Effect of Epidural Anesthesia and Analgesia on Perioperative Outcome

Park, Woo Young; Thompson, Jon S.; Lee, Kelvin K.

doi:10.1097/00000658-200110000-00015

Cited by 391 publications

(58 citation statements)

References 17 publications

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“…[89] Management of these responses with good post-operative analgesia is important in reducing post-operative morbidity and mortality. Hence the combination has an advantage of early recovery and mobilization.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy

et al. 2014

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Non-obstetric diseases during pregnancy are not uncommon. The presence of systemic disease may further insult the pregnancy leading to alteration in the normal function of other system. Hence, it is important to treat the disease depending upon the severity and type of urgency. Several systemic diseases in pregnancy and management have been reported earlier but it is necessary to report a rare pathology, treatment option and its anesthetic management. We report anesthetic management of a rare case of pseudo pancreatic cyst in a pregnant lady operated for cysto-gastrostomy and also highlighting the recent guidelines for non-obstetric surgery in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy

et al. 2014

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“…Reports have been published on its effects and efficacy [3-5,9]. In the clinical setting, anesthesia is sometimes inadequate despite an indwelling epidural tube.…”

Section: Discussionmentioning

confidence: 99%

Use of Imaging Agent to Determine Postoperative Indwelling Epidural Catheter Position

et al. 2010

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BackgroundEpidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain.MethodsIn this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging.ResultsThe indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery.ConclusionsAlthough the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.

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“…For the practice of obstetric anesthesia, it is widely accepted that regional techniques have an advantage for maternal mortality 11,12. This mortality advantage has been asserted in other patient populations, but the results have not been as reproducible 13,14. Anecdotally, an opinion held by many anesthesiologists is that primary regional anesthesia is the safest form of anesthesia for patients with the most critical comorbidities.…”

Section: Utility Of Regional Anesthesiamentioning

confidence: 99%

Neurological adverse events following regional anesthesia administration

Kent

2010

LRA

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Regional anesthesia and analgesia have been associated with improved analgesia, decreased postoperative nausea and vomiting, and increased patient satisfaction for many types of surgical procedures. In obstetric anesthesia care, it has also been associated with improved maternal mortality and major morbidity. The majority of neurological adverse events following regional anesthesia administration result in temporary sensory symptoms; long-term or permanent disabling motor and sensory problems are very rare. Infection and hemorrhagic complications, particularly with neuraxial blocks, can cause neurological adverse events. More commonly, however, there are no associated secondary factors and some combination of needle trauma, intraneural injection, and/or local anesthetic toxicity may be associated, but their individual contributions to any event are difficult to define.

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Effect of Epidural Anesthesia and Analgesia on Perioperative Outcome

Cited by 391 publications

References 17 publications

Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy

Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy

Use of Imaging Agent to Determine Postoperative Indwelling Epidural Catheter Position

Neurological adverse events following regional anesthesia administration

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