Anesthesiology
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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 7.
Access to U.S. Burn Centers Varies by Region
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Title: Access to U.S. Burn Centers Varies by RegionCategory: Health NewsCreated: 10/27/2009 4:10:00 PMLast Editorial Review: 10/28/2009
Source: MedicineNet Chronic Pain General - October 28, 2009 Category: Anesthesiology Source Type: consumer
[Audit on preoperative cardiac evaluation before non-cardiac surgery: The importance of a pocket guide to improve the anaesthesist's adhesion to ACC/AHA guidelines.]Email this article to a colleague.
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DISCUSSION: The use of the pocket reminder concerning the ACC/AHA recommendations significantly reduced both the total number of cardiology referrals, and the number of unjustified referrals. The use of a pocket guide may help in reducing both the cost and the postponement of scheduled surgery.
PMID: 19879104 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - October 28, 2009 Category: Anesthesiology Authors: Madi-Jebara S, Chalhoub V, Jabbour K, Yazigi A, Haddad F, Richa F, El-Hage C, Yazbeck P Tags: Ann Fr Anesth Reanim Source Type: journals
More Evidence for Link Between Stroke and Migraine (CME/CE)Email this article to a colleague.
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Individuals with migraine might have an increased risk of ischemic stroke, a meta-analysis showed.
Source: MedPage Today Pain Management - October 27, 2009 Category: Anesthesiology Source Type: news
Ultrasound and pain in children: A reviewEmail this article to a colleague.
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Abstract: Ultrasound guidance has been demonstrated to improve block characteristics in children including shorter block performance time, higher success rates, shorter onset time, longer block duration, less volume of local anesthetic agents and visibility of neuraxial structures.Clinical studies in children suggest that ultrasound guidance has some advantages over more traditional nerve stimulation-based techniques for regional block. However, the advantage of ultrasound guidance on safety over traditional has not been adequately demonstrated in children except ilio-inguinal blocks.There are only a limited number of rand...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Valeria Mossetti, Giorgio Ivani Source Type: journals
Ultrasound and facet blocks: A reviewEmail this article to a colleague.
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Abstract: Facet or zygapophysial joints are considered to be common sources of chronic spinal pain. In addition to causing localized spinal pain, facet joints may refer pain to adjacent structures. Cervical facet-joint pain may radiate to the head, neck, and shoulders. Thoracic facets may produce paraspinous mid-back pain with neuralgic characteristics; and lumbar facet joints may refer pain to the back, buttocks, and proximal lower extremities. Because the facet joint is innervated by the medial branches arising from the posterior rami of the spinal nerve at the same level and a level above the joint, LA blocks of these n...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Laura Bertini, M. Baciarello Source Type: journals
Ultrasound and peripheral blocks for acute and chronic pain: A reviewEmail this article to a colleague.
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Abstract: In the regional anesthesia field we assisted to an increasing study and use of ultrasound imaging for peripheral nerve blocks. This approach has been appreciated for good reliability in terms of clinical outcome of blocks and in terms of safety of the procedure. For this reason, ultrasound guidance is nearing to become the standard of care in regional anesthesia and for postoperative pain management. However, its role in invasive procedures in pain medicine is still discussed. The availability of other imaging techniques and lack of familiarization with ultrasonographic imaging are some of the reasons beneath thi...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Giorgio Danelli, Marco Gardini, Daniela Gemmi, Alessandra Markidis, Federico Bizzarri, Alessandro Dallospedale, Claudio Fattibene, Guido Fanelli Source Type: journals
Psychiatry and chronic pain: Examining the interface and designing a structure for a patient-center approach to treatmentEmail this article to a colleague.
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Abstract: Chronic pain disorders require comprehensive care. While interdisciplinary approaches are recommended, the role of the psychiatrist is often misunderstood. Psychiatrists should be involved with the care of patients with chronic pain as early as possible to maximize response to treatment and improvements in quality of life. Psychiatrists offer an expertise that specifically addresses important deficiencies in the care of patients with chronic pain: (1) the lack of a detailed formulation, (2) the lumping of all psychopathology, and (3) the failure to effectively utilize a rehabilitation model of treatment.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Michael R. Clark Source Type: journals
Pain and physical medicineEmail this article to a colleague.
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Abstract: The first stage of any physical medicine intervention for a patient with pain is an accurate diagnosis. This allows a decision on the proposed therapy to be made according to the clinical picture. Recent classifications of pain allow us to divide pain management treatment into three specific groups, aimed at: (1) cancer pain, (2) pain (acute, sub-acute or chronic) as a symptom of a specific pathology, and (3) chronic non-malignant pain. In this article, we offer a summary of our clinical experience regarding the drafting of rehabilitation plans for patients with pain who have been referred to us.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Elena Dalla Toffola, Maurizio Bejor Source Type: journals
Pain and rheumatology: An overview of the problemEmail this article to a colleague.
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Abstract: Actually pain is a very important health problem, affecting the majority of people, leading to a significant worsening of patients quality of life and being responsible for a large amount of both medical resources’ expenses and indirect costs. Between the different causes of pain, rheumatic conditions are predominant; in fact diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia (FM) and extra-articular rheumatisms (EARs) are not only frequently observed, but are also invariably associated with pain occurrence. According to the wide range of rheumatic diseases described, pain expression ...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Carlomaurizio Montecucco, Lorenzo Cavagna, Roberto Caporali Source Type: journals
Fibromyalgia: The diagnosis and pharmacologic treatmentEmail this article to a colleague.
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Abstract: Fibromyalgia (FM) is a chronic condition characterized by widespread pain and diffuse tenderness along with a constellation of ancillary symptoms. The 1990 ACR criteria for classification of FM are important in enhancing much the research of FM. FM is part of a spectrum of functional somatic syndromes. FM is not a homogenous condition and several subtypes of FM had been determined. The best strategy for management of FM is to use a multidisciplinary approach to treatment using both pharmacological and non-pharmacological interventions.Tramadol, tricyclic drugs, mixed reuptake inhibitors and anticonvulsants show e...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Dan Buskila Source Type: journals
Fibromyalgia: From treatment to rehabilitationEmail this article to a colleague.
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Abstract: Fibromyalgia is a clinical syndrome of chronic widespread pain and reduced pain thresholds to palpation. The pathophysiology remains unknown, but there is increasing evidence that peripheral and central sensitization cause an amplification of sensory impulses that may alter pain perception in fibromyalgia patients. Interventions to treat fibromyalgia should aim at different targets simultaneously in order to reduce peripheral and central sensitization. There are both pharmacologic and non-pharmacologic approaches with evidence for effectiveness in the treatment of fibromyalgia and its associated symptoms. Evidenc...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Marta Imamura, David A. Cassius, Felipe Fregni Source Type: journals
Pain in arthritisEmail this article to a colleague.
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Abstract: Under the term arthritis are grouped a large number of diseases characterized by the occurrence of an inflammatory process within the joints; between the different types of chronic arthritis, rheumatoid arthritis (RA) is the prototypical example. With the increasing importance of early diagnosis and treatment, in the last years several subsets of chronic arthritis have been described, starting from the early arthritis (EAs), term that include all the arthritis of recent onset; within the EAs we recognize the undifferentiated polyarthritis (UPA), that does not fulfill the classification criteria for an established...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Roberto Caporali, Lorenzo Cavagna, Carlomaurizio Montecucco Source Type: journals
Ultrasound and chronic pain: Innovative approachesEmail this article to a colleague.
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Abstract: Ultrasound (US) is an increasingly used imaging technique in interventional pain management. It allows the identification of soft tissues, vessels and nerves, without exposing patients and personnel to radiation. Imaging can be performed continuously and the fluid injected is visualized in a real time fashion. Possible applications are nerve blocks of the cervical and lumbar zygapophysial joints, stellate ganglion block, intercostal and paravertebral nerve blocks, inguinal nerve blocks, occipital nerve blocks, blocks of painful stump neuromas, caudal epidural injections and injections of trigger/tender points. Du...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Andreas Siegenthaler, Michele Curatolo, Urs Eichenberger Source Type: journals
Locoregional anesthesia and anticoagulationEmail this article to a colleague.
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Abstract: Spinal hematoma is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Risk factors include traumatic needle/catheter placement, sustained anticoagulation in an indwelling neuraxial catheter, and catheter removal during therapeutic levels of anticoagulation. Generally, a patient’s coagulation status should be optimized at the time of spinal or epidural needle/catheter placement, and the level of anticoagulation should be monitored during epidural catheterization. Signs of cord compression, such as severe back pain, progression of numbness or weakness, and bowel and bladder dysfunc...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Terese T. Horlocker Source Type: journals
Epidural space and regional anesthesiaEmail this article to a colleague.
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Abstract: Epidural fat provides sufficient cushion for the pulsatile movements of the dural sac, protects nerve structures, facilitates the movement of the dural sac over the periosteum of the spinal column during flexion and extension, and forms a pharmacologic reservoir of lipophilic substances. Root cuffs have a cellular component that affects the passage of substances injected epiduraly or near the intervertebral foramen, depending on the site of injection, preganglionar, postganglionar or ganglionar. We found fat inside root cuffs but not within the dural sac. Fat in this location may have affect kinetics of lipophili...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: José De Andrés, Miguel Angel Reina, Alberto Prats Source Type: journals
Epidural analgesia and laborEmail this article to a colleague.
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Abstract: Whilst women vary in their needs and desire for analgesia in labor it must be acknowledged that neuraxial analgesia is the only technique that can completely relieve the pain of labor. However the technique is not without its own inherent complications, both for the mother and for the process of labor and delivery. In this article the techniques for establishing and maintaining neuraxial analgesia in labor are discussed and the advantages and disadvantages of neuraxial analgesia in labor are explored.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Geraldine O’Sullivan Source Type: journals
Long-term intrathecal morphine influence on major compounds of the endocrine system in elderly populationEmail this article to a colleague.
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Conclusion: Long-term intrathecal opioid administration influenced FSH, LH and GH serum levels. Data on this issue are inadequately described in the literature. The finding of endocrine effects of opioid therapy, nonetheless, cannot be ignored, as it may have clinical relevance in both elderly and young population. We believe that during long intrathecal pain treatments with morphine, clinicians should be aware of both immediate and later opioids side effects, and in particular, they should monitor immune and endocrine changes.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: William Raffaeli, Boaz Gedaliahu Samolsky Dekel, Melotti Rita, Donatella Righetti, Alessandro Caminiti, Marco Balestri, Donatella Sarti, Fanelli Guido Source Type: journals
Systemic opioid and chronic painEmail this article to a colleague.
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Abstract: Opioid analgesic drugs currently represent the most powerful choice in pain therapy. They elicit their effects by mimicking endogenous substances – opioid peptides – the natural ligands of the opioid receptors. These analgesic drugs interact with specific receptors physiologically present in the central nervous system (CNS) and in the periphery, where they serve different functions. The opioid receptors modulate well-known functions related to nociceptive transmission, but this system is also involved in the regulation of gastrointestinal, endocrine, and autonomic functions. Opioids are being prescribed more ...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Giustino Varrassi, Chiara Angeletti, Cristiana Guetti, Franco Marinangeli, Antonella Paladini Source Type: journals
The pharmacological treatment of neuropathic painEmail this article to a colleague.
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We describe characteristics of NP symptoms in order to individualise our therapeutic target and then we list the possible therapeutic drugs for these kinds of symptoms.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: C. Bonezzi, M. Allegri, L. Demartini, M. Buonocore Source Type: journals
Spinal cord stimulation: A brief update on mechanisms of actionEmail this article to a colleague.
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Abstract: Spinal cord stimulation (SCS) originated from the gate control theory by Melzack and Wall some 40 years ago and is now widely practised as a therapy in neuropathic pain of peripheral origin. The physiological mechanisms behind the beneficial effects however are hitherto only fragmentarily known.In this short review the present knowledge is updated with recent data from animal experiments and from clinical observations. SCS used for neuropathic pain and for ischemic seems to utilize fundamentally different mechanisms and in the latter syndromes the primary effect seems to be reduction of tissue ischemia. In neurop...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Bengt Linderoth Source Type: journals
Editorial BoardEmail this article to a colleague.
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Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Source Type: journals
Analysis of a population of patients who were referred to a second level pain center: Clinical and demographic characteristicsEmail this article to a colleague.
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Abstract: Pain is the symptom that leads most patients to ask for medical intervention; if not controlled, pain may become a very costly item in the Italian Health Care system. Proper referral to a second level specialist pain center can extensively decrease the duration of a painful condition, prevent the onset of more pain and of the so-called pain syndromes, and also reduce the improper use of analgesic drugs or pain surgery. Patients should be referred to a specialist pain center when their pain is uncontrolled.In this observational study we analyzed the clinical and demographic data of a population referred for the fi...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: C. Bonezzi, E. Pitino, M. Allegri Source Type: journals
Interindividual variability of drug transporters: Impact on opioid treatment in chronic renal failureEmail this article to a colleague.
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Abstract: Some transmembrane transporters influence the absorption, the tissue distribution and the elimination of opioids, and their genetic variants may be an important factor in therapeutic efficacy and toxicity. Uptake and efflux transporters may facilitate or limit access of opioids to blood–brain barrier (BBB), modulating pain relief. As renal function is crucial in the metabolism and pharmacokinetic profile of any drug, renal failure and end-stage renal disease may alter drug disposition by affecting protein and tissue binding, and reducing systemic clearance of drugs.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Guglielmina Nadia Ranzani, Simona De Gregori, Manuela De Gregori, Mario Regazzi, Stefano Govoni Source Type: journals
Acute postoperative pain as a risk factor for chronic pain after surgeryEmail this article to a colleague.
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Abstract: Chronic postoperative pain is a major clinical problem. Several risk factors, including younger age, female gender, psychological, and genetic factors, have been identified. Surgery itself is the most important risk factor. Preoperative pain and severe acute postoperative pain are also very consistent risk factors for the development of chronic postoperative pain. Theoretically, a reduction of postoperative pain should reduce the risk of developing chronic postoperative pain. The present article will summarize the epidemiology of chronic pain after various surgical procedures. The emphasis will be on the relation...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Lone Nikolajsen, Cristina E. Minella Source Type: journals
Neuropathic pain: Peripheral and central mechanismsEmail this article to a colleague.
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Abstract: Neuropathic pain refers to a specific pain syndrome characterized by pain and sensory abnormalities in body parts that have lost their normal peripheral innervation or sensory representation. They are to be distinguished from other types of pain because of differences in the underlying pathophysiology and treatment. Following a peripheral nerve injury, a cascade of events occurs in primary afferents causing peripheral sensitization. Central sensitization, which is increased responsiveness in central neurons, is usually the result of an increased barrage from the periphery, but may also occur independent of such p...
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Troels Staehelin Jensen, Nanna Brix Finnerup Source Type: journals
Evaluation of peripheral nerve injuryEmail this article to a colleague.
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Abstract: Common etiologies of peripheral nerve injury include penetrating injury, crush, stretch, and ischemia. Management of nerve injury requires familiarity with the relevant anatomy, pathology, pathophysiology, and the surgical principles, approaches and concerns. Surgical repair is done at varying time intervals after the injury, and there are a number of considerations in deciding whether and when to operate. In neurapraxia, the compound muscle action and nerve action potentials on stimulating distal to the lesion are maintained indefinitely; stimulation above the lesion reveals partial or complete conduction block....
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: William W. Campbell Source Type: journals
Efficacy of drugs in regional anesthesia: A reviewEmail this article to a colleague.
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In conclusion, since many different drugs are available for regional anesthesia, we must choose wisely the one that exhibits the best safety-efficacy profile and that suits the chosen technique and type of anesthesia/analgesia best.
Source: European Journal of Pain Supplements - October 27, 2009 Category: Anesthesiology Authors: Massimo Allegri, Marco G. Delazzo, Paolo Grossi, Battista Borghi Source Type: journals
Osmolarity and partitioning of fluidsEmail this article to a colleague.
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Abstract: Substances move down concentration gradients. When fluids are mixed together, they diffuse down their own concentration gradients and come to a dynamic equilibrium such that the concentrations of the various substances in all parts of the medium are the same. When two solutions are separated by a semipermeable membrane (i.e. permeable to the solvent (water) but not the solutes), water moves down its concentration gradient such that the osmotic pressure on both sides of the membrane is the same. Cell membranes are effectively semipermeable membranes. Water passes freely but the movement of solutes across the membr...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Iain Campbell Tags: Physiology Source Type: journals
Laboratory tests in hepatic failureEmail this article to a colleague.
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[Anaesthesia and Intensive Care Medicine 2009; 326–7] Unfortunately, the first author's name was misspelt in the article Laboratory tests in hepatic failure in the July 2009 issue. The correct author details are reproduced here.
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Tags: Erratum Source Type: journals
MCQsEmail this article to a colleague.
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For further relevant MCQs, see Anaesthesia and Intensive Care Medicine 7: 436 (www.anaesthesiajournal.co.uk) (pages 528–9)
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Tags: Test yourself Source Type: journals
Anatomy of the spinal nerves and dermatomesEmail this article to a colleague.
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Abstract: There are 31 pairs of spinal nerves: eight cervical, 12 thoracic, five lumbar, five sacral and one coccygeal. They form by fusion of a posterior sensory spinal root (bearing its posterior root ganglion) with an anterior motor root. These join at each intervertebral foramen. Typically, the nerve then divides into a posterior and an anterior primary ramus. The former supplies the vertebral muscles and dorsal skin. The anterior primary ramus in the thoracic region bears a white ramus communicans to the sympathetic ganglion. Each spinal nerve receives a grey ramus from the sympathetic chain. The nerves T2–T12 suppl...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Harold Ellis Tags: Regional anaesthesia Source Type: journals
Adjuvant agents in regional anaesthesiaEmail this article to a colleague.
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Abstract: Adjuvant drugs are agents that, when co-administered with local anaesthetic agents, may improve the speed of onset, the quality and/or duration of analgesia. A wide range of drugs have been assessed for both neuraxial and peripheral nerve blocks. Here, we review the adjuvants used in clinical practice in the UK and also briefly mention other drugs that have been used for neuraxial administration to provide perioperative analgesia.
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Sudhakar R. Marri, Matthew R. Checketts Tags: Regional anaesthesia Source Type: journals
Regional anaesthesia in patients taking anticoagulant drugsEmail this article to a colleague.
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This article attempts to put the risks of these complications into context, with reference to different classes of anticoagulant drugs.
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Matthew R. Checketts Tags: Regional anaesthesia Source Type: journals
Does regional anaesthesia improve outcome?Email this article to a colleague.
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Abstract: There is conclusive evidence that regional anaesthesia techniques provide a quality of postoperative analgesia that is better than systemic opioid techniques. Continuous, effective postoperative analgesia is a worthwhile humanitarian aim in its own right, but regional anaesthesia also has the potential to improve the functional outcome from surgery. Proving that regional anaesthesia can influence the outcome of surgery is challenging; many studies are inconclusive with methodological weaknesses making comparison difficult and offering conflicting evidence. Large systematic reviews offer better evidence that regio...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Barrie Fischer Tags: Regional anaesthesia Source Type: journals
Spinal anaesthesiaEmail this article to a colleague.
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Abstract: Spinal anaesthesia is the injection of local anaesthetic into the subarachnoid space. It is a simple technique that can be used to provide surgical anaesthesia for procedures involving the abdomen, pelvis and lower limbs. To perform the technique safely, it is important to understand the physiology of the block and the pharmacology of the drugs commonly used. Although serious complications are rare, they must be recognized and managed quickly.
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Christina L. Beecroft Tags: CORE - Technical skills Source Type: journals
Techniques of epidural blockEmail this article to a colleague.
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Abstract: Spinal, epidural and caudal blockade are the three components of central neuraxial blockade, and provide surgical anaesthesia and postoperative analgesia for sub-umbilical surgery (thoracic epidurals provide effective analgesia but not anaesthesia for thoracic and upper abdominal surgery). While spinal and caudal blocks are usually performed as single-shot bolus techniques in adults and provide 2–4 h postoperative analgesia, epidural techniques can provide prolonged postoperative analgesia by inserting an epidural catheter and infusing a dilute local anaesthetic and opioid drug combination. Although useful regi...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Barrie Fischer Tags: CORE - Technical skills Source Type: journals
Acid–base balance: maintenance of plasma pHEmail this article to a colleague.
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Abstract: Homeostatic control of plasma pH (range 7.38–7.42) – defence of the alkaline environment in the face of massive daily acid production – is an essential requirement for life. This is achieved through three lines of defence: physico-chemical buffering, rapid respiratory changes in pCO2, and slow renal changes in H+ excretion and HCO3− reabsorption and production. Disturbances in acid–base balance are described according to the cause of a primary change in either pCO2 (respiratory acidosis, respiratory alkalosis) or plasma HCO3− concentration (metabolic acidosis, metabolic alkalosis). Buffering and respi...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: John C. Atherton Tags: Physiology Source Type: journals
ContentsEmail this article to a colleague.
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Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Source Type: journals
Editorial BoardEmail this article to a colleague.
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Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Source Type: journals
Medical gases, their storage and deliveryEmail this article to a colleague.
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Abstract: Medical gas production supply and distribution is a closely regulated process with many intrinsic safety designs and procedures. Supply and storage of both bulk and cylinder based systems are reviewed together with the production of common anaesthetic gases.
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: David Highley Tags: Clinical anaesthesia Source Type: journals
The sacrum and caudal blockEmail this article to a colleague.
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Abstract: Typically, the sacrum represents five fused sacral vertebrae. Variations are common: lumbarization of S1, sacralization of L5 and fusion of the coccyx. Frequently, a degree of spina bifida occulta is seen. The sacrum has a central mass, four anterior sacral foramina and a lateral mass. The foramina transmit the anterior primary rami of S1–S4. The wings of the sacrum (the alae) are crossed by the lumbosacral trunk, L4 and L5, which joins the sacral plexus. Posteriorly, a median crest ends below as the sacral hiatus, bearing the cornu on either side. The hiatus is covered posteriorly by the tough posterior sacroc...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Harold Ellis Tags: Regional anaesthesia Source Type: journals
The spinal cord and its membranesEmail this article to a colleague.
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Abstract: The spinal cord is 45 cm long in the adult. In the early foetus, it extends the length of the vertebral canal; differential growth results in its termination at L3 in the newborn. In the adult it terminates, as the conus medullaris, at the disc between L1 and L2, although there is a range from T12 to L3. Inferiorly, the nerve roots form the cauda equina, while the lower end of the cord is attached by the filum terminale, of pia mater, to the coccyx. The dural sac terminates usually at the second segment of the sacrum. The cord receives its arterial supply from the anterior and posterior spinal arteries, which des...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Harold Ellis Tags: Regional anaesthesia Source Type: journals
The anatomy of the epidural spaceEmail this article to a colleague.
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Abstract: The epidural space is important to the anaesthetist as the site for epidural block. It surrounds the spinal part of the dura and extends from the foramen magnum of the skull to the sacral hiatus. It contains the vertebral plexus of veins, small arteries, lymphatics and the epidural fat. This fat is loose and allows injected fluid to diffuse through it. The space projects through each intervertebral canal to lie behind the parietal pleura, whose negative pressure is transmitted to it. Anteriorly, the space lies against the posterior aspects of the vertebral bodies covered by the posterior longitudinal ligament. Al...
Source: Anaesthesia and intensive care medicine - October 27, 2009 Category: Anesthesiology Authors: Harold Ellis Tags: Regional anaesthesia Source Type: journals
Big, Beefy Football Players May Face Heart Problems LaterEmail this article to a colleague.
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Title: Big, Beefy Football Players May Face Heart Problems LaterCategory: Health NewsCreated: 10/26/2009 12:10:00 PMLast Editorial Review: 10/27/2009
Source: MedicineNet Chronic Pain General - October 27, 2009 Category: Anesthesiology Source Type: consumer
Transient neurological symptoms after spinal anaesthesia with levobupivacaine 5 mg/ml or lidocaine 20 mg/mlEmail this article to a colleague.
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Transient neurological symptoms (TNS) after spinal anaesthesia have been reported most commonly in association with lidocaine, but have been observed with other local anaesthetics. The aim of this prospective, randomized, double-blind study was to investigate the incidence of TNS after spinal anaesthesia with either levobupivacaine or lidocaine. Patients undergoing inguinal hernia, appendectomy, varicose vein or minor orthopaedic operations were included in the study (60 patients; 47 male, 13 female, overall mean age 30 years). All patients had an American Society of Anesthesiologists score of I or II. The patients were ra...
Source: Acta Anaesthesiologica Scandinavica - October 27, 2009 Category: Anesthesiology Authors: M. GOZDEMIR, B. MUSLU, H. SERT, B. USTA, R. I. DEMIRCIOGLU, O. F. KARATAS, O. SURGIT Source Type: journals
The Role of Catastrophizing in the Prediction of Postoperative PainEmail this article to a colleague.
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Conclusions. The present study findings suggest that it is possible to preoperatively identify patients at risk for experiencing more severe pain in the postoperative recovery period. In such cases, consideration might be given to utilizing a variety of resources to ameliorate or prevent pain.
Source: Pain Medicine - October 27, 2009 Category: Anesthesiology Authors: Marianna Papaioannou, Petros Skapinakis, Dimitris Damigos, Venetsanos Mavreas, Georgios Broumas, Androniki Palgimesi Source Type: journals
Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis.Email this article to a colleague.
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CONCLUSIONS: It is unnecessary to delay surgery in order to deliver a preload of fluid. Regardless of the fluid loading strategy, the incidence of maternal hypotension is high. Prophylactic or therapeutic vasopressors may be required in a significant proportion of patients.
PMID: 19859776 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - October 27, 2009 Category: Anesthesiology Authors: Banerjee A, Stocche RM, Angle P, Halpern SH Tags: Can J Anaesth Source Type: journals
Ultrasound assessment of the vertebral level of the palpated intercristal (Tuffier's) line.Email this article to a colleague.
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CONCLUSIONS: According to ultrasound, the palpated intercristal line falls at the L3-4 interspace, or below, in the majority of subjects positioned for neuraxial block in the sitting position. A palpated intercristal line at L2-3 was more likely in tall and male individuals.
PMID: 19859775 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - October 27, 2009 Category: Anesthesiology Authors: Pysyk CL, Persaud D, Bryson GL, Lui A Tags: Can J Anaesth Source Type: journals
Common Knee Pain May Improve With TherapyEmail this article to a colleague.
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Title: Common Knee Pain May Improve With TherapyCategory: Health NewsCreated: 10/23/2009 4:10:00 PMLast Editorial Review: 10/26/2009
Source: MedicineNet Chronic Pain General - October 26, 2009 Category: Anesthesiology Source Type: consumer
The Role of OROS® Hydromorphone in the Management of Cancer PainEmail this article to a colleague.
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The vast majority of cancer patients experience pain, and treatment with opioids offers the most effective option for pain management. Long-lasting opioid formulations are usually used as cancer pain management strategies. This review surveys the available literature on the only available once-daily sustained-release formulation of hydromorphone, and its use in cancer pain management. Sustained-release (SR) formulations have a more consistent opioid plasma concentration, thereby minimizing the peaks and troughs associated with immediate-release opioid formulations. OROS® hydromorphone (Jurnista[trade], Janssen Pharmaceuti...
Source: Pain Practice - October 26, 2009 Category: Anesthesiology Authors: Jackie Gardner-Nix, Sebastiano Mercadante Source Type: journals
