Complications of Postoperative Epidural Analgesia For Oncologic Surgery: A Review of 18,895 Cases

We describe our experience with postoperative EA for oncologic surgery. Materials and Methods: We searched our Acute Pain Medicine database for cases in which postoperative EA was used between 2003 and 2012. We used word search to identify and catalog cases of neurological changes, magnetic resonance imaging or computed tomography of the spine, electromyography studies, and neurologist or neurosurgeon consultations. Medical records of patients with documented persistent neurological deficits and patients who had spine imaging or neurology consultations were reviewed further. In addition, we cross-checked medical records with billing diagnosis codes for spinal epidural abscess or hematoma. Results: We reviewed 18,895 cases in which postoperative EA was used. Complications included neurological symptoms in 2436 cases (12.9%), epidural insertion site abnormalities in 1062 cases (5.6%), complete epidural catheter migration in 829 cases (4.4%), epidural replacement in 619 cases (3.3%), and inadvertent dura puncture in 322 cases (1.7%). There were 6 cases of persistent deficits of uncertain etiology, 4 deep spinal infections (1:4724), and 2 cases of catheter tip shearing. No spinal epidural hematomas were identified (95% confidence interval, 0-0.0002). Discussion: Our findings provide a contemporary review of some risks associated with the use of postoperative EA for patients undergoing oncologic surgery. Despite a not-uncommon incidence of neurological changes, serious co...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research

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Not all headache disorders are the same. An excruciating, sudden-onset headache known as thunderclap headache (TCH) is a medical emergency, very different from more common headache disorders such as migraine and tension headache. If you develop TCH, you should call 911 or immediately go to the closest hospital. TCH is associated with a variety of causes, ranging from benign to potentially fatal. Urgent evaluation in an emergency setting is needed to quickly identify and treat any underlying condition. Diagnosing and treating secondary thunderclap headache When you arrive at the hospital, the medical team will want to confi...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Headache Health Source Type: blogs
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Source: Anales del Sistema Sanitario de Navarra - Category: General Medicine Authors: Tags: An Sist Sanit Navar Source Type: research
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Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
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Source: PickTheBrain | Motivation and Self Improvement - Category: Consumer Health News Authors: Tags: health and fitness Herpes Encephalitis symptoms of herpes encephalitis Source Type: blogs
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Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusion Herpes encephalitis may rule your body but don't allow the infection to take over your brain. Herpes encephalitis is suppressible and so its symptoms if managed with great attention. Antiviral drugs such as Zovirax, acyclovir, Valacyclovir are some of the prominently used drugs in suppressing therapy of herpes infection. You are counseled to see your GP as soon as the very onset of any symptoms described above.You've read Cracking the Herpes Encephalitis Code | Causes, Symptoms and Treatment, originally posted on Pick the Brain | Motivation and Self Improvement. If you've enjoyed this, please visit our site f...
Source: PickTheBrain | Motivation and Self Improvement - Category: Consumer Health News Authors: Tags: health and fitness Herpes Encephalitis symptoms of herpes encephalitis Source Type: blogs
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
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Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
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