Accidental catheterization of epidural venous plexus: tomographic analysis

Souza, Mariano Paiva; Magalhães, Edno; Cascudo, Elialba de Farias; Jogaib, Marco Antonio Dias; Silva, Marcelo Carneiro da

doi:10.1016/j.bjane.2013.03.022

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…Epidural venous air embolism has been more frequently described as a complication of epidural anesthetic procedures causing injury of the plexus and resulting in the inadvertent entry of the air into the veins. [10] The air bubbles associated with the venous plexus of the hypoglossal canal in our case could be provided via its relation with the cervical epidural venous plexus, the inferior petrosal sinus and also the IJV. [9] The extracranial air bubbles in the right pterygoid venous plexus and the right superficial temporal vein was thought to be migrated from the dural venous sinuses via emissary veins.…”

Section: Discussionmentioning

confidence: 86%

Retrograde cerebral venous air embolism and the anatomical pathway of air bubbles: a case report

Erok¹,

Kıbıcı²,

Atça³

2020

Anatomy

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Pneumocephalus due to cerebral venous air embolism is an uncommon phenomenon. It results from retrograde progression of low weight air bubbles into dural venous sinuses during manipulation of a venous catheter, more frequently a central venous catheter through the subclavian and the jugular veins. However, it may also occur in relation with a peripheral intravenous catheter as in our case. We report a 91 year old female patient with congestive heart failure who had been examined in our emergency department two days previously due to dyspnea and received diuretic treatment through a peripheral intravenous line. She presented with vomiting and headache without obvious neurological deficits. Non-contrast cranial CT scan revealed wide spread punctate air bubbles inside and outside the cranial vault (pneumocephalus), within the venous system. The pneumocephalus was considered as iatrogenic due to the previous peripheral venous catheterization that resulted in retrograde migration of air bubbles through various venous connections into dural venous sinuses and extracranial veins. Since cerebral venous air embolism is a potentially serious complication of various medical procedures, it should be considered in differential diagnosis of nontraumatic headache and vomiting especially when there is a recent manipulation of venous lines. Cranial CT scan is helpful for early diagnosis.

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Section: Discussionmentioning

confidence: 86%

Retrograde cerebral venous air embolism and the anatomical pathway of air bubbles: a case report

Erok¹,

Kıbıcı²,

Atça³

2020

Anatomy

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“…Указанные осложнения требуют глубоких знаний о строении, топографии и возрастных преобразованиях внутренних позвоночных венозных сплетений. Это необходимо, в первую очередь, анестезиологам, нейрохирургам, травматологам, неврологам и специалистам по лучевой диагностике [9][10][11][12].…”

Section: оригинальные исследованияunclassified

Regional features of the internal vertebral venous plexus

Gaivoronsky¹,

Родионов²,

Bulyshchenko³

et al. 2020

Medical news of the North Caucasus

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Военно-медицинская академия им. С. м. Кирова, Санкт-петербург, Российская Федерация 2 Санкт-петербургский государственный университет, Российская Федерация 3 Национальный медицинский исследовательский центр им. В. А. Алмазова, Санкт-петербург, Российская Федерация regional feaTures of The inTernal VerTeBral Venous pleXus gaivoronsky i. V. 1, 2 , rodionov a. a. 2 , Bulyshchenko g. g. 1 , nichiporuk g. i. 1, 2 , gaivoronskaya m. g. 2, 3 , gaivoronsky a. i. 1, 2 1 s. m. Kirov military medical academy, st. petersburg, russian federation 2 st. petersburg state university, russian federation 3 V. a. almazov national medical research center, st. petersburg, russian federation На 32 препаратах позвоночного столба взрослых людей II периода зрелого возраста с применением инъекционных и коррозионных методик, стереоэпидуроскопии и пироговских срезов изучено венозное русло эпидурального пространства. Представлена топографическая анатомия внутреннего позвоночного венозного сплетения и особенности его строения в разных отделах позвоночного канала. Выделены магистральная, смешанная и сетевидная формы изученного сплетения. Приведены данные об изменениях площади поперечного сечения внутреннего позвоночного венозного сплетения в кранио-каудальном направлении. Рассмотрены структурно-функциональные характеристики венозного сплетения, его взаимоотношения с соединительнотканными структурами эпидурального пространства и их прикладное клиническое значение. Для предупреждения возможных осложнений во время выполнения различных врачебных манипуляций представлены данные об аваскулярных зонах эпидурального пространства. Исходя из анатомических особенностей топографии дугообразных анастомозов задних продольных вен внутреннего позвоночного сплетения, в разных отделах выделены зоны, манипуляции в которых можно проводить с большой степенью осторожности: опасной зоной является уровень С I-VII , Th I-XII ; зоной относительной безопасности-уровень L I-L V ; безопасной-зона S IS IV. Ключевые слова: вариантная анатомия, внутреннее позвоночное венозное сплетение, коррозионный препарат, позвоночный канал, позвоночный столб, эпидуральное пространство The venous bed of the epidural space was studied in 32 preparations of the vertebral column of adults of the II period of adulthood using injection and corrosion techniques, stereoepiduroscopy and Pirogov sections. The topographic anatomy of the internal vertebral venous plexus and the features of its structure in different parts of the spinal canal are presented. The main, mixed, and reticular forms of the studied plexus are distinguished. Data on changes in the cross-sectional area of the internal vertebral venous plexus in the cranio-caudal direction are presented. The structural and functional characteristics of the venous plexus, its relationship with connective tissue structures of the epidural space and their practical significance are considered. To prevent possible complications of various medical procedures, data on avascular zones of the epidural space are presented. Based on the anatomical featur...

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“…This is due to the risk of accidental catherisation of the epidural venous plexus at insertion, or through migration of the catheter. The risk of inadvertent catherisation of the epidural venous plexus is 9% (Souza et al, 2016). Once systemically absorbed by the mother, these medications can then cross the placenta with potential side effects for the fetus.…”

Section: Epidural Analgesia Side Effectsmentioning

confidence: 99%

Giving Birth on a Beach Women's Experiences of Using Virtual Reality in Labour A Pragmatic Mixed Methods Approach

Massov¹

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Birth is a normal physiological process, and many women want a natural birth. However, there is worldwide concern over the increasing use of epidural analgesia and other pharmacological pain relief methods for women in labour. This tendency renders birth non-physiological by increasing the use of obstetric interventions with associated risks. Women use a range of non-pharmacological pain relief methods to reduce labour pain intensity, to help manage labour pain and to induce relaxation. The purpose of this study was to explore the experiences of women using virtual reality (VR) as a non-pharmacological method of pain relief in labour and to determine whether there was an effect on labour pain intensity. Virtual reality has been shown to be an effective distraction technique in other acute pain settings and also reduces anxiety. This study used a pragmatic mixed method approach with a sequential exploratory design, combining in-depth antenatal and postnatal interviews with an intervention study in labour in a cross-over within-subjects trial. Thematic analysis was used to analyse the qualitative data. Twenty-six pregnant women were recruited to the study. Fourteen participants reported their pain and had their heart rate and blood pressure measured during active labour while using and not using VR. There were significantly lower reported pain scores (6.14 compared to 7.61, p =<.001) and maternal heart rate (79.86 beats per minute compared to 85.57, p = .033) and mean arterial pressure (88.78 mmHg compared to 92.61 mmHg, p = .022) were lower when using VR during active labour. These differences were all statistically significant. Findings from qualitative postnatal interviews indicated a positive response to the use of VR in labour. Several themes were identified in the data. The first theme, Impact of VR on Labour, described the impact of VR on labour in terms of distraction, relaxation, enjoyment and a positive birth experience. The second theme, Managing the Pain, describes how VR was used by the women to manage their labour pain using breathing techniques and gaining a sense of control. In the third theme, The Challenges and Surprises of Using VR in Labour, women’s narratives recounted the various challenges of using the VR technology. Despite these challenges, ninety-four percent of women reported that they would use VR in labour again and would recommend it to a pregnant friend. This study provides a unique and original contribution to the field of VR in labour and birth. It is consistent with other recent findings of reduced pain with the use of VR, and links decreased pain scales to heart rate and blood pressure, the physiological markers of pain. It also identifies VR as an acceptable and positive experience in the management of labour pain. Results from this study have the potential to inform design for future labour specific VR environments and expand its application in the field of biomedical technology.

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Accidental catheterization of epidural venous plexus: tomographic analysis

Abstract: It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter.

Cited by 5 publications

References 3 publications

Retrograde cerebral venous air embolism and the anatomical pathway of air bubbles: a case report

Retrograde cerebral venous air embolism and the anatomical pathway of air bubbles: a case report

Regional features of the internal vertebral venous plexus

Giving Birth on a Beach Women's Experiences of Using Virtual Reality in Labour A Pragmatic Mixed Methods Approach

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