Relevant bibliographies by topics / Spinale anesthesie

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers

Academic literature on the topic 'Spinale anesthesie'

Author: Grafiati
Published: 4 June 2021
Last updated: 15 February 2022

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Journal articles on the topic "Spinale anesthesie"

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PENES, Ovidiu, and Emilia VALEANU. "Fine tuning in neuraxial subarachnoid anesthesia." Romanian Journal of Medical Practice 11, no. 2 (June 30, 2016): 172–76. http://dx.doi.org/10.37897/rjmp.2016.2.12.

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The spinal anesthesia, a category of neuraxial anesthesia, is commenced in the lumbar spine, where the local anesthetic (LA) is injected into cerebrospinal fluid (CSF) to anesthetize the spinal nerves. This technique is most frequently used for analgesia and/or anesthesia for different forms of lower extremity, lower abdominal, pelvic, and perineal procedures. Preoperative evaluation that includes a medical history and anesthesia-directed physical examination should be performed for every patient who undergo any type of anesthesia. Focus should be made on the preoperative evaluation, when spinal anesthesia is considered, to prevent medical conditions that may alter the physiologic response to spinal anesthesia or increase the risk of complications and the baricity influences of the anesthetic distribution within the subarachnoid space.
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Park, Ji In, Sang Hi Park, Min Seok Kang, Gil Won Kang, and Sang Tae Kim. "Evaluation of changes in anesthetic methods for cesarean delivery: an analysis for 5 years using the big data of the Korean Health Insurance Review and Assessment Service." Anesthesia and Pain Medicine 15, no. 3 (July 31, 2020): 305–13. http://dx.doi.org/10.17085/apm.20021.

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Background: As an anesthesia induced during cesarean section, spinal anesthesia is preferred over general and epidural anesthesia. This study aimed to review the trend of anesthetic methods for cesarean section based on data obtained from the Korean Health Insurance Review and Assessment Service from 2013 to 2018.Methods: The anesthetic methods were analyzed in 753,285 parturients who underwent a cesarean section in Korea from 2013 to 2018. We determined the association between each anesthetic method and hospital type and maternal and fetal factors. We also evaluated whether the anesthetic method was associated with the parturients’ length of hospital stay.Results: General anesthesia, spinal anesthesia, and epidural anesthesia were induced in 28.8%, 47.7%, and 23.6% of parturients from 2013 to 2018, respectively. Trend analyses showed that spinal anesthesia increased from 40.0% in 2013 to 53.7% in 2018. The opposite trend applied to general anesthesia, decreasing from 37.1% in 2013 to 22.2% in 2018. The factors that were significantly associated with the anesthetic method were parturient’s parity, emergency condition, gestational age, and fetal weight. The type of hospital, parturient’s age, and multiple birth were also associated with the anesthetic methods. There was a strong association between general anesthesia and hospital stay longer than 7 days.Conclusions: Spinal anesthesia is currently the main anesthetic method used for cesarean delivery, and the rate of spinal anesthesia is gradually increasing in Korea.
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Frawley, Geoff, Graham Bell, Nicola Disma, Davinia E. Withington, Jurgen C. de Graaff, Neil S. Morton, Mary Ellen McCann, et al. "Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair." Anesthesiology 123, no. 1 (July 1, 2015): 55–65. http://dx.doi.org/10.1097/aln.0000000000000708.

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Abstract Background: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure. Methods: This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twenty-two infants 60 weeks or less postmenstrual age scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural, or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, were analyzed. Possible predictors of failure were assessed including patient factors, technique, experience of site and anesthetist, and type of local anesthetic. Results: RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty-four patients required conversion to GA, and an additional 23 patients (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (odds ratio = 2.46). Conclusions: The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone.
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Kim, Ha-Jung, Hee-Sun Park, Yon-Ji Go, Won Uk Koh, Hyungtae Kim, Jun-Gol Song, and Young-Jin Ro. "Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty." Journal of Clinical Medicine 8, no. 6 (May 31, 2019): 778. http://dx.doi.org/10.3390/jcm8060778.

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Recent studies have reported the advantages of spinal anesthesia over general anesthesia in orthopedic patients. However, little is known about the relationship between acute kidney injury (AKI) after total knee arthroplasty (TKA) and anesthetic technique. This study aimed to identify the influence of anesthetic technique on AKI in TKA patients. We also evaluated whether the choice of anesthetic technique affected other clinical outcomes. We retrospectively reviewed medical records of patients who underwent TKA between January 2008 and August 2016. Perioperative data were obtained and analyzed. To reduce the influence of potential confounding factors, propensity score (PS) analysis was performed. A total of 2809 patients and 2987 cases of TKA were included in this study. A crude analysis of the total set demonstrated a significantly lower risk of AKI in the spinal anesthesia group. After PS matching, the spinal anesthesia group showed a tendency for reduced AKI, without statistical significance. Furthermore, the spinal anesthesia group showed a lower risk of pulmonary and vascular complications, and shortened hospital stay after PS matching. In TKA patients, spinal anesthesia had a tendency to reduce AKI. Moreover, spinal anesthesia not only reduced vascular and pulmonary complications, but also shortened hospital stay.
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Mahan, KT, and J. Wang. "Spinal morphine anesthesia and urinary retention." Journal of the American Podiatric Medical Association 83, no. 11 (November 1, 1993): 607–14. http://dx.doi.org/10.7547/87507315-83-11-607.

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Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.
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McLain, Robert F., Iain Kalfas, Gordon R. Bell, John E. Tetzlaff, Helen J. Yoon, and Maunak Rana. "Comparison of spinal and general anesthesia in lumbar laminectomy surgery: a case-controlled analysis of 400 patients." Journal of Neurosurgery: Spine 2, no. 1 (January 2005): 17–22. http://dx.doi.org/10.3171/spi.2005.2.1.0017.

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Object. Despite a history of safety and efficacy, spinal anesthesia is rarely used in lumbar surgery. Application of regional anesthetics is widely preferred for lower-extremity surgery, but general anesthesia is used almost exclusively in spine surgery, despite evidence that spinal anesthesia is as safe and may offer some advantages. Methods. In this case-controlled study the authors analyzed outcomes obtained in 400 patients in whom either spinal anesthesia or general anesthesia was induced to perform a lumbar decompression. Patients were matched for anesthesia-related class, preoperative diagnosis, surgical procedure, and perioperative protocols. All aspects of surgery, recovery, postanesthesia care, and pain management were uniform irrespective of the anesthetic type. Case complexity was equivalent. An independent observer performed analysis of the data. Data from the intraoperative period through hospital discharge were collected and compared. Two hundred consecutive patients meeting inclusion criteria were included in each group. Patients were treated for either lumbar stenosis or herniated nucleus pulposus. Demographically, both groups were well matched. Anesthetic and operative times were longer for patients receiving a general anesthetic (p < 0.05), in whom more nausea and greater requirements for antiemetics and pain medication were also present during recovery (p < 0.05). Overall complication rates and, specifically, the incidences of urinary retention were significantly lower in spinal anesthesia—induced patients (p < 0.05). There were no neural injuries in either group, and the incidence of spinal headache was lower in patients receiving a spinal anesthetic (1.5% compared with 3%). Conclusions. Spinal anesthesia was as safe and effective as general anethesia for patients undergoing lumbar laminectomy. Potential advantages of spinal anesthsia include a shorter anesthesia duration, decreased nausea, antiemetic and analgesic requirements, and fewer complications. Successful surgery can be performed using either anesthesia type.
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Palaria, Urmila, Kamal Nayan Joshi, and Yeeti Upreti. "Achondroplasia and emergency caesarean section: A case report." Indian Journal of Clinical Anaesthesia 8, no. 1 (March 15, 2021): 129–32. http://dx.doi.org/10.18231/j.ijca.2021.025.

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Achondroplasia is the commonest variety of rhizomelic dwarfism, which results from abnormal cartilage formation at epiphyseal growth plates. The peculiar facial features, bony deformities and systemic abnormalities often pose a difficulty in administration of anesthesia, particularly in the parturients. There are very few reported cases of spinal anesthesia in achondroplastic parturients, because of its feared high risks. We reported, two cases of achondroplastic parturients with short stature, planned for emergency lower segment caesarean section (LSCS), in view of cephalo-pelvic disproportion under spinal anesthesia. We discussed the anesthetic issues to achondroplastic parturients and finally did under spinal anesthesia. Besides, a myriad of problems encountered in these patients warrant a careful pre-anesthetic evaluation to warrant patients' safety and affirmative procedure outcomes.
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Singh, Biant, Manpreet Kour, Shwetabh Pradhan, and Surinder Singh. "EMERGENCY LAPAROTOMIES: VALIDATING THE ROLE OF SPINAL ANESTHESIA IN HIGH RISK CASES. A RETROSPECTIVE, FACILITY BASED OBSERVATIONAL STUDY IN SRINAGAR, GARHWAL, UTTARAKHAND." International Journal of Advanced Research 8, no. 9 (September 30, 2020): 802–5. http://dx.doi.org/10.21474/ijar01/11724.

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Introduction: Perforation peritonitis is very rampant in hilly areas of Garhwal due to excessive consumption of alcohol, smoking and stresses of life due to difficult terrain and working conditions. Most of the patients with co-morbities like COPD have higher pulmonary related complications following surgery under G.A. It is a challenge and concern for surgeons and anesthetists to manage and provide optimal care to these patients. The study validates the role of spinal anesthesia in such cases. Materials And Method: We reviewed all cases of emergency laparotomies done between Jan 2019 and June 2020. Ninety cases were given spinal anesthesia as sole anesthetic agent out of which sixty cases were ASA IV and thirty cases were ASA III. Outcome in all cases was analyzed and recorded. Results: All cases were adequately operated and outcome was successful in all accept three cases which required G.A due to prolonged surgeries. None needed mechanical ventilatory support post operatively. Mean hospital stay was seven days and there was no report of major renal or respiratory complications. Conclusion: Spinal anesthesis is a safe option and alternate to G.A in high risk emergency laparotomies minimizing the requirement of ventilatory support in rural tertiary care hospitals were critical care facilities are compromised.
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Filimonov, R. V., S. A. Potalov, S. D. Shapoval, Yu Yu Malyuk, D. G. Burtsev, Ye V. Petrashenok, Yu Yu Kobelyatskiy, and I. V. Filimonova. "UNILATERAL SPINAL BLOCK FORMATION BY TACHYPHYLAXIS METHOD." Modern medical technologies 46, no. 3 (June 1, 2020): 28. http://dx.doi.org/10.34287/mmt.3(46).2020.5.

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Abstract The article presents the theoretical justification and comparative experience in the formation of a unilateral spinal block by tachyphylaxis in urgent surgery during operations on the lower extremities. The possibility of influencing the duration and severity of motor blockade on the operated side was established using the tachyphylaxis method for administering the anesthetic without decreasing the quality of anesthesia as a whole and without increasing the amount of anesthetic administered. The possibility of reducing the development time of full anesthesia to a minimum fixation time of anesthetic on nerve tissue (10 minutes) due to preliminary «sensitization» to nerve fiber anesthetics was established. The possibility of reducing the need for postoperative analgesia by increasing the duration of the postoperative painless period has been established. Keywords: unilateral spinal anesthesia, frequency-dependent blockade, motor block.
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Shah, Saurin J., Kristen Vanderhoef, and Michael Ibrahim. "Broken Spinal Needle in a Morbidly Obese Parturient Presenting for Urgent Cesarean Section." Case Reports in Anesthesiology 2020 (September 30, 2020): 1–3. http://dx.doi.org/10.1155/2020/8880464.

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Neuraxial anesthesia has become the preferred method of anesthesia for nonemergent cesarean delivery and cases where regional anesthesia is not contraindicated. Multiple cases of broken spinal and epidural needles have been reported in the literature over the last several years; however, the specific incidence of needle breakage is still unknown. Less reliance on general anesthesia and increasing parturient body mass index (BMI) has likely contributed to more reports of broken needles during regional anesthesia for obstetric surgery. We describe a case of a broken spinal needle after attempted spinal anesthetic placement for cesarean delivery in a morbidly obese parturient, subsequent postoperative management, and current treatment recommendations.
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Dissertations / Theses on the topic "Spinale anesthesie"

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Fishell, Royce A. "The Relationship Between Position and Incidence of Spinal Headache Following Spinal Anesthesia in the Young Adult Female." VCU Scholars Compass, 1988. http://scholarscompass.vcu.edu/etd/4550.

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This investigation determined the difference in the incidence of spinal headache in 33 patients placed in 30 degrees (°) head-up position versus 33 patients who remained flat for four hours following the administration of spinal anesthesia. An experimental design was used. The two randomly assigned groups presented for elective postpartum tubal ligation under spinal anesthesia. Group A was placed flat and group B had the head of their beds elevated 30° postoperatively. Strict procedural protocol was adhered to prior to and during the administration of the spinal anesthetic. To determine if the patients had any symptoms consistent with spinal headache, patients were visited postoperatively in the hospital and were contacted again on the seventh to ninth postoperative day. Pain in the frontal and/or occipital area which was aggravated by sitting up and relieved by lying down was used as the criteria for spinal headache. The data were analyzed using the Fisher Exact Test. There was no statistically significant difference in the incidence of headache between the postpartum tubal ligation patients who were placed flat postoperatively and those who had the head of their bed elevated 30° (p = 1). The null hypothesis was therefore supported at p > .05. The findings support relaxing restrictions placed on patient's positioning following spinal anesthesia.
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Wang, Yuan, and 王苑. "The effect of intravenous and intrathecal morphine preconditioning on hepatic ischaemia-reperfusion injury in normal and cirrhotic livers." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47849848.

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Hepatic ischaemia-reperfusion injury occurs when patients undergoing liver operations such as liver transplantation, tumour resection and shock. Intravenous and intrathecal administration of morphine can be used to provide analgesia prior or after liver surgery. It has been reported that systemically administered morphine conferred protective effect on numerous organs, including heart, brain and kidney. The focus of my research is to investigate the effect of intravenous and intrathecal morphine preconditioning on normal and cirrhotic livers. Further, PI3K/Akt, STAT3 and HO-1/iNOS pathways had been shown to ameliorate hepatic ischemia-reperfusion injury. Hence, we aim to investigate these possible signaling pathways associated with morphine mediated hepato-protection. A partial hepatic ischaemia reperfusion injury model in rats was used. The experiments were divided into two series: one involved in normal livers and the other one involved in cirrhotic livers. For the normal livers, morphine at different doses were administrated intravenously or intrathecally prior the onset of ischaemia, and the experiments were repeated with previous intravenous administration of naloxone methiodide (opioid receptor antagonist), or wortmannin (Akt inhibitor), respectively. For the cirrhotic livers, morphine at optimal doses were injected intravenously or intrathecally prior the onset of ischaemia. Those rats with only induced hepatic ischaemia-reperfusion injury only were marked as control groups. The effect of morphine preconditioning on hepatic architecture, apoptosis and liver function were evaluated respectively by hematoxylin-eosin (H&E) staining, Terminal deoxynucleotide transferase-mediated dUTP nick end labeling (TUNEL) staining, the expression of cleaved Caspase-3, and serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Meanwhile, the expression of phosphorylated Akt, phosphorylated JAK2, phosphorylated STAT3, HO-1 and iNOS were detected by Western Blot to determine the signaling pathways involved by intravenous and intrathecal morphine preconditioning. The normal livers series presented intravenous and intrathecal morphine preconditioning at the 100μg/kg, 10μg/kg, respectively, better persevered hepatic architecture when compared with control groups. The degree of liver cell apoptosis and expression of cleaved caspase-3 were also reduced by intravenous and intrathecal morphine preconditioning. In additional, intravenous and intrathecal morphine preconditioning ameliorated hepatocellular damage by reducing ALT&AST release. Moreover, the expressions of phosphorylated Akt and its downstream protein STAT3 were significantly increased by intravenous and intrathecal morphine preconditioning, compared with their respective control groups. The hepato-protective effect of intravenous and intrathecal morphine preconditioning was reversed by naloxone methiodide or wortmannin pretreatment. The similar pattern of protection was observed in cirrhotic livers. Both intravenous and intrathecal morphine preconditioning protected hepatic architecture much better than control groups. They also attenuated hepatic apoptosis degree and hepatocellular enzyme release. Furthermore, the expression of HO-1 was up-regulated, whereas the expression of iNOS was down-regulated by intravenous and intrathecal morphine preconditioning. In summary, this study provided evidence that intravenous and intrathecal morphine preconditioning could attenuate hepatic ischaemia-reperfusion injury in normal and cirrhotic livers. The involvement of opioid receptors, Akt/STAT3 pathway and HO-1 pathway might be the underlying mechanisms of morphine hepato-protection. Finally, the protective effect of morphine preconditioning might provide a potential therapeutic approach for clinical usage.
published_or_final_version
Anaesthesiology
Master
Master of Philosophy
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Erdoğan, Ayşen. "Spinal ve genel anestezinin artroskopik girişimlerde kullanılan turnikeye bağlı iskemi-reperfüzyon hasarına etkisi /." Isparta: SDÜ Tıp Fakültesi, Süleyman Demirel Üniversitesi, 2005. http://tez.sdu.edu.tr/Tezler/TT00251.pdf.

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Poma, Mara Aparecida Maricato. "Gabapentin association as an adjuvant the spinal anesthesia for acute pain control in conventional cholecystectomy." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16382.

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CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior
The cholelithiasis is the main biliary tract disease that affects a significant amount of the population, an issue of global public health. In Brazil, is the most common surgical abdominal disease, with about 200,000 hospitalizations annually by the Unified Health System (SUS). The treatment is surgical and can be done conventionally or laparoscopic surgery, the is gold standard option. But the reality of our public health system shows that the vast majority of surgical procedures performed are conventional cholecystectomy. What demand the need for appropriate anesthetic management for effective, safe anesthesia, with control of neuro endocrine response to trauma and postoperative pain. The objective of this clinical study, prospective, double-blind randomly distributed was to evaluate the use of gabapentin by mouth as an adjunct to spinal anesthesia for acute pain control in conventional cholecystectomy. We selected 59 patients with cholelithiasis for elective surgery in general surgery service of Hospital Santa Casa de Misericordia de Fortaleza, being divided into two groups: Gabapentin group (GGP), gabapentin was administered in 31 patients in the 600mg via dose oral 01 hour before surgery and the second control group (CG) were administered placebo, 1 tablet 01 hour before surgery in 28 patients. Both groups underwent spinal anesthesia with sufentanil for performing conventional cholecystectomy. The main variables were: age, gender, heart rate, systolic and diastolic blood pressure, glucose levels, pain scores and morphine consumption postoperatively. The results showed no statistically significant differences between the gabapentin group and the control group.We conclude that the use of gabapentin by mouth as an adjunct to spinal anesthesia in conventional laparoscopic not interfere with the hemodynamic response during surgery or in the control of acute postoperative pain, no consumption of morphine, either on the glycemic index in the post-period operatively.
A colelitÃase à a principal doenÃa do trato biliar que afeta uma quantidade significativa da populaÃÃo, representando um problema de saÃde pÃblica mundial. (BECKER et al 2013). No Brasil, à a doenÃa abdominal cirÃrgica mais comum, com cerca de 200.000 internaÃÃes ao ano pelo Sistema Ãnico de SaÃde (SUS). MinistÃrio da SaÃde - Sistema de InformaÃÃes Hospitalares do SUS (SIH/SUS) Seu tratamento à cirÃrgico podendo ser realizado de forma convencional ou por videocirurgia, que à o padrÃo ouro. (CASTRO;AKERMAN; MUNHOZ) 2014). PorÃm, a realidade do nosso sistema pÃblico de SaÃde demonstra que a grande maioria dos procedimentos cirÃrgicos realizados sÃo colecistectomias convencionais. O que demanda a necessidade de um manejo anestÃsico apropriado para obter anestesia eficaz, segura, com controle da resposta neuro endÃcrina ao trauma e da dor pÃs-operatÃria. O objetivo deste estudo clÃnico, prospectivo, aleatoriamente distribuÃdo e duplamente encoberto foi avaliar o uso da gabapentina por via oral como adjuvante da raquianestesia para controle da dor aguda em colecistectomia convencional. Foram selecionados 59 pacientes portadores de colelitÃase para cirurgia eletiva no serviÃo de cirurgia geral do Hospital Santa Casa de MisericÃrdia de Fortaleza, sendo distribuÃdos em dois grupos: grupo Gabapentina (GGP), administrou-se gabapentina, em 31 pacientes, na dose de 600mg via oral 01 hora antes do inÃcio da cirurgia e o segundo grupo Controle (GC) administrou-se placebo, 1 comprimido, 01 hora antes do inÃcio da cirurgia em 28 pacientes. Os dois grupos foram submetidos à raquianestesia com sulfentanil para a realizaÃÃo de colecistectomia convencional. As principais variÃveis avaliadas foram: idade, sexo, frequÃncia cardÃaca, pressÃo arterial sistÃlica e diastÃlica, nÃveis glicÃmicos, escores de dor e consumo de morfina no pÃs-operatÃrio. Os resultados obtidos nÃo demonstraram diferenÃas estatisticamente significantes entre o grupo gabapentina e o grupo controle. Conclui-se que o uso da gabapentina por via oral como adjuvante da raquianestesia em colecistectomia convencional nÃo interfere na resposta hemodinÃmica no intraoperatÃrio, nem no controle da dor aguda pÃs-operatÃria, nem no consumo de morfina, tampouco no Ãndice glicÃmico no perÃodo pÃs-operatÃrio.
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Dobrydnjov, Igor. "Perioperative effects of systemic or spinal clonidine as adjuvant during spinal anaesthesia /." Linköping : Univ, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med859s.pdf.

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Behnami, Delaram. "Joint multimodal registration of medical images to a statistical model of the lumbar spine for spine anesthesia." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59570.

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Facet joint injections and epidural needle insertions are widely used for spine anesthesia. Needle guidance is usually performed by fluoroscopy or palpation, resulting in radiation exposure and multiple needle re-insertions. Several ultrasound (US)-based guidance approaches have been proposed to eliminate such issues.However, but they have not widely accepted in clinics due to difficulties in interpretation of the complex spinal anatomy in US, which leads to clinicians' lack of confidence in relying only on information derived from US for needle guidance. In this thesis, a model-based multi-modal joint registration framework is introduced, where a statistical model of the lumbar spine is concurrently registered to intraprocedure US and easy-to-interpret preprocedure images. The goal is to take advantage of the complementary features visible in US and preprocedure images, namely Computed Topography (CT) and Magnetic Resonance (MR) scans. Two versions of a lumbar spine statistical model are employed: a shape+pose model and a shape+pose+scale model. The underlying assumption is that the shape and size of the spine of a given subject are common amongst all imaging modalities . However, the pose of the spine changes from one modality to another, as the patient's position is different at different image acquisitions. The proposed method has been successfully validated on two datasets: (i) 10 pairs of US and CT scans and (ii) nine US and MR images of the lumbar spine. Using the shape+pose+scale model on the US+CT dataset, mean surface distance error of 2.42 mm for CT and mean Target Registration Error (TRE) of 3.14 mm for US were achieved. As for the US+MR dataset, TRE of 2.62 mm and 4.20 mm for the MR and US images, respectively. Both models models were equally accurate on the US+CT dataset. For US+MR, the shape+pose+scale model outperformed the shape+pose model. The joint registration allows augmentation of important anatomical landmarks in both intraprocedure US and preprocedure domains. Furthermore, observing the patient-specific model in preprocedure domains allows the clinicians to assess the local registration accuracy qualitatively. This can increase their confidence in using the US model for deriving needle guidance decisions.
Applied Science, Faculty of
Graduate
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Abimussi, Caio José Xavier [UNESP]. "Eficácia e efeitos hemodinâmicos da anestesia raquidiana com ropivacaína isobárica, hipobárica ou hiperbárica seletiva em cães anestesiados com isofluorano." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/132895.

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Objetivou-se avaliar a anestesia raquidiana com ropivacaína em cães alterando a baricidade do anestésico local, investigando as alterações hemodinâmicas e complicações. Foram utilizados seis cães, Beagle, 4 anos, submetidos a anestesia inalatória com isofluorano e aos tratamentos: Ghipo = anestesia raquidiana hipobárica (0,5 mL NaCl 0,9% + 0,5 mL ropivacaína 0,75%); Giso = anestesia raquidiana isobárica (0,5 mL NaCl 1,53% + 0,5 mL ropivacaína 0,75%); Ghiper = anestesia raquidiana hiperbárica (0,5 mL glicose 10% + 0,5 mL ropivacaína 0,75%). Após indução anestésica e manutenção com isofluorano, os animais foram posicionados em decúbito lateral direito para a passagem de um cateter de artéria pulmonar pela veia jugular esquerda. Após esse procedimento, a punção subaracnóide foi realizada entre L5-L6 com uma agulha espinhal 22G, seguida da administração de 1 mL de anestésico local em 1 min. Os animais foram mantidos por 60 minutos anestesiados em decúbito ventral. A FC, f, PAM, DC, PAPm e TºC apresentaram aumento progressivo em todos os grupos enquanto que a PCPm, apenas no GHIPO, aumentou ao longo de todos os momentos. O IRPT no GISO apresentou valores significativamente superiores no M1, M5 e M10 comparado aos demais grupos, exceto no M5, em que o GISO diferiu somente do GHIPER. O IRVP no GISO aumentou no M5 em comparação ao MB. Foram observados efeitos adversos como déficit motor unilateral, atonia vesical, excitação, dor aguda e quemose. Conclui-se que as alterações hemodinâmicas não foram relevantes, embora a anestesia inalatória com isofluorano tenha influído sobre os resultados obtidos.
The aim of the study was to assess spinal anesthesia with ropivacaine in dogs altering the local anesthetic agent’s baricity in order to investigate hemodynamic changes and complications. Six beagle dogs aged 4 years old were anesthetized with isoflurane and subjected to the treatments: Ghypo = spinal anesthesia with hypobaric ropivacaine (0.5 mL of 0.9% NaCl + 0.5 mL ropivacaine at 0,75%); Giso = isobaric spinal anesthesia (0.5 mL of 0,906% NaCl + 0.5 mL ropivacaine at 0,75%); Ghyper = hyperbaric spinal anesthesia (0.5 mL of 10% glucose + 0.5 mL ropivacaine at 0.75%). After induction to anesthesia and maintenance with isoflurane, animals were positioned in right lateral recumbency for pulmonary artery catheterization through the left jugular vein. Rightafter, spinal anesthesia was performed between L5-L6 using a 22G Quincke tip needle, followed by administration of 1 mL of local anesthetic during 1 minute. Animals were maintained under anesthesia for 60 minutes in ventral recumbency. HR, FR, MAP, CO, mPAP and body temperature progressively increased in all groups. whereas PCWP increased only in GHYPO at all time points. The TPRI showed significantly higher values in GISO at M1, M5 and M10 compared to the other groups, except for M5, during which GISO differed only from GHYPER. The PVRI increased at M5 compared to MB in GISO. Side effects such as unilateral motor deficit, bladder atony, excitation, acute pain and chemosis were observed. In conclusion, the hemodynamic changes were not relevant, although inhalation anesthesia with isoflurane might have influenced the results.
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Forssblad, Magnus. "A concept for treatment of sports related knee injuries /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-799-1/.

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Souza, Marcio Antonio de. "Analgesia de parto : bloqueio combinado raqui-peridural versus bloquei peridural continuo em primigestas." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309851.

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Orientador: João Luiz de Carvalho Pinto e Silva
Dissertação ( mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: JUSTIFICATIVA E OBJETIVOS: O trabalho de parto produz desconforto e dor intensa à maioria das parturientes. O método de eleição que seria ideal para produzir analgesia deveria reduzir ao máximo os inconvenientes e a dor provocados pelo trabalho de parto, permitindo que a mãe participasse ativamente e com prazer da experiência de dar à luz. A analgesia combinada raqui-peridural (ACRP) apresentaria, como vantagens, a possibilidade de instalação precoce, rápido início de ação analgésica, uso de baixas doses de anestésicos locais, associando-se a trabalhos de partos mais curtos, menor bloqueio motor e ofereceria maior satisfação à parturiente. A analgesia peridural contínua (APC) utilizaria doses maiores de anestésicos locais, produzindo maior bloqueio motor, mas deveria ser realizada em fases mais adiantadas do período de dilatação. O potencial atrativo da ACRP seria o de incorporar as vantagens da administração intratecal de fármacos de ação analgésica rápida, com a manutenção de acesso através de um cateter peridural, disponível continuamente para complementação com novas doses ou adição de outras drogas, minimizando as desvantagens apresentadas por ambas as técnicas. O estudo compara os desfechos maternos e perinatais com a utilização da ACRP e APC em parturientes primigestas. SUJEITOS E MÉTODOS Foi realizado um ensaio clínico aleatorizado com 128 gestantes primigestas em trabalho de parto, divididas em dois grupos de igual tamanho (grupo APC e grupo ACRP) admitidas no pré-parto de duas maternidades na cidade de Jundiaí - SP, sendo estudadas as seguintes variáveis: tempo de latência de instalação da analgesia, intensidade da dor ao longo da analgesia, tempo total decorrido até a completa dilatação do colo uterino, Índice de Apgar de primeiro e quinto minutos, tempo de resolução do parto, grau de bloqueio motor, efeitos adversos como náuseas, vômitos, prurido, hipotensão arterial e o grau de satisfação materna. ANÁLISE DOS DADOS: A análise dos dados foi feita através do teste de Mann-Whitney para as variáveis contínuas não paramétricas. Utilizou-se também teste exato de Fisher e teste qui-quadrado de Pearson para variáveis categóricas. RESULTADOS: Não houve diferenças entre os grupos em relação à velocidade de dilatação cervical, tempo para resolução do parto, parâmetros hemodinâmicos maternos, vitalidade do recémnascido, complementações analgésicas durante o trabalho de parto e parto. Ocorreu maior rapidez de instalação da analgesia no grupo da ACRP. Com relação ao bloqueio motor também se observou diferença estatística significativa entre os dois grupos, sendo menor no grupo de APC. CONCLUSÕES: As duas técnicas mostraram-se seguras e eficientes, porém a ACRP ofereceu uma analgesia mais rápida, com alívio mais precoce da dor. O bloqueio motor menos intenso no grupo APC proporcionou movimentação mais ativa no leito e uma colaboração mais efetiva das gestantes durante o período expulsivo. A grande maioria das mulheres (97,6%) referiu satisfação com a analgesia recebida. As doses de anestésicos locais e opióides utilizadas em ambas as técnicas analgésicas propostas não produziram efeitos adversos maternos significativos e tampouco alteraram a vitalidade dos recém-nascidos dos dois grupos. Ambas as técnicas não mostraram qualquer predomínio de efeitos adversos
Abstract: PROBLEM AND OBJECTIVES: The childbirth arouses distress and intense pain to most of the parturients. The ideal method of producing analgesia must reduce the labor's pain and inconveniences to the utmost level, allowing the mother to participate on the delivery experience in an active and pleasant manner. The Combined Spinal-Epidural (CSE) analgesia offers the advantages of an early insertion, fast onset of analgesia, small dose of local anesthetic and reduced degree of motor block, being thus associated to short-time labors and yielding greater satisfaction to the puerpera. Otherwise, the Continuous Epidural Analgesia (CEA) would require larger doses of local anesthetics and a larger motor block as well, but it would be applied only in advanced stages of dilatation. The CSE analgesia has an attractive prospect, since it incorporates the advantages of the intrathecal administration of rapid onset pharmaceuticals, preserving this access through an epidural catheter that is uninterruptedly available for the insertion of other drugs and, at the same time, reducing the disadvantages that these both anesthesia techniques present. This study compares the combined spinal-epidural analgesia with the continuous epidural analgesia in primiparous parturients, through maternal and perinatal outcomes. APPROACH AND METHOD: 128 primiparous parturients in labor were recruited for the study. They were separated into two equal groups (CEA group and CSE group) when they applied to two of the maternity hospitals in Jundiaí city, during the pre-labor stage. A random clinical rehearsal was accomplished and the following variables were analyzed: latency time for the analgesia onset, pain intensity after its onset, total time elapsed until the complete cervical dilation, Apgar Index at the 1st and 5th minutes, time for delivery conclusion, degree of motor block, level of sensitive block, adverse effects (such as nausea, vomiting, pruritus and arterial hypotension) and degree of motherly approval. Data Analysis: The analysis was performed through the Mann-Whitney non-parametric test for continuous variables. Fisher's exact test and Pearson's chi-square test were also employed. RESULTS: Concerning the compared variables on the speed of cervical dilation, time for delivery conclusion, maternal hemodynamic parameters, newborn's healthiness, complementary analgesia during labor and labor, there were no significant statistic differences between the two groups studied. However, the CSE group had a faster analgesia insertion. In relation to the motor block, a significant statistic difference was detected between the two groups, revealing a reduced motor block in the group that received the CEA. CONCLUSIONS: Both techniques were proved as safe and efficient, though the CSE analgesia offered a faster analgesia and sooner pain relief. Due to a less intense motor block, the parturients from the CEA group were able to accomplish an active movement and effective collaboration during the expulsion stage. The major part of the women (95,4%) expressed satisfaction with the analgesia that was applied. The doses of local anesthetics and opioids, contained in both analgesia techniques, did not cause considerable adverse effects on the mothers and did not either affect the newborns in any of the two groups
Mestrado
Tocoginecologia
Mestre em Tocoginecologia
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Sharwood-Smith, Geoffrey H. "The inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia : studies in normal and preeclamptic pregnancy : a literature review and revision of fundamental concepts." Thesis, University of St Andrews, 2011. http://hdl.handle.net/10023/1815.

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Three clinical investigations together with a combined editorial and review of the cardiovascular physiology of spinal anaesthesia in normal and preeclamptic pregnancy form the basis of a thesis to be submitted for the degree of Doctor of Medicine at the University of St Andrews. First, the longstanding consensus that spinal anaesthesia could cause severe hypotension in severe preeclampsia was examined using three approaches. The doses of ephedrine required to maintain systolic blood pressure above predetermined limits were first compared in spinal versus epidural anaesthesia. The doses of ephedrine required were then similarly studied during spinal anaesthesia in preeclamptic versus normal control subjects. The principal outcome of these studies, that preeclamptic patients were resistant to hypotension after a spinal anaesthetic, was then further investigated by studying pulse transit time (PTT) changes in normal versus preeclamptic pregnancy. PTT was explored both as beat-to-beat monitor of cardiovascular function and also as an indicator of changes in arterial stiffness. The cardiovascular physiology of obstetric spinal anaesthesia was then reviewed in the light of the three clinical investigations, developments in reproductive vascular biology and the regulation of venous capacitance. It is argued that the theory of a role for vena caval compression as the single cause of spinal anaesthetic induced hypotension in obstetrics should be revised.
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Books on the topic "Spinale anesthesie"

1

J, Brull Sorin, ed. Physiology of spinal anesthesia. 4th ed. Baltimore, Md: Williams & Wilkins, 1993.

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Spinal and epidural anesthesia. New York: McGraw Hill Medical, 2007.

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R, Macintosh R. Sir Robert Macintosh's Lumbar puncture and spinal analgesia: Intradural and extradural. 5th ed. Edinburgh: Churchill Livingstone, 1985.

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1939-, Krämer Jürgen, ed. Spinal injection techniques. Stuttgart: Thieme, 2009.

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Robert, MacIntosh. Sir Robert Macintosh's Lumbar puncture and spinal analgesia: Intradural and extradural. 5th ed. Edinburgh: Churchill Livingstone, 1985.

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Anesthesia for spine surgery. Cambridge: Cambridge University Press, 2012.

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Hans, Renck, ed. Handbook of thoraco-abdominal nerve block. Orlando: Grune & Stratton, 1987.

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Interventional and neuromodulatory techniques for pain management. Philadelphia: Elsevier/Saunders, 2012.

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Cepunov, Boris, Konstanciya Gozhenko, and Evgeniy Zhilyaev. Surgery. ru: INFRA-M Academic Publishing LLC., 2021. http://dx.doi.org/10.12737/1048569.

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The tutorial consists of two sections. The section "General surgery" covers the issues of prevention of surgical infection, issues of anesthesia, organization of preoperative and postoperative periods and other issues of general surgery (blood transfusion, transfusion, open and closed injuries, types of operative and non-operative surgical techniques, surgical infection, tumors). Attention is paid to general disorders of the vital activity of the body, as well as resuscitation, emergency care in case of accidents. The section "Specific types of surgical pathology" describes injuries and diseases of the head and neck, chest, abdominal cavity, spine and pelvis, limbs, peripheral vessels and nerves. Much attention is paid to the care of surgical patients at all stages of treatment. The principles and methods of providing first medical and pre-medical care in critical conditions of the patient are described in detail. The final chapter is devoted to the technique of surgical manipulations. Meets the requirements of the federal state educational standards of secondary vocational education of the latest generation. It is intended for students of paramedic, obstetric and nursing departments of medical colleges and colleges.
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Lee, J. Alfred, Margaret J. Watt, and R. S. Atkinson. Sir Robert MacIntosh's Lumbar Puncture and Spinal Analgesia. Churchill Livingstone, 1986.

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Book chapters on the topic "Spinale anesthesie"

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Spencer, Adam O., Santhanam Suresh, and Ban C. H. Tsui. "Spinal Anesthesia." In Pediatric Atlas of Ultrasound- and Nerve Stimulation-Guided Regional Anesthesia, 527–37. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-0-387-79964-3_34.

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Kloesel, Benjamin, and Galina Davidyuk. "Spinal Anesthesia." In Anesthesiology, 357–65. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50141-3_46.

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Nolte, H. "Spinal Anesthesia." In Gynecology and Obstetrics, 621–22. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70559-5_214.

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Archer, Thomas L. "High Spinal." In Obstetric Anesthesia, 109–17. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-26478-9_9.

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Archer, Thomas L. "Another Spinal Mishap." In Obstetric Anesthesia, 287–89. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-26478-9_31.

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Khanna, Ashish K., and Ehab Farag. "Anesthesia for Spine Osteotomy Surgery." In Spinal Osteotomy, 37–56. Dordrecht: Springer Netherlands, 2014. http://dx.doi.org/10.1007/978-94-017-8038-4_5.

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Archer, Thomas L. "Rescuing a Low Spinal." In Obstetric Anesthesia, 217–22. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-26478-9_21.

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Wasson, Cassandra, Albert Kelly, David Ninan, and Quy Tran. "Epidural, Caudal, Spinal, Combined Spinal/Epidural." In Absolute Obstetric Anesthesia Review, 53–59. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96980-0_21.

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Turnbull, John H., and Pedram Aleshi. "Spinal and Epidural Anesthesia." In Basic Clinical Anesthesia, 211–31. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-1737-2_21.

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Otero, Pablo E., and Luis Campoy. "Epidural and Spinal Anesthesia." In Small Animal Regional Anesthesia and Analgesia, 227–59. West Sussex, UK: John Wiley & Sons, Inc., 2013. http://dx.doi.org/10.1002/9781118783382.ch14.

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Conference papers on the topic "Spinale anesthesie"

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Martins Pereira, AP, FJ Moutinho Teixeira, JC Patrício Sampaio, and M. de Sá Rodrigues Moura Vieira. "93 Instrumented lumbar spine surgery under spinal anesthesia and erector spinae block in a stage IV lung cancer patient – a case-report." In ESRA 2021 Virtual Congress, 8–9–10 September 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/rapm-2021-esra.93.

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Cavanagh, Daniel P., Asena Abay, Jessica M. Brito, Jasmine R. Joyner, Jordyn N. Nally, and Xianren Wu. "A Novel Epidural Catheter Fixation Device." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3490.

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Epidurals are a method of long-term pain relief administered by injecting and continuously delivering an anesthetic via catheter in the spine. This method of pain relief is often used for patients in the Obstetrics/Gynecology unit as well as those in pre- and post-operational care. For almost 2 million singleton vaginal deliveries across 27 states in 2008 (representing 65% of all US singleton vaginal births in 2008), 61% of patients received some form of an epidural or spinal injection [1]. Additionally, this number has been increasing. For the 18 states for which 2006 and 2008 data are available, the average of the state-level increases in epidural/spinal injections is approximately 4.2% revealing an overall increase in these injections. Just between 2000 and 2010, the use of epidural injections increased by 160% [2]. Commonly, epidural catheters are inserted into the patient’s back in the appropriate location and then secured to the body with an adhesive medical dressing. Movement and subsequent dislocation of the catheter beneath the adhesive medical dressing can result in inefficient anesthetic delivery, increased patient discomfort, and repeated administration of the epidural. Secondary migration of epidural catheters is a problem responsible for failure in approximately 6.8% of epidurals administered [3]. Requiring an anesthesiologist to repeat the procedure is also an increased cost. A solution to secondary migration of epidural catheters would ensure effective delivery of the anesthetic to the patient, reduce the need for a repeated procedure, and prevent unwanted additional healthcare expenses.
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Diwan, S. "ESRA19-0310 Bilateral ultrasound guided cervical erector spinae plane catheters for posterior cervical spine fusion." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.359.

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Shetye, Snehal S., and Christian M. Puttlitz. "Biaxial Response of Ovine Spinal Cord Dura Mater." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14210.

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The dura mater plays a major functional role in the spinal cord-meningeal complex (SCM). Being the strongest structure of the meninges, it helps in sustaining the flow and pressure of the cerebral spinal fluid (CSF) in addition to protecting the spinal cord from external mechanical loading. Loss of integrity of the dura can result in subdural and epidural hematomas. Accidental damage of the dura during procedures such as lumbar puncture and epidural anesthesia can potentially result in post-dural-puncture headaches (PDPH).
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Nakajima, K. "ESRA19-0141 A case of ultrasound-guided erector spinae plane block using phenol for abdominal spasticity in a patient with spinal cord injury." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.173.

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Grimaud, O. "ESRA19-0511 Continuous spinal analgesia in trial for labour using wiley spinal." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.143.

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Fung, P., G. Dumont, M. Ansermino, M. Huzmezan, and A. Kamani. "Toward an advisory system for cesarean section spinal anesthesia." In Proceedings of the 2004 American Control Conference. IEEE, 2004. http://dx.doi.org/10.23919/acc.2004.1383730.

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Grimaud, O. "ESRA19-0581 Continuous spinal anesthesia for major abdominal surgery." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.245.

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Hosny, M., M. Lamei, E. El Taher, and SA Al-Touny. "128 Spinal anesthesia versus general anesthesia in neonates undergoing infraumbilical surgeries regarding hemodynamics and complications." In ESRA 2021 Virtual Congress, 8–9–10 September 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/rapm-2021-esra.128.

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Strumia, A., F. Costa, R. Cataldo, F. Gargano, LM Remore, C. Pantanelli, and FE Agrò. "68 1% Chloroprocaine spinal anesthesia for short duration surgical procedures." In ESRA 2021 Virtual Congress, 8–9–10 September 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/rapm-2021-esra.68.

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