Ultrasound-assisted vs. landmark-guided paramedian spinal anaesthesia in the elderly: A randomised controlled trial

BACKGROUND Neuraxial ultrasound might improve the efficacy of spinal anaesthesia but this has not been tested for the paramedian approach in the elderly. OBJECTIVE The current study aims to assess whether the ultrasound-assisted paramedian technique can decrease the number of needle passes required for success compared with the landmark-guided paramedian technique in the elderly. DESIGN Randomised controlled study. SETTING Single-institution, tertiary-level hospital in Seoul, Republic of Korea from October 2017 to January 2018. PATIENTS Eighty patients aged at least 60 years undergoing orthopaedic surgery. INTERVENTION All received paramedian spinal anaesthesia by either the landmark-guided or preprocedural ultrasound-assisted technique. MAIN OUTCOME MEASURES The number of needle passes required for successful dural puncture. RESULTS The number of needle passes (median [interquartile range]) was significantly lower (1.0 [1.0 to 2.0] vs. 4.5 [2.0 to 7.0]) and the success rate at first pass significantly higher at 65.0 vs. 17.5% in the ultrasound compared with the landmark group (both Pā€Š
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

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CONCLUSIONS: This survey provided a comprehensive update of the present cataract surgery practices in the Republic of Korea. The results emphasized the increasing use of premium intraocular lenses, optical biometry, and topical anesthesia. PMID: 31612656 [PubMed - in process]
Source: Korean Journal of Ophthalmology : KJO - Category: Opthalmology Tags: Korean J Ophthalmol Source Type: research
ConclusionThe resulting framework will inform the utilization of POCUS within Saskatchewan. Both this process and its outcomes could inform the development of multidisciplinary POCUS standards within other jurisdictions.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
ConclusionWe report continuing positive outcomes and satisfaction with our introduction of Minitouch Endometrial Ablation Procedure as our standard clinical practice. It has provided noticeable improvement in our ablation service from safety and efficacy perspectives. The ability to perform more procedures per session, lowered use of analgesics/anesthetics, and quicker recovery are important benefits in our private hospital setting.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusions Acoustic shadowingvia the use of double developing lines significantly improved the success rate of radial artery puncture in young children, compared with that achieved with the use of traditional ultrasound guidance.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Source: Anesthesiology - Category: Anesthesiology Source Type: research
This video demonstrates a laparoscopic assisted transverse abdominis plane (TAP) block as an alternative to the traditional anesthesiology-driven ultrasound-guided TAP block to reduce postoperative pain.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Plenary 1: Laparoscopy (11:00 AM ā€“ 12:45 PM) 11:20 AM Source Type: research
AbstractBackgroundLaparoscopic surgeries are a risk factor for raised intracranial **pressure and neurological complications. Even though rare, the consequences may be severe.MethodsOne hundred and one patients of laparoscopic cholecystectomy were enrolled and were randomized into two groups: low-pressure 8  mm Hg (Group A) and high-pressure 14 mm Hg (Group B) carbon dioxide pneumoperitoneum during surgery. Fifty patients were in group A and 51 patients were in group B. Intracranial pressure was measured by measuring the optic nerve sheath diameter (ONSD) using ultrasound examination. Baseline ONSD w as recorded ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Abstract BACKGROUND: A light breakfast has been found to empty from the stomach within four hours in healthy volunteers. AIM: The aim of this study was to investigate if a light breakfast of yoghurt or gruel empties from the stomach within four hours, in children scheduled for general anaesthesia. METHOD: In this observational cohort study, children aged 1-6 years, scheduled for elective general anaesthesia were prescribed free intake of yoghurt or gruel four hours prior to induction. They were subsequently examined with gastric ultrasound within four hours of ingestion. In case of gastric contents, the ...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
ConclusionsThe current rapid, multi-slice acquisition and real-time implementation of temperature and displacement visualization may be useful in clinical practices. It may help defining operational safety margins, improving therapy precision and efficacy. Simulations were in good agreement with experimental data and may thus be used prior treatment for procedure planning.
Source: NeuroImage - Category: Neuroscience Source Type: research
Delayed gastric emptying and the resultant “full stomach” is the most important risk factor for perioperative pulmonary aspiration. Using point-of-care gastric sonography, we aimed to investigate the prevalenc...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
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