Comparing epidural surgical anesthesia and spinal anesthesia following epidural labor analgesia for intrapartum cesarean section: a prospective randomized controlled trial.
Comparing epidural surgical anesthesia and spinal anesthesia following epidural labor analgesia for intrapartum cesarean section: a prospective randomized controlled trial. Korean J Anesthesiol. 2017 Aug;70(4):412-419 Authors: Yoon HJ, Do SH, Yun YJ Abstract BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h. In the ESA group (n = 163), ESA was performed with 17 ml of 2% lidocaine mixed with 100 µg fentanyl, 1 : 200,000 epinephrine, and 2 mEq bicarbonate. In the SA group (n = 160), SA was induced with 10 mg of 0.5% hyperbaric bupivacaine and 15 µg fentanyl. We investigated the failure rate of achieving pain-free surgery and the incidence of complications between the two groups. RESULTS: The failure rate of achieving pain-free surgery was higher in the ESA group than the SA group (15.3% vs. 2.5%, P
Sacroiliac joint (SIJ) pain is an important cause of lower back problems. Multiple SIJ injection techniques have been proposed over the years to help in the diagnosis and treatment of this condition. However, the SIJ innervation is complex and variable, and truly intra-articular injections are sometimes difficult to obtain. Different sacroiliac joint injections have shown to provide pain relief in patients suffering this ailment. Various techniques for intraarticular injections, sacral branch blocks and radiofrequency ablation, both fluoroscopy guided and ultrasound guided are discussed in this paper. Less common technique...
Facet or zygapophysial joint pain is commonly seen in the aging population. Interventional procedures, such as facet joint nerve blocks, facet intraarticular injections, and radiofrequency denervation, are used for the diagnosis and treatment of axial spinal chronic neck and low back pain. The focus of this article is to understand how radiofrequency denervation works in the cervical and lumbar spine and to be able to properly select appropriate patients who might benefit from this safe and effective procedure.
This article integrates ultrasonographic diagnosis of fascial injury with examination findings taught in traditional prolotherapy technique. Thoracolumbar fascial anatomy and biotensegrity theory are used to explain patient presentation and response to treatment at these pathologic findings. Detailed case reports provide proof of concept for the 60-year history of prolotherapy in the treatment of chronic low back pain.
Lumbar epidural steroid injections under fluoroscopic guidance are used very commonly for the treatment of low back and lower extremity radicular pain. These procedures have been shown to be effective for pain relief in the short term and are relatively safe. The indications, evidence, and safety considerations for 2 different techniques —namely, interlaminar and transforaminal—are discussed.
Ultrasonography has become an increasingly valuable and promising tool for performing image-guided spine interventions. The increase in the use of ultrasound utilization has led to more studies evaluating ultrasound-guided interventional spine procedures in comparison to fluoroscopy and computed tomography. Several studies have investigated the use of ultrasound for lumbosacral pain management procedures with favorable outcomes.
Conditions: Pain, Intractable; Pain, Back Intervention: Device: Stimulation will be delivered at with different microdosing setting to identify the optimal parameter values for each patient. Sponsor: St. Jude Medical Recruiting
Teagan has lived and breathed dance — ballet, jazz, tap, and more — since she was 5 years old. “It’s what makes me happy,” the now 12-year-old says. But two years ago, she started to feel pain in her hip that persisted after dance class and worsened over time. As her spring dance season wrapped up with four shows in two days, Teagan ended the final show with her pain at its worst. But since her injury didn’t seem to be anything more than a minor muscle pull, her mother Jeannine had Teagan lay low over the summer, hoping that rest would help the pain go away. When dance classes started ag...
Conclusions: Pretreatment TEAS effectively reduces the incidence and severity of propofol injection-related pain, the incidence of postoperative nausea and vomiting, and patient postoperative pain scores. PMID: 29156873 [PubMed]
This study aimed to investigate the relationship of sagittal spinal curvature, mobility, and low back pain (LBP) in women with and without urinary incontinence (UI). Materials and methods: Thirty-two women with UI (incontinence group) and 41 women without UI (control group) were included in this study. The sagittal spinal curvature and mobility were assessed with a Spinal Mouse device (IDIAG, Fehraltorf, Switzerland). Urogenital symptom distress, LBP, and disability caused by LBP were assessed using the Urogenital Distress Inventory-6 (UDI-6), a visual analog scale (VAS), and the Oswestry Disability Index (ODI), respective...
Conclusion: Sleep disturbances are more of a problem in patients with AS compared to healthy patients and in active AS patients compared to inactive ones. However, sleeping postures do not seem to affect either sleep disturbances or disease activity in patients with AS. PMID: 29156863 [PubMed]