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over-needle-spinal catheter

Grace Lim, Jamie M Zorn, Yuanxu J Dong, Joseph S DeRenzo, Jonathan H Waters
OBJECTIVE: This report aimed to describe the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. CASE REPORTS: Eleven obstetric patients had SDHs associated with the use of labor epidural analgesia over 7 years at a tertiary care hospital. Ten of 11 patients had signs consistent with postdural puncture headache before the diagnosis of SDH. Five patients (45%) had a recognized unintentional dural puncture, 1 (9%) had a combined spinal-epidural with a 24-gauge needle, and 5 (45%) had no recognized dural puncture...
September 2016: Regional Anesthesia and Pain Medicine
Chandra M Kumar
No abstract text is available yet for this article.
July 2016: Regional Anesthesia and Pain Medicine
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
Adnan I Qureshi, Asif A Khan, Ahmed A Malik, Mohammad Rauf Afzal, Nabeel A Herial, Mushtaq H Qureshi, M Fareed K Suri
BACKGROUND: Lumbar catheter placement under fluoroscopic guidance may reduce the rate of technical failures and associated complications seen with insertion guided by manually palpable landmarks. METHODS: We reviewed our experience with 43 attempted lumbar catheter placements using paramedian approach under fluoroscopic guidance and ascertained rates of technical success, and clinical events. RESULTS: Among the 43 patients, 18, 1, and 1 patients were on aspirin (with dipyrimadole in 2), clopidogrel, and combination of both, respectively...
January 2016: Journal of Vascular and Interventional Neurology
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
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
Adnan I Qureshi, Mushtaq H Qureshi, Ahmed A Malik, Vikram Jadhav, Stanley H Kim
BACKGROUND: Approaching and aspirating cervical and high thoracic epidural abscesses through a trans-epidural route from the lumbar region access represents an alternative method for selected patients. OBJECTIVE: We determined the feasibility of catheter-based manipulation and aspiration using the trans-epidural route. MATERIAL AND METHODS: A custom designed infusion-suction catheter system that includes an outer suction catheter and inner infusion catheter in concentric relation with radio-opaque marker bands was tested in a cadaveric preparation to determine (1) the ability to place an aspiration catheter over a guidewire using a percutaneous approach within the posterior lumbar epidural space; (2) the highest vertebral level a catheter can be advanced within the epidural space; and (3) the ability to aspirate artificial purulent-like material placed in the cervical and thoracic level epidural space...
September 2015: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Amer Dastgir, Nathan J Ranalli, Theresa L MacGregor, Philipp R Aldana
The authors report an unusual case of intrathecal baclofen withdrawal due to the perforation and subsequent leakage of a baclofen pump catheter in a patient with spastic cerebral palsy. A 15-year-old boy underwent an uncomplicated placement of an intrathecal baclofen pump for the treatment of spasticity due to cerebral palsy. After excellent control of symptoms for 3 years, the patient presented to the emergency department with increasing tremors following a refill of his baclofen pump. Initial evaluation consisted of radiographs of the pump and catheter, which appeared normal, and a successful aspiration of CSF from the pump's side port...
September 2015: Journal of Neurosurgery. Pediatrics
Shawn A Candler, Michael D Osborne, Michael J Derr, Eric W Nottmeier
OBJECTIVE: We describe the 3-dimensional (3D) image-guided placement technique for a lumbar intrathecal catheter through a dorsal fusion mass. This is the first time this technique has been reported. A patient with 6 prior spine surgeries and chronic pain syndrome presented with a challenging large dorsal fusion mass. The use of 3D cone beam computed tomography-based image guidance proved advantageous for the placement of an intrathecal drug delivery system (IDDS). METHOD: Under general anesthesia, image guidance was accomplished with the Medtronic Stealth S7 image guidance system, used in conjunction with the O-ARM (Medtronic Inc...
November 2013: Clinical Journal of Pain
Heather S Dodge, Nosakhare N Ekhator, Lena Jefferson-Wilson, Mark Fischer, Ian Jansen, Paul S Horn, William E Hurford, Thomas D Geracioti
BACKGROUND:   Although headache is the most common complication of dural puncture, knowledge gaps remain about patient-related risks. Data are lacking on the role, if any, of tobacco smoking, race, anxiety, depression, and Post Traumatic Stress Disorder (PTSD) in conferring risk for post-dural puncture headache (PDPH). OBJECTIVE:   To determine the influence of tobacco smoking, race, anxiety,depressed mood, and PTSD on the risk for PDPH. STUDY DESIGN:   Retrospective chart review, single site...
January 2013: Pain Physician
A Fah, J Sutton, V Cohen, K Dowling, A M Cyna
BACKGROUND: Detecting inadvertent dural puncture during labour epidural insertion can be difficult when using a loss of resistance to saline technique. Testing fluid for glucose that leaks from a Tuohy needle may confirm the presence of cerebrospinal fluid and infer inadvertent dural puncture. This study compared the glucose content of intrathecal fluid obtained during spinal anaesthesia for elective caesarean delivery with that of fluid from a Tuohy needle or epidural catheter when establishing epidural analgesia for labour...
July 2012: International Journal of Obstetric Anesthesia
Hung-Ta H Wu, Cheng-Yen Chang, Hsu Chang, Chueh-Chuan Yen, Henrich Cheng, Paul Chih-Shueh Chen, Hong-Jen Chiou
BACKGROUND: Minimally invasive interventional biopsy procedures have the advantages of accurate localization, small incisions, and rapid recovery. The purpose of this study was to clinically test and evaluate the efficacy of the magnetic resonance imaging (MRI)-guidance techniques for obtaining musculoskeletal biopsies using the appropriate imaging modalities and instruments. METHODS: We used MRI-compatible biopsy needles from the Invivo Bone Biopsy Set (Daum, Germany), and a 1...
April 2012: Journal of the Chinese Medical Association: JCMA
Asokumar Buvanendran, Jeffrey S Kroin, Craig J Della Valle, Mario Moric, Kenneth J Tuman
BACKGROUND: Total knee replacement (TKR) is of enormous benefit to patients with osteoarthritis of the knee; however, the acute postoperative pain can be severe and difficult to manage. The role of major spinal cord neurotransmitters in this acute postoperative period is not clear, although there are a few studies in humans. We performed the first prospective clinical study undertaken to delineate the changes in the spinal neurotransmitters after a surgery such as TKR. Furthermore, we also determined whether antihyperalgesic drugs at clinically acceptable doses modulate spinal neurotransmitter concentrations in patients during the perioperative period...
February 2012: Anesthesia and Analgesia
R Andresen, S Radmer, P Kamusella, C Wissgott, J Banzer, H C Schober
PURPOSE: In older patients with reduced bone quality, fatigue fractures of the os sacrum are relatively common and are typically accompanied by strong, disabling pain. The aim of our study was to verify the feasibility and safety of sacroplasty using a balloon catheter as well as the reduction of pain. MATERIALS AND METHODS: 25 patients were diagnosed with an os sacrum fracture in MRI. As a manifestation of an extant bone reconstruction process, all patients were diagnosed with distinctive edema on the basis of MRI strong T 2-weighted images...
January 2012: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
W Tao, A P Nguyen, B O Ogunnaike, M G Craig
Seven women received labor analgesia with 0.125% bupivacaine and fentanyl 2 μg/mL delivered through a new generation of over-the-needle 23-gauge spinal catheters. The first patient was managed with intermittent bolus injections but inadequate pain control prompted a conversion to a continuous infusion for subsequent patients. One patient developed a postdural puncture headache following catheterization for 5 h, but there were no headaches in those who had an indwelling catheter for 8h or longer. In one patient the catheter was also used to provide anesthesia for cesarean delivery with 0...
October 2011: International Journal of Obstetric Anesthesia
Susanne Abdulla, Walied Abdulla, Regina Eckhardt
BACKGROUND: Post-dural puncture headache (PDPH) is the most common complication of procedures in which the dura mater is penetrated. OBJECTIVES: To evaluate the effectiveness of caudal saline injections as a therapeutic approach for handling post-dural puncture headache. STUDY DESIGN: Prospective observational study between 1995 and 2010. SETTING: Associated teaching hospital. METHODS: A 5-cm 20-gauge short-beveled needle, connected by extension tube to a 20-mL syringe filled with normal saline was used for injection...
May 2011: Pain Physician
Luiz Eduardo Imbelloni, Savino Gasparini Neto, Eliana Marisa Ganem
BACKGROUND AND OBJECTIVES: Better control of the level, intensity, and duration of spinal analgesia represents the greatest advantages of continuous spinal anesthesia. With the advent of intermediate catheters (over-the-needle catheter) and its low incidence of headaches and neurological symptoms, the technique has been gaining credibility. The objective of this paper is to report the possible safety of the new catheter with a large dose of hyperbaric 0.5% bupivacaine with 1.6% glucose associated with hyperbaric 2% lidocaine with 1...
September 2010: Revista Brasileira de Anestesiologia
Alzahrani Tariq
A healthy man developed cauda equina syndrome after uneventful combined spinal and epidural anesthesia. No pre-existing neurologic disorder was recorded. There was no pain or paresthesia during needle placement, drug injection or catheter insertion. The sensory levels were improved within a few days following the deficit but little improvement on motor power but not on sphincter tone. Local anesthesia neurotoxicity was thought to be the leading cause of neurologic deficit in our case.
June 2010: Middle East Journal of Anesthesiology
Eric R Cosman, Christian D Gonzalez
Ex vivo photographic temperature mapping of bipolar radiofrequency (RF) lesions in animal tissue is performed over a wide range of electrode tip spacings, tip lengths, tip diameters, tip temperatures, and lesion times. In vivo temperature measurements collected during clinical treatment of sacroiliac joint (SIJ) pain corroborate those collected ex vivo. Generation of a "strip lesion" connecting two separated bipolar electrode tips is demonstrated ex vivo for tip spacings as large as 20 mm. A rounded rectangular bipolar lesion with midline dimensions 12 mm × 15 mm × 8 mm (L × W × D) is demonstrated using 10 mm parallel tip spacing, 10 mm tip lengths, 20 gauge cannulae, 90°C tip temperature, and 3-minute lesion time...
January 2011: Pain Practice: the Official Journal of World Institute of Pain
Brian Cowie, Desmond McGlade, Jason Ivanusic, Michael J Barrington
BACKGROUND: Multiple approaches to the paravertebral space have been described to produce analgesia after thoracic surgery. Ultrasound-guided regional anesthesia has the potential to improve efficacy and reduce complications via real-time visualization of the paravertebral space, surrounding structures, and the approaching needle. We compared a single- versus dual-injection technique for ultrasound-guided paravertebral blockade in a cadaver model, evaluating the spread of contrast dye and location of a catheter...
June 1, 2010: Anesthesia and Analgesia
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