Lengthy complex lumbar fusion surgery in high-risk elderly patient under spinal anesthesia: A case report
ConclusionThe case reported, herein, demonstrates the feasibility of SA in elderly patients undergoing lengthy complex lumbar surgeries who have been designated “high-risk” patients (ASA > II) and provides support for future investigation into surgical and anesthesia treatment options for geriatric high-risk patients presenting with complex lumbar spine pathologies.
This study aims to characterize the anesthetic management and perioperative outcomes of AVT and traditional posterior spinal fusion (PSF) after establishing the technique at our institution. Scoliosis correction procedures performed in patients aged 10 to 21 years between January 2014 and August 2017 were identified in the electronic medical record. Patient characteristics and perioperative data about anesthetic use and pain management were extracted. Descriptive statistics were generated. Thirty-five patients undergoing AVT and 40 patients undergoing PSF met inclusion criteria. Preoperative fluoroscopy-guided epidural pla...
ConclusionBilateral bi-level ESP blocks are a simple method of providing pre-emptive regional analgesia in extensive multi-level spine surgery. Integration of ESP blocks into a multimodal regimen that employs other opioid-sparing strategies may have additive, and potentially synergistic, benefits in improving postoperative analgesia and reducing opioid requirements.
ConclusionsIH is an under-recognized cause of seizure following the spinal or cranial surgery, lumbar puncture, or spinal anesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow, and cortical irritation secondary to subdural hygromas.
Alcyone Lifesciences recently obtained Breakthrough Device Designation from the FDA for their novel implantable intrathecal bolus drug delivery catheter and port system, the ThecaFlex DRx System. The system is intended for use in conditions that requ...
Conclusion. A multimodal intraoperative anesthetic regimen incorporating ESP blocks was able to eliminate the need for postoperative opioid analgesia following posterior spinal fusion. surgery. This case report serves as proof-of-concept that this regimen may significantly improve pain trajectories and reduce opioid use in this patient population. Level of Evidence: 4
CONCLUSIONS: There is moderate- and low-quality evidence that there may be a small additional reduction in pain up to 72 hours after surgery with epidural analgesia compared with systemic analgesia. Two very small studies showed epidural analgesia with local anaesthetic alone may accelerate the return of gastrointestinal function. The safety of this technique in children undergoing thoraco-lumbar surgery is uncertain due to the very low-quality of the evidence. The study in 'Studies awaiting classification' may alter the conclusions of the review once assessed. PMID: 30650189 [PubMed - as supplied by publisher]
Pediatric Anesthesia,Volume 28, Issue 10, Page 873-880, October 2018.
ConclusionWith the dosing regimens in the current study, the only benefit noted with methadone was a decrease in perioperative opioid requirements. However, given the potential for hyperalgesia with the intraoperative use of remifentanil, adjunctive use of methadone appears warranted.
CONCLUSION: Liposomal bupivacaine was not associated with reductions in postoperative opioid use in pediatric spinal surgery. PMID: 30207019 [PubMed - as supplied by publisher]
ConclusionsA successful model was built predicting ODI MCID. Most important predictors were not modifiable surgical parameters, indicating that baseline clinical and radiographic status is a critical factor for reaching ODI MCID.Level of EvidenceLevel II.