spinal anaesthesia

Weiling Liu, Chunmei Li, Francis Chee Kuan Tan, Hong Jye Neo, Yiong Huak Chan, Chian-Ming Low, Tat Leang Lee
BACKGROUND: Chronic osteoarthritic pain is not well understood in terms of its pathophysiological mechanism. Activated glial cells are thought to play a role in the maintenance of chronic pain. T98G glioblastoma cell line was previously observed to release higher amounts of interleukin-6 (IL-6) when treated with cerebrospinal fluid (CSF) from patients with another chronic pain condition, post-herpetic neuralgia. In this study, we investigated the ability of CSF from patients diagnosed with knee osteoarthritis suffering from chronic pain, to trigger the release of pro-inflammatory cytokines, IL-6, IL-1beta and tumour necrosis factor alpha (TNF-α) from T98G...
March 25, 2020: BMC Anesthesiology
Ho Sang Leung, Ryan Ka Lok Lee, Eric Ka Chai Law, Wai Kit Mak, James Francis Griffith, Simon Chun Ho Yu
Pre-operative embolization of spinal tumours are mainly performed using a transarterial approach. Percutaneous embolization of spinal tumours are undertaken much less frequently, though its use has been reported in hypervascular spinal metastases1,2 and spinal paraganglioma.3 We present a patient in whom pre-operative percutaneous embolization has been performed to a recurrent lumbar nerve root haemangioblastoma that had previously been embolized using a transarterial approach. Percutaneous embolization, through targeted percutaneous puncture of the extradural component, helped reduce intraoperative blood loss, and minimize risk of spinal ischaemia...
March 2020: BJR Case Reports
N Rotigliano, I Füglistaler, M-O Guenin, G-B Dursunoglu, D Freiermuth, M von Flüe, D C Steinemann
BACKGROUND: The benefit of a perianal block as an adjunct to general or regional anaesthesia is debated. This RCT aimed to compare pain at 24 h and up to 14 days after proctological surgery in patients with and without a perianal block. METHODS: Between January 2018 and April 2019, patients were allocated to receive a perianal block with ropivacaine or placebo as an adjunct to anaesthesia. Patients, surgeons and assessors were blinded. The primary outcome was pain measured on a numerical rating scale (NRS) after 24 h...
March 18, 2020: British Journal of Surgery
Jorge Mineiro, Muharrem Yazici
Purpose: Cerebral palsy (CP) is a disorder arising from a non-progressive lesion in the developing immature brain with an encephalopathy, that results in various levels of motor and sensory dysfunction. Motor disability of these children can be assessed by the Gross Motor Function Classification System in five levels, and depending on their motor functional capability, the most severely affected children fall into levels IV and V. Children in groups IV and V present a full spectrum of musculoskeletal deformities, among which, scoliosis is the most frequently found spinal deformity that most often requires surgical treatment...
February 1, 2020: Journal of Children's Orthopaedics
Jehan Helmy Shehata, Ahmed Ibrahim El Sakka, Amina Omran, Mahmoud Abdeltawab Mahmoud Atia Gbre, Ahmed Abdalla Mohamed, Ahmed Mohamed Fetouh, Abdelrahman Ahmed Aly Hassan Abourhama, Mohamed Ibrahim Belita
AIM: In this study we aimed to find out the heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anesthesia in preeclamptic parturients undergoing elective cesarean section. METHODS: Electrical Cardiometry system was used to measure Heart rate variability (HRV) at five different time points before fluid loading (T0, baseline), after fluid loading (T1), 5 min after spinal anaesthesia (T2), 15 min after spinal anaesthesia (T3) and 30 min after spinal anaesthesia (T4)...
December 15, 2019: Open Access Macedonian Journal of Medical Sciences
Saloumeh Peivandi, Mohammad Reza Habibi, Afshin Gholipour Baradari, Abdolmajid Gholinataj, Ali Habibi, Mohammad Khademloo, Foad Foladi
BACKGROUND: Nowadays, spinal anaesthesia is a suitable choice for most elective and emergency cesarean section (C-section) deliveries. AIM: This study aimed to determine the effect of adding low-dose naloxone to intrathecal morphine on postoperative pain and morphine related side effects after C-section. MATERIAL AND METHODS: In the present double-blind, randomised clinical trial, 70 women aged over 18 years, who were candidates for elective medical C-section under spinal anaesthesia were selected and randomly assigned to either the study group or the control group...
December 15, 2019: Open Access Macedonian Journal of Medical Sciences
Mustafa Kaçmaz, Hacı Bolat
BACKGROUND & AIMS: Primary aim of this study is to determine whether the use of local anaesthesia performed with IINB and IHNB against spinal anaesthesia in inguinal hernia repair is accepted as an alternative medicine. METHODS: 75 cases in the class of American Society of Anesthesia physical status (ASA) I-III between the ages of 18 and 75 diagnosed with single-sided inguinal hernia and hospitalized for surgery in general surgery clinic were prospectively and randomly included in this study...
March 11, 2020: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Ana Filipa Pires, Teresa Martins Mendes, Ana Areia Reis, Ana Ferreira Pacheco, Vítor Fagundes, Mari Mesquita
Introduction: Lumbar epidural anaesthesia is a commonly used technique for analgesia during labour. One of the rare complications of this technique is pneumocephalus. Case description: We report the case of a 35-year-old female admitted to the Emergency Department with severe headache associated with fast head movements. Five days previously she had a eutocic delivery and lumbar epidural anaesthesia was performed. A brain computed tomography (CT) scan showed pneumocephalus and she was admitted to the hospital ward...
2020: European Journal of Case Reports in Internal Medicine
Moses Gicheru, Vitalis Mung'ayi, Samina Mir, Jimmie Kabugi
Background: Spinal anaesthesia is an effective regional anaesthesia technique, which is preferred in almost 86% of caesarean sections in the United States and United Kingdom. Eighty percent of caesarean sections done at the Aga Khan University hospital are under spinal anaesthesia. Shivering is a common complication of spinal anaesthesia, it occurs in 40%-64% of patients after neuraxial anaesthesia. Shivering may cause maternal and fetal hypoxemia, maternal discomfort and a problem to the anaesthesiologists when it comes to monitoring the patient during caesarean sections...
September 2019: African Health Sciences
Adina Stoian, Anca Motataianu, Zoltan Bajko, Adrian Balasa
Introduction: There are rare reports of the occurrence of acute transverse myelitis and Guillain-Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain-Barré and acute transverse myelitis overlap syndrome. In this article, we present the case of a second trimester pregnant patient who developed Guillain-Barré and acute transverse myelitis overlap syndrome. Case presentation: We report the case of a 16-year-old female patient who underwent a therapeutic termination of pregnancy two weeks prior to the onset of the disease with gradual development of a motor deficit with walking and sensitivity disorders, fecal incontinence...
January 2020: Journal of Critical Care Medicine
J Chin, J Blackett, D C Kieser, C Frampton, G Hooper
Objective: To determine the effect on the need for transfusion when intravenous tranexamic acid (TXA) is administered intraoperatively in patients undergoing total hip arthroplasty (THA). Method: A prospective, double blinded, randomised control trial of 88 patients undergoing THA was randomly allocated to receive 1 g of intravenous TXA or normal saline on induction of anaesthesia. All patients received spinal anaesthesia. The primary outcome measure was transfusion rate, and the secondary outcomes were intraoperative blood loss, haemoglobin levels, length of hospital stay, functional scores, and thromboembolic complications...
2020: Advances in Orthopedics
Cristina Di Palma, Fabiana Micieli, Barbara Lamagna, Annalisa Nieddu, Valeria Uccello, Gerardo Fatone, Giancarlo Vesce
Aim of this blinded, prospective, randomized clinical study was to compare three different lubricant eye drops (LED) in healthy adult dogs undergoing general anaesthesia (GA) for non-ophthalmic surgery. Tear production rate was monitored by means of Schirmer tear test-1 (STT-1), and incidence of post-operative corneal abrasions/ulcerations was detected by corneal staining. A complete ophthalmic examination was performed before premedication, at extubation time and 24 h after GA in twenty-five non-brachycephalic dogs (fifty eyes) undergoing elective orthopaedic or spinal surgery procedures...
February 18, 2020: Veterinary Sciences
Hüseyin Utku Yıldırım, Mesut Bakır, Şebnem Rumeli Atıcı
Although spontaneous intracranial hypotension cases related to connective tissue diseases have been reported in the literature, to the best of our knowledge, no cases of iatrogenic intracranial hypotension have been described. In this paper, we plan to discuss a case of acute subdural haematoma and postdural puncture headache that developed after spinal anaesthesia in a patient with Sjögren's syndrome.
February 2020: Turkish Journal of Anaesthesiology and Reanimation
Mehmet Cantürk, Nazan Kocaoğlu, Meltem Hakkı
Objective: The aim of this study was to assess the accuracy and precision of the actual epidural depth (ND) and ultrasound (US) estimates of the distance from the skin to the epidural space in the transverse median plane (ED/TM) and paramedian sagittal oblique plane (ED/PSO) in patients who were not pregnant and who were undergoing unilateral inguinal hernia repair surgery under combined spinal epidural anaesthesia. Methods: A total of 100 patients with the American Society of Anaesthesiology status I-III of either gender were recruited...
February 2020: Turkish Journal of Anaesthesiology and Reanimation
Takeru Tsujimoto, Kota Suda, Satoko Matsumoto Harmon, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
INTRODUCTION: Traumatic cervical spondyloptosis, including compressive-extension stage 5 of Allen's classification of cervical spine injuries, is commonly observed; however, cases involving locked spinous process and vertebral arch into the spinal canal are extremely rare. CASE PRESENTATION: We present two individuals with spondyloptosis of C7 with locked spinous process of C6 and the vertebral arch into the spinal canal. Closed reduction was unable to be performed due to rigid locking of the cervical spine in the first case, whereas preoperative closed reduction was achieved with mild traction in a prone position after general anaesthesia in the second case...
February 18, 2020: Spinal Cord Series and Cases
Gabriel Beecham, Rachael Cusack, Sebastian Vencken, Grace Crilly, Donal J Buggy
BACKGROUND: Hip fracture is a growing healthcare challenge, with 6-8% 30-day mortality and 20-30% of patients incurring major morbidity, including impaired mobilisation and ability to live independently. While observational studies have shown no benefit of general versus spinal anaesthesia on 30-day mortality, intraoperative hypotension during hip fracture surgery is associated with increased 30-day mortality regardless of anaesthetic technique. Although a recent trial on younger patients demonstrated reduced postoperative complications by maintaining intraoperative arterial blood pressure close to preoperative baseline, there are no data correlating intraoperative hypotension during hip fracture surgery with postoperative morbidity...
February 13, 2020: Irish Journal of Medical Science
Robin Russell
PURPOSE OF REVIEW: Preeclampsia remains an important cause of maternal and neonatal morbidity and mortality. Recent interest in angiogenic biomarkers as a prognostic indicator is reviewed, together with analgesic, anaesthetic and critical-care management of the preeclamptic patient. RECENT FINDINGS: There has been recent interest in the angiogenic biomarkers placental growth factor and soluble fms-like tyrosine kinase-1 in establishing the diagnosis of preeclampsia and guiding its management...
February 11, 2020: Current Opinion in Anaesthesiology
Toni T Kfoury, Mouna Ben Rehouma, Paul J Zetlaoui, Dan Benhamou, Jean Xavier Mazoit
Purpose: Animal models of regional anaesthesia are useful for studying the effects of blocks and improve their efficacy. The aim of our experiments was to validate a multi-site paravertebral block in the rat. Material and methods: Dissection and indigo carmine dye injection were performed in five rats (3 rats were dissected and 2 were dye injected). In other groups (n=7rats/group), after inflammation inductive carrageenan injection in the abdominal wall, bupivacaine or saline was injected laterally to the spinal column at the T5, T10, L1, L4 and S1 level...
2020: Journal of Pain Research
Martin F Bjurström, Niklas Mattsson, Andreas Harsten, Nicholas Dietz, Mikael Bodelsson
BACKGROUND: Multiple patient and clinical characteristics contribute to the variable outcome of spinal anaesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with higher extent of sensory block. METHODS: Interventional cohort study. 102 patients undergoing total hip arthroplasty (THA) were included. Fifty-one patients underwent sampling of 10 mL CSF prior to SPA (CSF aspiration group); 51 consecutive patients were used as controls...
January 30, 2020: Minerva Anestesiologica
M Heesen, N Hilber, K Rijs, R Rossaint, T Girard, F J Mercier, M Klimek
Phenylephrine is recommended for the management of hypotension after spinal anaesthesia in women undergoing caesarean section. Noradrenaline, an adrenergic agonist with weak β-adrenergic activity, has been reported to have a more favourable haemodynamic profile than phenylephrine. However, there are concerns that noradrenaline may be associated with a higher risk of fetal acidosis, defined as an umbilical artery pH < 7.20. We performed a systematic review of trials comparing noradrenaline with phenylephrine, concentrating on primary outcomes of fetal acidosis and maternal hypotension...
February 3, 2020: Anaesthesia
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