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Search Results: 1 - 10 of 3300 matches for " cervical epidural anaesthesia "
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Cervical epidural anaesthesia for thyroid surgery
R Khanna,DK Singh
Kathmandu University Medical Journal , 2009, DOI: 10.3126/kumj.v7i3.2731
Abstract: Background: Cervical epidural anaesthesia is a regional anaesthesia technique which has been used for upper limb surgery, upper thoracic wall surgery, carotid artery surgery and neck dissections. Anaesthesia for thyroid surgery can be complicated due to the altered functional status of the thyroid or its large size. Objective: This prospective study was designed to assess the effectiveness and safety of cervical epidural anaesthesia for thyroid surgery. Materials and methods: Cervical epidural anaesthesia was attempted in 9 patients and the results compared with 44 patients who underwent thyroid surgery under conventional general anaesthesia with endotracheal intubation. The epidural catheter was placed in the C7 - T1 vertebral interspace and 10 - 15 ml of 1% Lignocaine with adrenaline was injected. Results: The technique of cervical epidural anaesthesia was successfully used in 8 out of 9 patients in whom it was attempted All patients were maintained in a state of conscious - sedation and effective analgesia was obtained in all 8 patients. There were no significant complications especially those related to diaphragmatic function and cardiovascular stability. In contrast patients undergoing surgery under conventional general anaesthesia had complications related to endotracheal intubation, cardiac arrhythmias and hypotension Conclusion: The technique of cervical epidural anaesthesia should be considered in thyroid patients where difficult endotracheal intubation is anticipated and in those in whom alterations in thyroid functional state make them vulnerable to cardiovascular complications under conventional general anaesthesia.
Epidural haematoma: Rare complication after spinal while intending epidural anaesthesia with long-term follow-up after conservative treatment
Goswami Devalina,Das Jyotirmoy,Deuri Achyut,Deka Ajit
Indian Journal of Anaesthesia , 2011,
Abstract: Epidural anaesthesia (EA) is an extensively used procedure for many surgeries. Increase incidence of bleeding in the epidural space [epidural haematoma (EH)] is reportedly more common in patients with altered coagulation and patients on anticoagulation treatment. EH secondary to spinal while intending EA for caesarean section (C-section) in a healthy individual leading to transient or persistent neurological problems is very rare. We report a case of EH after spinal while intending EA for C-section in a healthy young female along with 5-yrs follow-up after conservative treatment.
Combined Spinal Epdiural Anaesthesia: Single Space Technique
Khairat Mohd, Shigufta Qazi, Showkat Hussain
JK Science : Journal of Medical Education & Research , 2005,
Abstract: A study of single space combined spinal epidural (CSE) block was carried out in 30 patients forlower extremity orthopaedic surgery. Hyperbaric bupivacaine (0.5%) was used for subarachanoidblock and (0.25%) isobaric bupivacaine was given through epidural catheter for “top-up” doses tofacilitate surgery and for postoperative analgesia. Operative conditions were described as excellentin 73.33% patients, good in 23.33% patients and fair 3.33%) patients. Similarly post operativeanalgesia was excellent in 70%, good in 26.66% and fair in 3.33% cases. Intra operative complicationslike hypotension < 80mm Hg occurred in 3.33% patients and < 90 mmHg in 10% patients. No postspinal headache or neurological complications were seen. CSE anaesthesia appears to combine thereliability of spinal and the flexibility of epidural block while their drawbacks are minimized.
Transverse myelitis following general and thoracic epidural anaesthesia
Mojca Drnovsek Globokar,Vesna Paver Erzen,Vesna Novak Jankovic
Signa Vitae , 2010,
Abstract: Acute bacterial transverse myelitis, secondary to an epidural catheter, developed in a 49-year-old man who underwent surgery for carcinoma of the left lung. Left pneumonectomy was performed under combined general and epidural (Th6-7) anesthesia. The operative procedure, anaesthesia and early postoperative course were uneventful. On the fifth postoperative day, the patient developed neurological deficits consistent with high-level paraplegia. Elevated inflammatory parameters along with the results of cerebrospinal fluid analysis and magnetic resonance imaging were suggestive of acute transverse bacterial myelitis of the dorsal part of the spinal cord secondary to epidural analgesia. Despite prompt antibiotic therapy, anti-oedema treatment and rehabilitation, the neurological deficit failed to resolve.
Caring about medullary anesthesia in Saimiri sciureus: the conus medullaris topography
Lima, Ana R.;Fioretto, emerson T.;Fontes, Rodrigo F.;Imbeloni, Aline A.;Muniz, José A. P. C.;Branco, érrika;
Anais da Academia Brasileira de Ciências , 2011, DOI: 10.1590/S0001-37652011000400020
Abstract: saimiri sciureus is a new world non-human primate (nhp) that inhabits brazilian rain forests. surgical interventions in wild nhps can be considered common both for experimental studies procedures and corrective procedures for endangered species. among various anesthetic procedures, the epidural anesthesia or blockades, depending on the surgical procedure, might be considered elective for wild monkeys, mostly based on its safeness, efficiency and non-time consuming characteristics. however its safeness would be limiting because of the spinal cord arrangement. notwithstanding the available former studies on new world nhp anatomy, the description of the medullar cone of saimiri sciureus is still scarce. therefore, we believe that the better understanding the medullar cone of saimiri sciureus would contribute to improve the applicability of epidural procedures in the species. vertebrae architecture of saimiri sciureus was composed by 9 lumbar, 3 sacral and 18 coccygeal vertebrae, and the medullar cone measured about 3.3 cm. we can conclude that the conus medullaris in saimiri sciureus is situated more caudally in comparison to other species.
Newborns from deliveries with epidural anaesthesia
Avramovi? Lidija,?utura Ne?o,Soldo Vesna,?urkovi? Aleksandar
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1004192a
Abstract: Introduction. The use of epidural anaesthesia in delivery with the purpose to reduce pain and fear in a pregnant woman has the influence on the physiological status of the woman in childbirth and the course of delivery. From the epidural space of the pregnant woman, one part of free anaesthetic comes in the foetal circulation through the mother's circulation and placenta and connects with the foetal proteins. A lower value of albumins and serum proteins in the foetal circulation give bigger free fraction of anaesthetic which is accumulated in the foetal liver, brain and heart full of blood. Objective. The aim of the study was to examine the influence of epidural anaesthesia on the newborn. Methods. Retrospective study of 6,398 documents of newborns was performed in our Clinic of Gynaecology and Obstetrics 'Narodni front' during 2006. The first group was made of 455 newborns from deliveries with epidural anaesthesia and the second was the control group of 5,943 remaining newborns. In both groups we analysed the following: sex, week of gestation, weight, Apgar score, measure of care and resuscitation, perinatal morbidity and then the obtained results were compared. Results. Most of deliveries were vaginal without obstetric intervention (86.6%). The number of deliveries finished with vacuum extractor (4.6%) was statistically significantly bigger in the group with epidural anaesthesia than in the control group. Most of the newborns in the first group were born on time (96.5%) in 39.0±1.0 week of gestation and with foetal weight 3448±412 grammes. There was no statistical significance in Apgar score between both groups. Epidural anaesthesia does not increase the degree of the newborn's injury. Lower pH of blood was found in the newborns from deliveries with vacuum extractor or operated on (the Ceasarean section). Conclusion. Application of epidural anaesthesia decreases duration of delivery and has no adverse effects on the newborn and hypoxic encephalopathy is lower.
Complete dorsal wall defect in a dry human sacrum: A case report
Dr Swathi Poornima C
International Journal of Medical Research and Health Sciences , 2013, DOI: 10.5958/j.2319-5886.2.2.010
Abstract: The human sacrum is a triangular bone formed by the fusion of five separate vertebras along with the intervertebral discs. Gross morphology of sacrum shows a concave ventral surface, a convex dorsal surface and a triangular sacral canal. The sacral canal consists of an anterior wall formed by the fusion of the posterior aspects of sacral vertebral bodies and the dorsal wall is formed by the fused laminae, spines and ossified ligaments flava. During the routine course of osteology for undergraduates one of the sacrum showed complete absence of the dorsal wall of the sacral canal. Anatomical variations frequently occur around the dorsal wall of the sacral canal especially in relation to sacral hiatus. The variations may be attributed to the dependency of the sacrum to the load related fusion of the bone structure. Knowledge of such variations is of profound importance in spinal injuries, neurosurgeries and caudal epidural anaesthesia.
Evaluation of the effect of magnesium sulphate vs. clonidine as adjunct to epidural bupivacaine
Ghatak Tanmoy,Chandra Girish,Malik Anita,Singh Dinesh
Indian Journal of Anaesthesia , 2010,
Abstract: For treatment of intra and postoperative pain, no drug has yet been identified that specifically inhibits nociception without associated side effects. Magnesium has antinociceptive effects in animal and human models of pain. The current prospective randomised double-blind study was undertaken to establish the effect of addition of magnesium or clonidine, as adjuvant, to epidural bupivacaine in lower abdominal and lower limb surgeries. A total of 90 American Society of Anesthesiology (ASA) grade I and II patients undergoing lower abdominal and lower limb surgeries were enrolled to receive either magnesium sulphate (Group B) or clonidine (Group C) along with epidural bupivacaine for surgical anaesthesia. All patients received 19 ml of epidural bupivacaine 0.5% along with 50 mg magnesium in group B, 150 mcg clonidine in Group C, whereas in control group (Group A), patients received same volume of normal saline. Onset time, heart rate, blood pressure, duration of analgesia, pain assessment by visual analogue score (VAS) and adverse effects were recorded. Onset of anaesthesia was rapid in magnesium group (Group B). In group C there was prolongation of duration of anaesthesia and sedation with lower VAS score, but the incidence of shivering was higher. The groups were similar with respect to haemodynamic variables, nausea and vomiting. The current study establishes magnesium sulphate as a predictable and safe adjunct to epidural bupivacaine for rapid onset of anaesthesia and clonidine for prolonged duration of anaesthesia with sedation.
Anaesthetic Management for Emergency Caesarean Section in an Achondroplastic Dwarf
Punam Raghove,Karampal Singh,Jatin Lal,Nandita Kad
Indian Anaesthetists' Forum , 2012,
Abstract: Achondroplasia is the most common form of dwarfism. Underdevelopment and premature ossification of bones result in characteristic craniofacial and spinal abnormalities resulting in difficulties in both - airway management and in regional anaesthesia. In this case report, we describe the anesthetic management of an achondroplastic dwarf for caesarean section.
Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation
Bajwa Sukhminder,Bajwa Sukhwinder,Kaur Jasbir,Singh Gurpreet
Indian Journal of Anaesthesia , 2011,
Abstract: Efforts to find a better adjuvant in regional anaesthesia are underway since long. Aims and objectives are to compare the efficacy and clinical profile of two α-2 adrenergic agonists, dexmedetomidine and clonidine, in epidural anaesthesia with special emphasis on their sedative properties and an ability to provide smooth intra-operative and post-operative analgesia. A prospective randomized study was carried out which included 50 adult female patients between the ages of 44 and 65 years of (American Society of Anaesthesiologists) ASAI/II grade who underwent vaginal hysterectomies. The patients were randomly allocated into two groups; ropivacaine + dexmedetomidine (RD) and ropivacaine + clonidine (RC), comprising of 25 patients each. Group RD was administered 17 ml of 0.75% epidural ropivacaine and 1.5 μg/kg of dexmedetomidine, while group RC received admixture of 17 ml of 0.75% ropivacaine and 2 μg/kg of clonidine. Onset of analgesia, sensory and motor block levels, sedation, duration of analgesia and side effects were observed. The data obtained was subjected to statistical computation with analysis of variance and chi-square test using statistical package for social science (SPSS) version 10.0 for windows and value of P< 0.05 was considered significant and P< 0.0001 as highly significant. The demographic profile, initial and post-operative block characteristics and cardio-respiratory parameters were comparable and statistically non-significant in both the groups. However, sedation scores with dexmedetomidine were better than clonidine and turned out to be statistically significant (P< 0.05). The side effect profile was also comparable with a little higher incidence of nausea and dry mouth in both the groups which was again a non-significant entity (P> 0.05). Dexmedetomidine is a better neuraxial adjuvant compared to clonidine for providing early onset of sensory analgesia, adequate sedation and a prolonged post-operative analgesia.
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