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Epidurals

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https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#1
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#2
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29138074/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-cervical-foraminal-stenosis
#3
Min Son Kim, Dong Gyu Lee, Min Cheol Chang
BACKGROUND CONTEXT: Cervical transforaminal epidural steroid injection (TFESI) is considered one of the most effective treatments for radicular pain induced by cervical foraminal stenosis. PURPOSE: To evaluate the treatment outcome of TFESI according to the severity of cervical foraminal stenosis DESIGN: Retrospective study. PATIENT SAMPLE: Fifty-three patients with cervical radiculopathy due to cervical foraminal stenosis. OUTCOME MEASURES: Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, 2 weeks, and 1, 2, and 3 months after TFESI...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29136737/-research-progress-on-early-diagnosis-reasonable-prevention-and-treatment-of-symptomatic-spinal-epidural-hematoma-following-spinal-surgery
#4
X W Ye, S S Liu, P H Zeng, B L Liu
Symptomatic spinal epidural hematoma (SSEH) following spinal surgery is rare but one of the serious complications. SSEH can leave devastating neurological consequences if missing the optimal timing for treatment. The early diagnosis of SSEH is critical to the neurologic recovery, and MRI examination can help to check the location and the scope of the hematoma and provide imaging information for surgical operation. The risk factors of SSEH can be divided into preoperative factors, intraoperative factors and postoperative factors...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29136257/risk-factors-for-pathological-fracture-and-metastatic-epidural-spinal-cord-compression-in-patients-with-spinal-metastases
#5
Catherine S Hibberd, Gerald M Y Quan
Vertebral pathological fracture and metastatic epidural spinal cord compression (MESCC) due to metastatic cancer inevitably cause pain, neurological deficit, impaired function, and decreased quality of life and are indications for surgery. In such cases, earlier surgical intervention has the potential to prevent permanent neurological deficit and disability and to maintain function and quality of life. Therefore, the aim of this study was to identify and evaluate risk factors for pathological fracture and MESCC in patients with spinal metastases...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136026/operative-technique-at-caesarean-delivery-and-risk-of-complete-uterine-rupture-in-a-subsequent-trial-of-labour-at-term-a-registry-case-control-study
#6
Dorthe L A Thisted, Laust H Mortensen, Lone Hvidman, Lone Krebs
OBJECTIVE: To estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC) at term. STUDY DESIGN: Population-based case-control study. We identified all women (n = 39 742) recorded in the Danish Medical Birth Registry (DMBR) during a 12-year period (1997-2008) with a singleton pregnancy at term and TOLAC. Among these, all women with a complete uterine rupture were identified (cases)...
2017: PloS One
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#7
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29135475/using-activity-trackers-to-quantify-postpartum-ambulation-a-prospective-observational-study-of-ambulation-after-regional-anesthesia-and-analgesia-interventions
#8
Julia Ma, Rachel Martin, Bokman Chan, Michael Gofeld, Michael P Geary, John G Laffey, Faraj W Abdallah
BACKGROUND: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery...
November 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29131086/intracranial-epidural-haematoma-following-surgical-removal-of-a-giant-lumbosacral-schwannoma-a-case-report-and-literature-review
#9
Jakob Nemir, Vjerislav Peterković, Ines Trninić, Ivan Domazet, Hrvoje Barić, Miroslav Vukić
Postoperative intracranial epidural haematoma (EDH) is an extremely rare complication following spinal surgery, with only a handful of cases described in the literature. We report the case of a 16-year-old girl who underwent a successful subtotal resection of a giant lumbosacral schwannoma (L2-S2 level). Recovery from general anaesthesia was uneventful; however, her neurological status deteriorated rapidly within 24 h after surgery. A head computed tomography scan revealed a large right frontoparietal EDH with midline shift...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29130237/in-situ-forming-oxidised-hyaluronic-acid-adipic-acid-dihydrazide-hydrogel-for-prevention-of-epidural-fibrosis-after-laminectomy
#10
M H Hu, K C Yang, Y H Sun, Y C Chen, S H Yang, F H Lin
Post-operative epidural fibrosis is a biological response after laminectomy that may lead to clinical symptoms, such as radicular pain. An ideal material for prevention of epidural fibrosis should be able to inhibit fibroblast adhesions and reduce formation of scar tissue. An injectable hydrogel would be the material of choice for this purpose, since it could fill an irregular surgical defect completely, gelate in situ and be delivered in a minimally-invasive manner. The objective of this study was to evaluate, in vitro and in vivo, the cytocompatibility and anti-adhesive effect of an oxidised hyaluronic acid/adipic acid dihydrazide (oxi-HA/ADH) hydrogel...
November 13, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/29125646/epidural-abscess-caused-by-schizophyllum-commune-a-rare-case-of-rhinogenic-cranial-complication-by-a-filamentous-basidiomycete
#11
Kazuya Tone, Ryuichi Fujisaki, Shigehiro Hagiwara, Takashi Tamura, Shinobu Ishigaki, Mohamed Mahdi Alshahni, Makoto Takehisa, Takehiro Watanabe, Takuya Yasui, Takuo Tokairin, Toshiyo Sagawa, Tetsuya Sakamoto, Ken Ito, Kazuyoshi Kuwano, Koichi Makimura
Central nervous system (CNS) infections due to filamentous basidiomycetes are extremely rare. We encountered a case of epidural abscess due to Schizophyllum commune that extended from sinusitis. A 53-year-old Japanese man presented at our hospital with a headache. Computed tomography (CT) of the cranium and sinuses showed ethmoid and sphenoid sinusitis with no intracranial abnormalities. The patient was diagnosed with acute sinusitis and underwent antibiotic treatment. However, the symptoms deteriorated, and the patient came to our hospital again with consciousness disturbance...
November 10, 2017: Mycoses
https://www.readbyqxmd.com/read/29125031/a-rapidly-expanding-calvarial-langerhans-cell-histiocytosis-with-low-ki-67-in-an-adult-a-challenging-diagnosis-on-magnetic-resonance-imaging
#12
Mustafa Kemal Demir, Ozlem Yapıcıer, Teyyub Hasanov, Deniz Kilic, Turker Kilic
Langerhans cell histiocytosis may have a wide variety of clinical presentations. The growth of localised form is usually slow and it mainly involves bones such as the skull, femur, spine, ribs, mandible and pelvis in children. The spectrum of clinical manifestations and magnetic resonance imaging findings of the disease may sometimes mimic infections as well as benign and malignant tumours. In this report, we describe an unusual case of rapidly progressive calvarial Langerhans cell histiocytosis with a painful and tender mass in a 27-year-old man that created diagnostic and therapeutic challenges...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/29123892/a-case-of-panspinal-epidural-abscess-that-presented-with-meningeal-irritation
#13
Naoki Okada, Takashi Nishiyama, Maki Kurihara, Yusuke Nishimura, Yoshiro Nishimura, Yukihiro Ando, Saori Otsubo, Katsumi Yamada, Yuji Maeda
Case: In rare cases, spinal epidural abscess involves the entire spine and can lead to neurological deficits and sepsis if treatment is delayed or suboptimal. A 65-year-old man was admitted with a diagnosis of bacterial meningitis. After admission, magnetic resonance imaging showed a spinal epidural abscess from the cervical to lumbar spine. Blood culture revealed Staphylococcus aureus. The patient was initially treated medically because he had no neurological deficits. Repeat blood culture remained positive and abscesses were found in the mediastinum and bilateral psoas muscles...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123881/unexpected-complications-immediately-after-cranioplasty
#14
Akihito Kato, Hiroyuki Morishima, Goro Nagashima
Case: An 84-year-old man with subarachnoid hemorrhage underwent craniotomy and clipping with external decompression. Perfusion magnetic resonance imaging showed subclinical sinking skin flap syndrome, and he underwent cranioplasty on postoperative day 58. No problems occurred during the operation, but cerebral edema and hemorrhage were recognized on immediate postoperative computed tomography. Edema continued to progress, but edema and bleeding eventually improved without additional surgery...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123623/effect-of-epidural-corticosteroid-injection-on-magnetic-resonance-imaging-findings
#15
Min Soo Kim, Tae Yoon Jeong, Yu Seon Cheong, Young Wook Jeon, So Young Lim, Seong Sik Kang, In Nam Kim, Tsong Bin Chang, Hyun Ho Seong, Byeong Mun Hwang
Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29123430/the-use-of-invos%C3%A2-somatic-oximetry-to-measure-variations-in-placental-tissue-oxygenation-in-laboring-healthy-term-parturients-with-epidural-analgesia-an-observational-study
#16
Christian Loubert, Mélissa Ouellette, Valérie Zaphiratos, Issam Tanoubi
Purpose: Near-infrared spectroscopy provides a non-invasive continuous real-time monitoring of tissue oxygen saturation. As uterine contractions during labor may be associated with a transient uteroplacental hypoperfusion, this prospective, observational study investigates the ability of near-infrared spectroscopy to detect variation in uteroplacental oximetry during uterine contractions. Patients and methods: Four Invos™ oximetry probes (Medtronic(®), Minneapolis, MN, USA) per subjects were applied on the placental surface (PLA), the abdomen (MYO), the forearm (ARM) and the leg (LEG), of twenty healthy laboring parturients with epidural analgesia...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29122901/spinal-epidural-empyema-extending-from-a-pleural-empyema-case-description-and-anatomical-overview
#17
Gabriel Torrealba Acosta, Sylvia Josephy Hernández, Gabriel Castro Ulloa, Greivin Rodríguez Rojas
We present a case of a patient with diabetes with a pleural empyema originated from a pyomyositis process established after a central line procedure. This empyema later on extended into the spinal canal deriving into an epidural empyema, leading towards a spinal neurogenic shock and death. We discuss the anatomical substrate for this extension as well as the anatomopathological findings observed in the autopsy.
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29122701/predictors-of-quality-of-life-improvement-after-surgery-for-metastatic-tumors-of-the-spine-prospective-cohort-study
#18
Ori Barzilai, Lily McLaughlin, Mary-Kate Amato, Anne S Reiner, Shahiba Q Ogilvie, Eric Lis, Yoshiya Yamada, Mark H Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Surgical decompression and stabilization followed by radiosurgery represents an effective method for local tumor control and neurologic preservation for patients with metastatic epidural spinal cord compression. We have previously demonstrated improvement in HrQOL after this combined modality treatment ("hybrid therapy"). PURPOSE: The current analysis focuses on delineation of patient-specific prognostic factors predictive of HrQOL change after combined surgery-SRS treatment of MESCC...
November 6, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29122622/epidural-abscess-following-prostate-biopsy
#19
Scott D Lundy, Bradley C Gill, Iain H Kalfas, Amr F Fergany, Andrew J Stephenson
No abstract text is available yet for this article.
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29122332/epidural-catheter-breakage
#20
E Pereira, J Correia, M Fernandes
No abstract text is available yet for this article.
November 6, 2017: Revista Española de Anestesiología y Reanimación
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