Search results for "Epidural"
showing 10 items of 45 documents
<title>Noninvasive detection of intracerebral hemorrhage using near-infrared spectroscopy (NIRS)</title>
1998
Intracerebral Hemorrhage (IH) is an important cause of secondary brain injury in neurosurgical patients. Early identification and treatment improve neurologic outcome. We have tested Near Infrared Spectroscopy (NIRS) as an alternative noninvasive diagnostic tool compared to CT-Scans to detect IH. We prospectively studied 212 patients with neurologic symptoms associated with intracranial pathology before performing a CT-scan. NIRS signals indicated pathologies in 181 cases (sensitivity 0.96; specificity 0.29). In a subgroup of subdural hematomas NIRS detected 45 of 46 hematomas (sensitivity 0.96; specificity 0.79). Identification of intracerebral hemorrhage using NIRS has the potential to al…
Risk factors in iatrogenic spinal cord injury
2017
Study design: In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. Objective: The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. Methods: A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade o…
Lumbar osteomyelitis and epidural abscess complicating recurrent pilonidal cyst: report of a case.
2000
PURPOSE: This study was conducted to report the rare presentation of lumbar osteomyelitis and epidural abscess as a complication of a pilonidal cyst. METHODS: A case report is presented. RESULTS: We describe the rare case of a male patient with diabetes with a recurring pilonidal cyst who developed a lumbar osteomyelitis and epidural abscess three weeks after pilonidal cyst excision with epidural anesthesia, with a fatal outcome despite emergency treatment. CONCLUSIONS: Life-threatening complications should be kept in mind in high-risk patients with repetitive surgery and neurologic involvement.
Prophylactic Percutaneous Sealing of Lumbar Postdural Puncture Hole with Fibrin Glue to Prevent Cerebrospinal Fluid Leakage in Swine
2000
UNLABELLED We explored the effect of fibrin glue injection at the site of dural puncture on cerebrospinal fluid (CSF) leakage in a swine model. Pigs were subjected to a lumbar dural CSF puncture in the sitting position with a 17-gauge Tuohy needle. Fibrin glue 1.4 mL was injected through the same needle into the epidural space. Evans blue dye was infused through the cisterna magna 15 min later, and the appearance of dyed CSF through the skin puncture and along the needle trajectory to the dura was inspected and categorized. In seven of eight animals, the CSF leak was sealed with fibrin glue. Control animals were injected with 1.4 mL saline. A sham operation group of animals underwent cister…
Epidural ropivacaine -- where are the benefits? A prospective, randomized, double-blind trial in patients with retropubic prostatectomy.
2007
Background: In comparison with bupivacaine, ropivacaine exhibits comparable anaesthetic effects but with less motor impairment and systemic toxicity. However, the analgesic potency may differ. For example, ropivacaine during obstetric epidural analgesia provides an approximately 40% lower analgesic potency than bupivacaine. Equal visual analogue pain scores require significantly higher dosages of ropivacaine, and general statements about a favourable benefit–risk profile relative to that of bupivacaine may therefore have limited clinical impact. We addressed this topic in a male pain model by evaluating the analgesic efficacy of epidural ropivacaine 0.2% vs. bupivacaine 0.125% after retrop…
Microscopic Study of Injectable Steroids: Effects of Postmixing Time on Particle Aggregation
2020
Background: Epidural steroid injection (ESI) is a common practice for pain treatment since 1953. In 2014, the FDA issued a warning about ESI. Studies have focused on the effect of the particle size and their ability to generate harmful aggregates. Although steroid aggregates provide longer times for reabsorption, therefore a longer anti-inflammatory effect, they are potentially harmful to the central nervous system via embolic mechanisms. Previous studies have established that steroidal aggregates with asizes over 100 μm are potentially able to occlude blood vessels. Studies by Tiso et al and Benzon et al addressed the role of steroids on CNS adverse events, with similar outcomes. The main …
Effects of the prolonged thoracic epidural analgesia on ventilation function and complication rate after the lung cancer surgery.
2006
Thoracic epidural analgesia has been considered to have a good anesthetic efficacy and to decrease the postoperative complication rate, while its effect upon the ventilation function is still the topic of many clinical studies. The aim of this study was to evaluate the course of early postoperative period using thoracic epidural analgesia. Material and methods. A total of 453 patients undergoing the operation due to the non–small cell carcinoma were selected and examined. Their postoperative complications and mortality rate were evaluated. In 79 patients, arterial oxygen saturation (SaO2), forced vital capacity, forced expiratory volume in the first second, and the efficacy of analgesia wer…
Treatment algorithm for spontaneous spinal infections: A review of the literature
2019
Background: Primary spinal infections are rare pathologies with an estimated incidence of 5% of all osteomyelitis. The diagnosis can be challenging and this might result in a late identification. The etiological diagnosis is the primary concern to determine the most appropriate treatment. The aim of this review article was to identify the importance of a methodological attitude toward accurate and prompt diagnosis using an algorithm to aid on spinal infection management. Methods: A search was done on spinal infection in some databases including PubMed, ISI Web of Knowledge, Google Scholar, Ebsco, Embasco, and Scopus. Results: Literature reveals that on the basis of a clinical suspicion, the…
Ossovenography and Epidural Venography
1976
Henning (1940) and Ehrhardt and Kneip (1943) were the first to report injection of contrast medium into bone. In 1952 Fischgold et al. reported that contrast injections into a human spinous process resulted in an outline of the venous plexus of the attached vertebral body. In subsequent years improvements have been made which now permit contrast visualization of the venous plexuses of the entire vertebral axis.
Influencia de la analgesia epidural en los resultados obstétricos y neonatales
2021
El dolor en el parto es, probablemente, el dolor más severo que va a experimentar una mujer a lo largo de su vida, por ello, no es extraño que las mujeres se pregunten sobre los métodos de alivio del mismo. Su interés por ellos no se basa solo en cómo afectará a la progresión y a la finalización del parto, sino en cómo puede afectar al bebé. Sin embargo, no existe una respuesta unánime en la literatura científica. Además, la mayoría de estudios han sido realizados en mujeres primíparas, o sin diferenciar paridad, a pesar de que se trata de una variable que influye en la progresión del parto. Objetivos El objetivo general del estudio fue conocer la influencia de la analgesia epidural en los …