performed with internally cooled electrodes and vertebral augmentation for the treatment of painful spinal malignancies. MATERIALS AND METHODS: Consent was waived for retrospective study participation. Review of electronic records identified 11 consecutive patients (6 females; 5 males; mean age 61.3 ± 11.6 years) with one-index painful spinal tumour, who were treated between June 2016 and October 2017 with bipolar RFA and vertebral augmentation...
January 18, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29345843/does-the-use-of-epiduroscopic-lysis-of-adhesions-reduce-the-need-for-spinal-cord-stimulation-in-failed-back-surgery-syndrome-a-short-term-pilot-study
#4
S J Tuijp, J Van Zundert, P De Vooght, M Puylaert, R Mestrum, R Heylen, P Vanelderen
BACKGROUND AND AIMS: Persistent low back pain after initially successful surgery that is not attributed to structural deficits, is called failed back surgery syndrome (FBSS). When conservative and minimal invasive therapy fail, the recommended treatment is spinal cord stimulation (SCS). Because epidural fibrosis can be a contributing factor in the majority of FBSS patients, lumbosacral epiduroscopic lysis of adhesions may be considered as a less invasive alternative treatment option. We hypothesized that the use of epiduroscopic lysis of adhesions could reduce the need for SCS...
January 18, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29345393/the-protective-effect-of-spinal-cord-stimulation-postconditioning-against-spinal-cord-ischemia-reperfusion-injury-in-rabbits
#5
Huixian Li, Xiuhua Dong, Mu Jin, Weiping Cheng
BACKGROUND: Delayed paraplegia due to spinal cord ischemia/reperfusion injury (IRI) remains one of the most severe complications of thoracoabdominal aneurysm surgery, for which effective prevention and treatment is still lacking. OBJECTIVES: The current study investigates whether spinal cord stimulation (SCS) postconditioning has neuroprotective effects against spinal cord IRI. METHOD: Ninety-six New Zealand white male rabbits were randomly divided into four groups as follows: a sham group and three experimental groups (C group, 2 Hz group, and 50 Hz group) n = 24/group...
January 18, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29343042/harlequin-syndrome-as-a-rare-complication-after-epidural-anaesthesia-in-an-obstetric-patient
#6
Juan M Redondo, María Rivas, María L Martín, María D Torrado, María J Rodríguez
No abstract text is available yet for this article.
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29340585/spinal-tuberculosis-clinicoradiological-findings-in-274-patients
#7
Suzaan Marais, Izanne Roos, Ayesha Mitha, Sepelong J Mabusha, Vinod Patel, Ahmed I Bhigjee
Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations. Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29339580/advantages-of-soft-subdural-implants-for-the-delivery-of-electrochemical-neuromodulation-therapies-to-the-spinal-cord
#8
Marco Capogrosso, Jérôme Gandar, Nathan Greiner, Eduardo Martin Moraud, Nikolaus Wenger, Polina Shkorbatova, Pavel E Мusienko, Ivan Minev, Stephanie P Lacour, Gregoire Courtine
We recently developed soft neural interfaces enabling the delivery of electrical and chemical stimulation to the spinal cord. These stimulations restored locomotion in animal models of paralysis. Soft interfaces can be placed either below or above the dura mater. Theoretically, the subdural location combines many advantages, including increased selectivity of electrical stimulation, lower stimulation thresholds, and targeted chemical stimulation through local drug delivery. However, these advantages have not been documented, nor have their functional impact been studied in-silico or in a relevant animal model of neurological disorders using a multimodal neural interface...
January 17, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#9
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336785/the-erector-spinae-plane-block-in-4-cases-of-video-assisted-thoracic-surgery
#10
J C Luis-Navarro, M Seda-Guzmán, C Luis-Moreno, J L López-Romero
Multimodal anaesthesia, combining epidural catheter and general anaesthesia, is a common technique in thoracic surgery, however, epidural catheter placement is not always possible. Recently, erector spinae plane block has been described, which provides analgesia like that of the epidural block, although unilateral, and which has been used in various procedures at thoracic level. At present, there are no studies comparing the efficacy or safety of this block with those commonly used in thoracic surgery. However, its safety profile and contraindications seem different from those of the epidural catheter, since its placement is done under ultrasound view, the needle introduction is done in plane and the ultrasound target, the transverse process, is easily identifiable and is relatively remote from major neural or vascular structures and the pleura...
January 11, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#11
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29332332/a-study-on-cellular-immune-function-of-patients-treated-with-radical-resection-of-pulmonary-carcinoma-with-two-different-methods-of-anesthesia-and-analgesia
#12
Jie Chen, Feng Luo, Min Lei, Zhoumiao Chen
PURPOSE: To compare the influence on the immune system of two different methods of anesthesia and analgesia in patients treated with radical resection of pulmonary carcinoma. METHODS: Thirty-four patients treated with radical resection of pulmonary carcinoma were randomly divided into two groups (group A and group B, 17 cases in each group). Patients in group A were administered total intravenous anesthesia (TIVA) without inhaled hypnotics and intravenous analgesia while patients in group B were administered TIVA combined with epidural anesthesia and epidural analgesia...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#13
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#14
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29330575/a-new-technique-for-minimal-invasive-complete-spinal-cord-injury-in-minipigs
#15
Elena E Foditsch, Gratian Miclaus, Irina Patras, Ioan Hutu, Karin Roider, Sophina Bauer, Günter Janetschek, Ludwig Aigner, Reinhold Zimmermann
BACKGROUND: The aim of this study was to develop a minimal invasive complete spinal cord injury (SCI) minipig model for future research applications. The minipig is considered a translationally relevant model for SCI research. However, a standardized minimal invasive complete SCI model for pigs has not yet been established. METHODS: Adult Göttingen minipigs were anesthetized and placed in extended prone position. After initial computed tomography (CT) scan, the skin was incised, a needle placed in the epidural fatty tissue...
January 12, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#16
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326813/surgical-treatment-of-aggressive-vertebral-hemangioma-causing-progressive-paraparesis
#17
M Dobran, F Mancini, D Nasi, M Gladi, S Sisti, M Scerrati
Vertebral hemangioma is a benign vascular lesion that may onset with neurologic symptoms due to spinal cord compression by epidural extension. Surgical procedure, embolization and radiotherapy are the gold standard for the treatment of this disease. We present a case of a 84 years old woman admitted at our department with worsening paraparesis and urinary retention. Her magnetic resonance images (MRI) showed a lesion involving both anterior and posterior vertebral element of D5, with extension into epidural space and spinal cord compression...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#18
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29326182/variations-in-childbirth-interventions-in-high-income-countries-protocol-for-a-multinational-cross-sectional-study
#19
Anna Seijmonsbergen-Schermers, Ank de Jonge, Thomas van den Akker, Katrien Beeckman, Annick Bogaerts, Monalisa Barros, Patricia Janssen, Lorena Binfa, Eva Rydahl, Lucy Frith, Mechthild Gross, Berglind Hálfdánsdóttir, Deirdre Daly, Jean Calleja-Agius, Patricia Gillen, Anne Britt Vika Nilsen, Eugene Declercq
INTRODUCTION: There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325956/rapid-onset-thoracic-myelopathy-due-to-an-epidural-sarcoid-like-lesion-in-a-pediatric-patient
#20
Michael A Galgano, Carlos R Goulart, Karen Chisholm, Melissa Hazen, Scellig Stone
Isolated intraspinal neurosarcoidosis is a rare clinical entity, with most reports describing intramedullary involvement in adults. We detail the case of a nine-year-old girl with rapid onset compressive myelopathy secondary to a thoracic epidural lesion. Although pathological diagnosis was challenging, a presumptive diagnosis of isolated extradural neurosarcoidosis was made in light of the patient's investigations and dramatic response to corticosteroids. Though less likely than neoplasia, rheumatologic processes such as inflammatory granulomatous disease warrant consideration in similar cases...
January 8, 2018: World Neurosurgery
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