Neuraxial blocks in parturients with scoliosis and after spinal surgery

Sharma, Mouveen; McConachie, Ian

doi:10.4103/2249-4472.191594

Cited by 3 publications

(2 citation statements)

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“…Neuraxial techniques are challenging in patients with operated spine instrumentation [9]. Further neurological adverse events are known in patients with metastatic spine undergoing a SAB [10].…”

Section: Discussionmentioning

confidence: 99%

Impact and Outcomes of Regional Anesthesia Techniques in Elderly Patients With Fracture of Proximal Femur: A Retrospective Study

Diwan¹,

Zundert²,

Nair³

et al. 2021

Cureus

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Background Although subarachnoid block (SAB) is the most popular regional anesthesia (RA) technique for fixation of femur fractures, continuous lumbar epidural (CLE) anesthesia, and lumbosacral plexus blocks (LSPB) are also employed in specific situations. The choice of RA technique depends on either the choice of the anesthesiologist or based on the underlying comorbidities. At our institute, we anesthetize elderly patients who come for fixation of femur fracture with multiple comorbidities using RA techniques as mentioned based on comorbidities and overall general condition. Methods In a cohort of 184 elderly patients, we analyzed RA techniques employed over a period of five years in elderly patients admitted with fractures of the proximal femur, its hemodynamic implications and thus attempted to find the suitable RA technique with minimal adverse events after ethics committee approval. We also compared the length of stay in the hospital in relation to RA techniques. Results The demographic data was comparable with no significant difference in administering the three RA techniques. SAB, CLE and LSPB was implemented at 33.33%, 35.96%, and 30.7% respectively. Perioperative noradrenaline infusion was a feature in patients who received SAB (p<0/001). The higher number of CLE and LSPB patients had a length of stay of fewer than 48 hours whereas most SAB patients had a length of stay of more than 48 hrs (p<0.001). Conclusion Elderly patients with multiple comorbidities should be offered CLE instead of SAB so as to maintain stable hemodynamics. RA technique in an elderly patient with multiple comorbidities should be standardized so as to provide uneventful surgical anesthesia.

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Section: Discussionmentioning

confidence: 99%

Impact and Outcomes of Regional Anesthesia Techniques in Elderly Patients With Fracture of Proximal Femur: A Retrospective Study

Diwan¹,

Zundert²,

Nair³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Preparations should then be made for an intracranial pressure-controlled general anesthetic for surgery in these patients [51]. The preanesthetic evaluation may include referral for magnetic resonance imaging, neurosurgical consultation, and discussion of alternate anesthetic plans when neuraxial anesthesia is contraindicated [52,53].…”

Section: Neurological Neuromuscular and Skeletal Disordersmentioning

confidence: 99%

Complex Pathology and Management in the Obstetric Patient: A Narrative Review for the Anesthesiologist

Metzger¹,

Teitelbaum²,

Weber³

et al. 2021

Cureus

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Pregnant patients may present with multiple complex comorbidities that can affect peripartum management and anesthetic care. The preanesthesia clinic is the ideal setting for early evaluation of high-risk pregnant patients. Comorbidities may include cardiovascular pathology such as valvular abnormalities, septal defects, aortopathies, arrythmias and cardiomyopathies. Additional comorbidities include pulmonary conditions such as obstructive sleep apnea as well as preexisting neuromuscular and skeletal disorders that may impact anesthetic management. Hematologic conditions involving both bleeding diathesis and thrombophilias may present unique challenges for the anesthesiologist. Patients may also present with endocrinopathies including diabetes and obesity. While not as common, high-risk patients may also have preexisting gastrointestinal conditions such as liver dysfunction, renal failure, and even post-transplant status. Ongoing and prior substance abuse, obstetric conditions such as placenta accreta spectrum disorders, and fetal conditions needing ex utero Intrapartum treatment also require advanced planning. Preanesthesia evaluations also help address important ethical and cultural considerations. Counseling patients regarding anesthetic considerations as well as addressing concerns will play a role in reducing racial and ethnic disparities. Anticipatory guidance by means of pre-anesthetic planning can facilitate multidisciplinary communication and planning. This can allow for an impactful and meaningful role in the care provided, allowing for safe maternal care and optimal outcomes.

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Study of Trunk Morphological Imbalance and Rehabilitation Outcome of Adolescent Idiopathic Scoliosis with Intelligent Medicine

Zhao

Huang

et al. 2022

Computational Intelligence and Neuroscience

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In recent years, artificial intelligence technology has been widely used in various medical fields to effectively assist physicians in patient treatment operations. In this paper, we design and implement a deep biblical network model-based orthotic design for adolescent idiopathic scoliosis to quickly and effectively assist physicians in designing orthotics for adolescent idiopathic scoliosis. A fuzzy set is used to express the knowledge of adolescent idiopathic scoliosis orthosis design, and a fuzzy reasoning based on the confidence level is implemented. Finally, the efficiency of the design of adolescent idiopathic scoliosis orthoses was improved by 50% through two cases of adolescent idiopathic scoliosis patients, and the deviation rate between the inference value and the actual operation value of the domain experts was less than 10%.

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Neuraxial blocks in parturients with scoliosis and after spinal surgery

Cited by 3 publications

References 0 publications

Impact and Outcomes of Regional Anesthesia Techniques in Elderly Patients With Fracture of Proximal Femur: A Retrospective Study

Impact and Outcomes of Regional Anesthesia Techniques in Elderly Patients With Fracture of Proximal Femur: A Retrospective Study

Complex Pathology and Management in the Obstetric Patient: A Narrative Review for the Anesthesiologist

Study of Trunk Morphological Imbalance and Rehabilitation Outcome of Adolescent Idiopathic Scoliosis with Intelligent Medicine

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