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Continuous spinal anaesthesia

Martin Ellenrieder, Thomas Tischer, Rainer Bader, Peter Cornelius Kreuz, Wolfram Mittelmeier
INTRODUCTION: The application of traction in hip arthroscopy is associated with peri-operative complications. Within a therapeutic case series, patient-related factors correlating with high-traction forces during hip arthroscopy and occurring complications should be identified. MATERIALS AND METHODS: In 30 male and 38 female patients (mean age: 44.5 years), intra-operative traction forces were monitored continuously using a specialised measurement device. A multivariate analysis was employed to identify patient-related factors influencing the traction force...
September 30, 2016: Archives of Orthopaedic and Trauma Surgery
Ban Leong Sng, Fahad Javaid Siddiqui, Wan Ling Leong, Pryseley N Assam, Edwin Sy Chan, Kelvin H Tan, Alex T Sia
BACKGROUND: Bupivacaine is an amide local anaesthetic used in hyperbaric and isobaric forms. These are administered intrathecally into the spine to provide regional anaesthesia for caesarean section. Several trials have compared hyperbaric and isobaric bupivacaine but none have conclusively shown the benefit of either. This review was first published in 2013 and updated in 2016. OBJECTIVES: Our objectives were to:1. Determine the effectiveness of hyperbaric bupivacaine compared to isobaric bupivacaine for spinal anaesthesia in women undergoing caesarean section;2...
September 15, 2016: Cochrane Database of Systematic Reviews
Sunil Kumar Sinha, Yudhyavir Brahmchari, Manpreet Kaur, Aruna Jain
BACKGROUND AND AIMS: Unilateral paravertebral block (PVB) as a sole anaesthetic technique is underutilised even in experienced hands. Hence, this study was undertaken regarding the efficacy and safety of PVB and compared with subarachnoid block (SAB) for inguinal hernia repair procedures. METHODS: Sixty-three consenting adult male patients scheduled for unilateral inguinal hernia repair were randomly assigned to receive either PVB or SAB (Group P: PVBs at T10-L2 levels, 5 mL of 0...
July 2016: Indian Journal of Anaesthesia
Lyn Li Lean, Ryan Yee Shiun Hong, Lian Kah Ti
Communication of feedback during teaching of practical procedures is a fine balance of structure and timing. We investigate if continuous in-task (IT) or end-task feedback (ET) is more effective in teaching spinal anaesthesia to medical students. End-task feedback was hypothesized to improve both short-term and long-term procedural learning retention as experiential learning promotes active learning after encountering errors during practice. Upon exposure to a 5-min instructional video, students randomized to IT or ET feedbacks were trained using a spinal simulator mannequin...
July 27, 2016: Advances in Health Sciences Education: Theory and Practice
James Hunt, Jo Murrell, David Knazovicky, John Harris, Sara Kelly, Toby G Knowles, B Duncan X Lascelles
Naturally occurring canine osteoarthritis represents a welfare issue for affected dogs (Canis familiaris), but is also considered very similar to human osteoarthritis and has therefore been proposed as a model of disease in humans. Central sensitisation is recognized in human osteoarthritis sufferers but identification in dogs is challenging. Electromyographic measurement of responses to nociceptive stimulation represents a potential means of investigating alterations in central nociceptive processing, and has been evaluated in conscious experimental dogs, but is likely to be aversive...
2016: PloS One
Tilemahos L Anagnostou, George M Kazakos, Ioannis Savvas, Charalampos Kostakis, Paraskevi Papadopoulou
OBJECTIVE: The aim of this study was to investigate whether an increased frequency of gastro-oesophageal reflux (GOR) is more common in large-sized, deep-chested dogs undergoing spinal surgery in sternal recumbency than in small-sized, barrel-chested dogs. STUDY DESIGN: Prospective, cohort study. ANIMALS: Nineteen small-sized, barrel-chested dogs (group B) and 26 large-sized, deep-chested dogs (group D). METHODS: All animals were premedicated with intramuscular (IM) acepromazine (0...
July 7, 2016: Veterinary Anaesthesia and Analgesia
Anje J Scarfe, Susanne Schuhmann-Hingel, Joanna K Duncan, Ning Ma, Yasoba N Atukorale, Alun L Cameron
A continuous paravertebral block is used when pain relief is required beyond the duration of a single-injection paravertebral block. Surgical procedures requiring an incision into the pleural cavity are some of the most painful procedures postoperatively and, if not managed appropriately, can lead to chronic pain. The current gold standard for post-cardiothoracic surgery pain management is epidural analgesia, which has contraindications, a failure rate of up to 12% and risk of complications such as epidural abscess and spinal haematoma...
May 30, 2016: European Journal of Cardio-thoracic Surgery
Vishal Uppal, Harsha Shanthanna, Christopher Prabhakar, Dolores M McKeen
INTRODUCTION: Bupivacaine is the most commonly used local anaesthetic for spinal anaesthesia (SA). There are two forms of commercially available bupivacaine; isobaric bupivacaine (IB): a formulation with a specific gravity or density equal to cerebrospinal fluid, and hyperbaric bupivacaine (HB): a formulation with density heavier than cerebrospinal fluid. The difference in densities of the two available preparations is believed to affect the diffusion pattern that determines the effectiveness, spread and side-effect profile of bupivacaine...
2016: BMJ Open
Sisinti Sanjeeb Patro, Hemant Deshmukh, Yerramalli Roja Ramani, Gitanjali Das
INTRODUCTION: Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on. Currently Dexmedetomidine, a highly selective α2-adrenoreceptor agonist is being studied for its adjuvant action in spinal anaesthesia...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Jane Sandall, Hora Soltani, Simon Gates, Andrew Shennan, Declan Devane
BACKGROUND: Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. OBJECTIVES: To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (25 January 2016) and reference lists of retrieved studies...
2016: Cochrane Database of Systematic Reviews
María Mercedes López, Emilia Guasch, Renato Schiraldi, Genaro Maggi, Eduardo Alonso, Fernando Gilsanz
BACKGROUND AND OBJECTIVES: Aortic stenosis increases perioperative morbidity and mortality, perioperative invasive monitoring is advised for patients with an aortic valve area <1.0 cm(2) or a mean aortic valve gradient >30 mmHg and it is important to avoid hypotension and arrhythmias. We report the anaesthetic management with continuous spinal anaesthesia and minimally invasive haemodynamic monitoring of two patients with severe aortic stenosis undergoing surgical hip repair. CASE REPORT: Two women with severe aortic stenosis were scheduled for hip fracture repair...
January 2016: Brazilian Journal of Anesthesiology
Maurizio Sodo, Umberto Bracale, Gennaro Argentino, Giovanni Merola, Roberta Russo, Giuseppina Sannino, Tania Strazzullo, Domenico Russo
INTRODUCTION: The presence of pre-existing abdominal wall defect (AWD) could represent a potential contraindication for peritoneal dialysis (PD) treatment. We report the results of our 6-year experience involving simultaneous repair of pre-existing AWD and catheter insertion for PD. METHODS: Patients with estimated glomerular filtration rate (e-GFR) 7-10 ml/min attending a single nephrology clinic between January 2008 and December 2014 were evaluated. Simultaneous AWD repair and catheter placement was performed...
October 2016: Journal of Nephrology
Krishan Yogesh Sawhney, Sandeep Kundra, Anju Grewal, Sunil Katyal, Gurdeep Singh, Ananjit Kaur
BACKGROUND: Continuous epidural infusion of Bupivacaine and Ropivacaine with or without the addition of Fentanyl has been evaluated by various researchers for effective postoperative pain relief. Studies however, depict significant variability in their results with regard to analgesic efficacy and adverse effects like hypotension, motor blockade etc. AIM: To comparatively evaluate postoperative analgesic efficacy, motor sparing effect, postoperative haemodynamic variations and total postoperative analgesic consumption in first 24 hours...
September 2015: Journal of Clinical and Diagnostic Research: JCDR
C K Rumboll, R A Dyer, C J Lombard
BACKGROUND: Oxytocin causes clinically significant hypotension and tachycardia. This study examined whether prior administration of phenylephrine obtunds these unwanted haemodynamic effects. METHODS: Forty pregnant women undergoing elective caesarean section under spinal anaesthesia were randomised to receive either an intravenous 50 μg bolus of phenylephrine (Group P) or saline (Group S) immediately before oxytocin (3U over 15s). Systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were recorded using a continuous non-invasive arterial pressure device...
November 2015: International Journal of Obstetric Anesthesia
Sarika Katiyar, Chhavi Dwivedi, Saifullah Tipu, Rajnish K Jain
BACKGROUND AND AIMS: Spinal anaesthesia is used for many years for surgeries below the level of umbilicus. It has certain disadvantages such as limited duration of blockade and post-operative analgesia. This study was undertaken to evaluate the effects of additives fentanyl and magnesium sulphate along with bupivacaine during spinal anaesthesia for prolongation of analgesia and motor blockade. METHODS: This randomised study was conducted in 120 patients of either sex of American Society of Anesthesiologists physical status I and II, posted for infraumbilical surgeries...
August 2015: Indian Journal of Anaesthesia
Jane Sandall, Hora Soltani, Simon Gates, Andrew Shennan, Declan Devane
BACKGROUND: Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. OBJECTIVES: To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies...
2015: Cochrane Database of Systematic Reviews
Sadic Kagwa, Mark A Hoeft, Paul G Firth, Stephen Ttendo, Vicki E Modest
BACKGROUND: Transversus abdominis plane (TAP) block provides 12-24 h of analgesia to the parietal peritoneum and abdominal wall, and are best used combined with oral or intravenous medications. Despite ease of use, a large margin of safety, and a high success rate, TAP blocks remain under used in settings where patients could most benefit from their use. Previous studies have used oral or intravenous narcotics for supplementation. However, the efficacy of TAP blocks in low-resourced settings where patients do not have dependable access to these medications is unknown...
April 27, 2015: Lancet
Andrzej Marciniak, Radosław Owczuk, Maria Wujtewicz, Krzysztof Preis, K Majdyło
OBJECTIVE: verification of a hypothesis assuming that 5-HT3 receptor blockade by intravenous administration of ondansetron reduces the incidence of hypotension and bradycardia in patients undergoing spinal anaesthesia for Caesarean section. MATERIAL AND METHODS: The study design was approved by the Bioethics Committee and included 72 patients undergoing elective Caesarean section, randomly assigned to ondansetron group (group 0) or placebo group (group P). Finally group 0 encompassed 35 patients administered ondansetron 8 mg i...
June 2015: Ginekologia Polska
Katrin Waurick, René Waurick
In 1901, the first Epidural anesthesia via a caudal approach was independently described by two FrenchmanJean-Anthanase Sicard and Fernand Cathelin.. The Spanish military surgeon, Fidel Pagés Miravé, completed the lumbar approach successfully in 1921. The two possibilities for identification of the epidural space the "loss of resistance" technique and the technique of the "hanging drop" were developed by Achille Mario Dogliotti, an Italian, and Alberto Gutierrez, an Argentinean physician, at the same time...
July 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
R P Olonisakin, P T Sotunmbi, O O Afuwape, O O Ayandipo, T A Adigun
BACKGROUND: Laparoscopy is now readily being deployed for abdominal surgeries in our centre, thanks to the surgeons' interest and the desire to follow best practice as obtained in other climes. General anaesthesia (GA) with intermittent positive pressure ventilation is usually the preferred mode of anaesthesia for this procedure. There are reports of laparoscopic surgery of abdomen performed under spinal and or epidural anaesthetic techniques. METHODS: With Intra-Abdominal Pressure (IAP) from CO2 insufflations limited to 10-12 mmHg, Laparoscopic Appendicectomy (LA) was performed under Combined Spinal Epidural (CSE) for ten consenting ASA 1 and II patients with mean age 23...
September 2014: African Journal of Medicine and Medical Sciences
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