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https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/26427307/a-comparison-of-ultrasound-alone-vs-ultrasound-with-nerve-stimulation-guidance-for-continuous-femoral-nerve-block-in-patients-undergoing-total-knee-arthroplasty
#11
Hee-Young Kim, Gyeong-Jo Byeon, Hyun-Jun Cho, Seung-Hoon Baek, Sang-Wook Shin, Hyung-Jun Cho
STUDY OBJECTIVE: To compare analgesic efficacy of ultrasound (US) guidance alone and US guidance combined with nerve stimulation (NS) for continuous femoral nerve block (CFNB) in patients undergoing total knee arthroplasty (TKA). DESIGN: Prospective, randomized double-blind trial. SETTING: Postanesthesia care unit and general ward. PATIENTS: Fifty American Society of Anesthesiologist physical status I to II patients undergoing TKA under spinal anesthesia...
August 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/26421698/complications-of-761-short-term-intrathecal-macrocatheters-in-obstetric-patients-a-retrospective-review-of-cases-over-a-12-year-period
#12
J Cohn, D Moaveni, J Sznol, J Ranasinghe
BACKGROUND: A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle...
February 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/26419103/-a-case-of-postoperative-paraplegia-caused-by-idiopathic-spinal-cord-infarction-following-hepatectomy-under-both-general-and-epidural-anesthesia
#13
Yukari Koga, Teruyuki Hiraki, Kazuo Ushijima
A 73-year-old woman (height : 155 cm, weight : 55 kg) was scheduled to undergo a laparotomic hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Her medical history did not include any relevant conditions such as cardiovascular or neurological disorders. A thoracic epidural catheter was introduced at T8-9 before the induction of anesthesia with intravenous propofol. General anesthesia was maintained with the inhalation of oxygen, air, and desflurane, and the continuous infusion of remifentanil...
April 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26366789/cesarean-analgesia-using-levobupivacaine-continuous-wound-infiltration-a-randomized-trial
#14
RANDOMIZED CONTROLLED TRIAL
Claude Jolly, François Jathières, Hawa Keïta, Envel Jaouen, Bernard Guyot, Antoine Torre
OBJECTIVE: Neuraxial morphine is considered as a "gold standard" for pain relief after cesarean section, however it causes bothersome side effects. Alternative analgesia including nonsteroidal antiinflammatory drugs (NSAID) has been proposed. We aimed to assess the morphine sparing effect of continuous wound infiltration with a local anesthetic, when added to multimodal systemic analgesia including NSAID without subarachnoid morphine. STUDY DESIGN: Sixty-eight women scheduled for elective cesarean section under spinal anesthesia were included in a randomized controlled open-label trial...
November 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/26273746/continuous-spinal-analgesia-for-labor-and-delivery-an-observational-study-with-a-23-gauge-spinal-catheter
#15
Weike Tao, Erica N Grant, Margaret G Craig, Donald D McIntire, Kenneth J Leveno
BACKGROUND: The aim of the study was to assess postdural puncture headache, pain relief, motor blockade, and success rate of conversion to cesarean delivery anesthesia of a 23-gauge spinal catheter (Wiley Spinal®) for labor analgesia. METHODS: After insertion of the spinal catheter, intrathecal bupivacaine 2.5 mg was administered, followed by patient-controlled intrathecal analgesia (basal infusion of 0.0625% bupivacaine with fentanyl 2 μg/mL at a rate of 2 mL/h, demand bolus 1 mL, lockout interval 20 minutes)...
November 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26230893/-history-and-technique-of-epidural-anaesthesia
#16
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
https://www.readbyqxmd.com/read/25936783/anesthetic-management-of-super-morbidly-obese-parturients-for-cesarean-delivery-with-a-double-neuraxial-catheter-technique-a-case-series
#17
C M Polin, B Hale, A A Mauritz, A S Habib, C A Jones, Z Y Strouch, J E Dominguez
Parturients with super-morbid obesity, defined as body mass index greater than 50kg/m(2), represent a growing segment of patients who require anesthetic care for labor and delivery. Severe obesity and its comorbid conditions place the parturient and fetus at greater risk for pregnancy complications and cesarean delivery, as well as surgical and anesthetic complications. The surgical approach for cesarean delivery in these patients may require a supra-umbilical vertical midline incision due to a large pannus...
August 2015: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/25885386/continuous-spinal-anesthesia-with-epidural-catheters-an-experience-in-the-periphery
#18
S Parthasarathy, M Ravishankar
BACKGROUND AND AIM: Continuous spinal anesthesia (CSA) offers considerable advantages over "singleshot" spinal or epidural anesthesia since it allows administration of well-controlled anesthesia using small doses of local anesthetics and a definite end point with less failure rate. There are described technical difficulties with introduction of spinal micro catheters and hence this study was undertaken by using epidural catheters. MATERIALS AND METHODS: Sixty patients of ASA grade II to III were selected and they were administered continuous spinal anesthesia with Portex 18-G epidural catheters...
July 2011: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/25819374/continuous-local-anesthetic-infusion-for-children-with-spina-bifida-undergoing-major-reconstruction-of-the-lower-urinary-tract
#19
COMPARATIVE STUDY
D J Chalmers, A Bielsky, T T Wild, G L Siparsky, D T Wilcox
OBJECTIVE: While many options for postoperative analgesia are available to the general patient population, choices are limited for individuals with spinal dysraphism. We hypothesized that the use of continuous local anesthetic infusion following major reconstruction of the lower urinary tract in children with spina bifida would significantly decrease need for opiate use, while maintaining adequate pain control. MATERIALS AND METHODS: Children with spina bifida who underwent major reconstruction of the lower urinary tract at Children's Hospital Colorado were identified from January, 2003 through January, 2013 were identified...
April 2015: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/25745476/neuraxial-modulation-for-treatment-of-vt-storm
#20
REVIEW
Roderick Tung, Kalyanam Shivkumar
In the hyperadrenergic state of VT storm where shocks are psychologically and physiologically traumatizing, suppression of sympathetic outflow from the organ level of the heart up to higher braincenters plays a significant role in reducing the propensity for VT recurrence. The autonomic nervous system continuously receives input from the heart (afferent signaling), integrates them, and sends efferent signals to modify or maintain cardiac function and arrhythmogenesis. Spinal anesthesia with thoracic epidural infusion of bupivicaine and surgical removal of the sympathetic chain including the stellate ganglion has been shown to decrease recurrences of VT...
January 2015: Journal of Biomedical Research
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