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https://www.readbyqxmd.com/read/28928555/continuous-femoral-nerve-blockade-versus-epidural-analgesia-for-postoperative-pain-relief-in-knee-surgeries-a-randomized-controlled-study
#1
Suma Vishwanatha, Sandhya Kalappa
BACKGROUND: Peripheral neural blockade provides effective analgesia with potentially less side effects than an epidural blockade. The present study was undertaken to compare continuous femoral nerve blockade (CFNB) with continuous epidural analgesia (CEA) for postoperative pain control in knee surgeries. MATERIALS AND METHODS: The patients belonging to the American Society of Anesthesiologists Class I and II scheduled for various knee surgeries under spinal anesthesia were enrolled in this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28861414/continuous-spinal-anesthesia-for-obstetric-anesthesia-and-analgesia
#2
REVIEW
Ivan Veličković, Borislava Pujic, Charles W Baysinger, Curtis L Baysinger
The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28861197/comparison-of-the-effect-of-continuous-femoral-nerve-block-and-adductor-canal-block-after-primary-total-knee-arthroplasty
#3
Seung Suk Seo, Ok Gul Kim, Jin Hyeok Seo, Do Hoon Kim, Youn Gu Kim, Beyoung Yun Park
BACKGROUND: This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. METHODS: Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#4
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#5
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of Enhanced Recovery After Surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#6
RANDOMIZED CONTROLLED TRIAL
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28492437/continuous-intrathecal-infusion-of-cannabinoid-receptor-agonists-attenuates-nerve-ligation-induced-pain-in-rats
#7
Sheng-Jie Shiue, Hsien-Yu Peng, Chung-Ren Lin, Shih-Wei Wang, Ruey-Horng Rau, Jen-Kun Cheng
BACKGROUND AND OBJECTIVES: Cannabinoid receptors (CB1R/CB2R) are known to play important roles in pain transmission. In this study, we investigated the effects of continuous intrathecal infusion of CB1/2R agonists in the L5/6 spinal nerve ligation pain model. METHODS: Under isoflurane anesthesia, rats received nerve ligation and intrathecal catheter connected to an infusion pump. After surgery, saline (1 μL/h), CB1/2R agonist WIN55,212-2, CB1R agonist ACEA, or CB2R agonist AM1241 (1 μmol/h) was given intrathecally for 7 days...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28435149/regional-anesthesia-did-not-delay-diagnosis-of-compartment-syndrome-a-case-report-of-anterior-compartment-syndrome-in-the-thigh-not-masked-by-an-adductor-canal-catheter
#8
Arissa Torrie, Jyoti Sharma, Mark Mason, Hillenn Cruz Eng
BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter...
April 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28368941/continuous-ropivacaine-subfascial-wound-infusion-compared-with-intrathecal-morphine-for-postcesarean-analgesia-a-prospective-randomized-controlled-double-blind-study
#9
RANDOMIZED CONTROLLED TRIAL
Manon Lalmand, Madeleine Wilwerth, Jean-François Fils, Philippe Van der Linden
BACKGROUND: After cesarean delivery, postoperative pain management allows early rehabilitation and helps prevent postpartum depression and chronic pain. Our present prospective, randomized controlled, double-blind study assessed the duration and effect of intrathecal analgesia and continuous ropivacaine wound infiltration versus a control group after cesarean delivery. The primary outcome was analgesia duration, defined as time to first morphine request. Secondary outcomes were cumulative postoperative morphine consumption, number of patients who did not require IV morphine, incidence of adverse effects, and time to first ambulation...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27924199/in-plane-three-step-needle-insertion-technique-for-ultrasound-guided-continuous-femoral-nerve-block-after-total-knee-arthroplasty-a-retrospective-review-of-488-cases
#10
Hyeon Ju Shin, Jung Sub Soh, Hyong Hwan Lim, Bumjoon Joo, Hye Won Lee, Hae Ja Lim
BACKGROUND: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. METHODS: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#11
Mark J Lenart, Jeffrey M Carness
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site...
September 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#12
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27315182/the-wiley-spinal-catheter-over-needle-system-for-continuous-spinal-anesthesia-questions-remain
#13
COMMENT
Chandra M Kumar
No abstract text is available yet for this article.
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27308842/a-modified-procedure-for-lumbar-intrathecal-catheterization-in-rats
#14
Yongheng Hou, Lina Wang, Jianling Gao, Xin Jin, Fuhai Ji, Jianping Yang
OBJECTIVES: Intrathecal catheterization and drug delivery in rats has always been a very important method for neuroscience and pain research. Although the technique has been continually improved since the first report, the experience gained over the years suggested that some defects remained unsolved. On the basis of modification of the standard epidural needle, lumbar needle, and intrathecal tube, we aimed to develop a simple and practical technique for intrathecal catheterization, which was similar to the 'needle-through-needle technique' used in combined spinal-epidural (CSE) anesthesia...
August 2016: Neurological Research
https://www.readbyqxmd.com/read/27162431/retrograde-epidural-catheter-relieves-intractable-sacral-pain
#15
Ruchir Gupta, Shivam Shodhan, Amr Hosny
Pain caused by tumor infiltration of the sacral area remains a major clinical challenge. Patients with poor pain control despite comprehensive medical management may be treated with neuraxial techniques such as continuous epidural or spinal anesthetic. We report a case in which a patient with metastatic breast cancer experienced inadequate pain relief after multiple intravenous pain management regimens as well as intrathecal (IT) drug delivery. The concentration of local anesthetics delivered via the IT catheter was limited due to the patient's baseline motor weakness which would be exacerbated with higher concentrations of local anesthetics...
April 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/26909488/the-wiley-spinal-catheter-over-needle-system-for-continuous-spinal-anesthesia-a-case-series-of-5-cesarean-deliveries-complicated-by-paresthesias-and-headaches
#16
Christine P McKenzie, Brendan Carvalho, Edward T Riley
Intrathecal catheter devices using a catheter-over-needle design and softer flexible material have been introduced to clinical practice with the aim of reducing some of the complications such as postdural puncture headaches and paresthesias seen with previous versions of intrathecal catheters. We present a case series of 5 cesarean deliveries using the Wiley Spinal intrathecal system (Epimed, Johnstown, New York), which was recently approved by the US Food and Drug Administration. The intrathecal catheter system consists of a flexible 23-gauge intrathecal cannula over a 27-gauge pencil-point spinal needle...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26790323/-combined-general-and-spinal-epidural-anesthesia-under-spontaneous-breathing-in-a-patient-with-a-giant-bulla
#17
Nobuyuki Tomita, Norikazu Katsumata, Manami Nomura, Maiko Kurihara, Seiichiro Kumakura, Shin Hariya, Michiko Kakishita, Takeshi Ishikawa, Kumiko Nitanai
This paper reports the successful perioperative management of a patient with a giant bulla, who underwent radical prostatectomy under general anesthesia performed under combinet spinal-epidural anesthesia while maintaining spontaneous respiration. A 61-year-old man was scheduled for radical prostatectomy. He had undergone conservative treatment using a drainage tube for right-sided pneumothorax at the age of 23. Preoperative chest CT revealed the presence of a giant bulla in the left upper lobe, multiple bullae in the entire right lung, and emphysematous alterations in both lungs...
December 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26702204/continuous-spinal-analgesia-with-levobupivacaine-for-postoperative-pain-management-comparison-of-0-125-versus-0-0625-in-elective-total-knee-and-hip-replacement-a-double-blind-randomized-study
#18
Alessandro D'Ambrosio, Savino Spadaro, Chiara Natale, Antonella Cotoia, Michele Dambrosio, Gilda Cinnella
BACKGROUND AND AIMS: Continuous spinal anesthesia (CSA) has not been widely used for postoperative analgesia, mainly to avoid complications from the subarachnoid injection. Recently, the introduction of low caliber CSA catheters (Spinocath(®)), has allowed to decrease anesthetics doses and volumes with good analgesia and reduced complications. The aim of this present study was to compare two concentrations of levobupivacaine administered through CSA for postoperative pain management after major orthopedic surgery...
October 2015: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/26689075/-abnormal-low-blood-pressure-after-induction-of-general-anesthesia-in-a-patient-on-medication-for-depression
#19
Shinya Sakamoto, Yoshiharu Hasegawa, Kosuke Takata, Masayuki Ueno, Tomonori Takazawa, Shigeru Saito
A patient under medication for depression underwent orthopedic surgery for osteoarthritis of the knee four times. For the second surgery, general anesthesia was induced with propofol, remifentanil, and rocuronium. Immediately after induction, she developed severe hypotension that was resistant to vasopressors. The hypotension likely resulted from the effect of psychotropic drugs, including levomepromazine, olanzapine, and clomipramine, which she had been receiving for a long time. Although her blood pressure recovered, the surgery was cancelled...
November 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26661449/the-utility-of-anatomic-diagnosis-for-identifying-femoral-nerve-palsy-following-gynecologic-surgery
#20
Tatsunori Watanabe, Masayuki Sekine, Takayuki Enomoto, Hiroshi Baba
We describe a case in which an anatomic diagnosis was useful for diagnosing and estimating the cause of femoral nerve palsy following gynecologic surgery. A 49-year-old female received general and epidural anesthesia for radical ovarian cancer surgery. Although injection pain was noted in the left medial shin with 1 % mepivacaine administered as a test dose, the catheter was left indwelling because it improved her symptoms. The surgery, which lasted 195 min, was performed in the lithotomy position, and a self-retained retractor was used to gain a good surgical field...
April 2016: Journal of Anesthesia
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