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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

100 women ranging in age from 26-34 years were followed up for 4-21 months after undergoing sterilization by tubal occlusion using intraluminal threads and silver clips. The number of children/woman ranged from 1-5 with 80% having 2. 31 women underwent sterilization postmenstrually, 11 midmenstrually, 28 premenstrually, 12 after abortion, and 8 during lactation. The timing was unknown in 8 cases. The silver clips used were hook eye "db" shaped, 3 mm wide, .5 mm thick, and 70, 100, or 150 mg in weight. Local anesthesia, suprapubic small abdominal incision, and oviduct delivery were the usual procedures. The clips were placed where the tube is relatively straight and avascular, often near the isthmus or ampulla. No. 4 nylon thread was drawn through the tube and a silver clip was put on each tube and tightened until the threads could no longer be moved. The extra thread was snipped off about 3 mm from the clip. There were no pregnancies among 95 patients followed up. 18 patients had varying degrees of lumbago or leg pain and 1 complained of serious lower abdominal pain, especially after coitus. Pelvic examination in 74 patients showed 1 case of slight thickening in the right appendix region but no pelvic masses. Hysterosalpingography in 22 patients showed 1 case with incomplete occlusion on 1 side. The method is believed to be safe and suitable for use in smaller hospitals and outpatients. Reversibility has been demonstrated in rabbits.
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PMID:Oviduct occlusion by intraluminal thread and silver clips. 641 60

The technique of large volume caudal extradural injection of a solution containing bupivacaine hydrochloride, hydrocortisone acetate and methylprednisolone acetate for low back pain is described. The results of 500 such injections are reviewed. The technique provides a rapid safe method for the treatment of low back pain. Pain was relieved in over half the patients treated by a single injection.
Anaesthesia 1980 May
PMID:Caudal extradural injection for the treatment of low back pain. 644 64

Lumbar vertebral body and disk infection, presenting as low back pain, is a relatively uncommon disease but is seen more often in drug addicts. Radiographs show typical changes of infection of the lumbar vertebrae and adjacent disc. Under local anesthesia a fine needle is placed, saline injected, and aspirated. The entire needle-syringe unit is submitted to the bacteriology department. Pseudomonas infection is usually found. This method of diagnosis is simple, cost effective, well accepted by the patients, and can be done on outpatients.
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PMID:Fine needle diagnosis in lumbar osteomyelitis. 663 91

A case is presented of a pregnant heroin addict patient, with a septic sacro-iliitis due to Staphylococcus aureus. The incidence of joint infections in heroin addicts and the difficulty of diagnosis is discussed with the potential risks of spinal or extradural anaesthesia when there is infection in joints close to the needle site. Caution is advised with patients addicted to heroin who have low back pain and may have infectious sacro-iliitis.
Anaesthesia 1984 Feb
PMID:Sacro-iliitis in a heroin addict. A contra-indication to spinal anaesthesia. 670 71

Cauda Equina Compression (CEC) is a clinical syndrome consisting of low back pain, bilateral sciatica, saddle anesthesia, bilateral lower extremity weakness, and even frank paraplegia with bowel and bladder incontinence. At the onset of CEC, the clinical picture may resemble typical intervertebral disk disease with low back pain and unilateral sciatica. The back pain is severe, overshadowing the leg pain, and should alert the physician to the periodic evaluation of the patient and evidence of a progressive neurologic deficit. Early discovery of CEC is necessary if neurologic recovery is to be expected from decompressive laminectomy.
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PMID:Cauda equina syndrome presenting as a herniated lumbar disk. 737 4

Biomechanical experiments have shown high stability and load acceptance of the pelvis if the external device is mounted as a trapezoid compression frame. Clinical results in 22 patients with double vertical pelvic fractures illustrate the reduction of displaced pelvic fractures and the mounting of the frame. Reduction is obtained under general anesthesia within two days of the trauma. The external compression frame affords noteworthy relief of pain in all patients and greatly facilitates nursing. The patients were verticalized three weeks later and the frame removed six weeks after its applcation. There was one death. The early stabilization of the pelvis and consequently controlled hemorrhage may have contributed to the low mortality. At follow-up, the radiographic result was graded as excellent in 15 cases, good in four cases and poor in two cases. Impaired gait was recorded in two patients and persistent low back pain in one. The trapezoid compression frame is applied as soon as possible after admission of all patients with severely unstable pelvic fractures.
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PMID:External fixation of unstable pelvic fractures: experiences in 22 patients treated with a trapezoid compression frame. 741 26

A 50-year-old man had an inguinal hernia repair under spinal anaesthesia with bupivacaine. On the 2nd postoperative day, he complained of backache and paresis at the posterior part of the lower extremities, well relieved by non-steroidal anti-inflammatory drugs. On the 6th postoperative day, he came back to hospital, because of low back pain associated with a heavy feet sensation. The hypothesis of a neurological complication of the spinal anaesthesia was considered. The interview of the patient revealed a history of lumbar disk disease, not reported during the preoperative visit. After an in depth clinical examination, two causes seemed possible: subarachnoid haematoma and lumbar disk protusion. Against the first diagnosis were the initial clinical signs. However, in many cases, objective neurological deficit arise too late to allow efficient neurosurgical treatment. Thus, a MRI examination was performed which is non invasive in comparison with a computed tomography myelogram. In our patient, it did not detect a true lumbar disk protusion, but a simple degenerative disease of the L5-S1 disk. In suppressing the lumbar lordosis, spinal anaesthesia probably allowed a distension of spinal capsules and tendons, responsible for the troubles.
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PMID:[Delayed low back pain after spinal anesthesia]. 748 83

Nerves leave the spinal cord as mainly motor primary rootlets and sensory rootlets. These join to nerve root before leaving the spinal canal. After the root canal, the nerve root branches into the ventral root, which contains sensory and motor fibers innervating the extremities, and the dorsal root, that is, the dorsal ramus, which innervates the posterior structures, for example, back muscles: the dorsal ramus itself may become irritated (dorsal ramus syndrome). Especially predisposed to entrapment is the medial branch of the dorsal ramus, which innervates the multifidus muscle and also contains pain fibers. Here we describe the influence of local anesthesia and back-muscle-training therapy on subjective and objective pain parameters in 21 low-back-pain patients who had similar clinical status and neurophysiologic findings and whose recurrent low back pain was most apparently associated with dorsal ramus neuropathy, without any radiologic or neurophysiologic evidence of more proximal ventral nerve root damage in the spinal cord or at the nerve root origin. After treatment, all were pain free and back muscle activity during lumbar-pelvic rhythm was normalized.
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PMID:Dorsal ramus irritation associated with recurrent low back pain and its relief with local anesthetic or training therapy. 771 74

Low back pain is a common reason for physician visits and is associated with enormous costs to health care and industry. Radiographic abnormalities of the lumbar spine, including disk protrusion, are common in asymptomatic subjects and only loosely associated with symptoms and neurologic examination. Therefore, highly selective evaluation is required to avoid subjecting patients with back pain to unnecessary tests and surgical procedures. Reassurance about the favorable prognosis of low back pain is an important component of therapy. Most patients with simple back pain recover with symptomatic treatment. Plain radiographs are indicated for evaluation of patients with radiculopathy and those with risk factors for underlying medical conditions. The majority of patients with back pain, even those with radiculopathy, improve with conservative management and surgery is unnecessary. Surgical consultation and CT or MR imaging scans are indicated for patients with persistent or progressive neurologic deficits or persistent sciatica with nerve root tension signs. Acute radiculopathy with bilateral neurologic deficits, saddle anesthesia, or urinary symptoms is suggestive of cord compression or cauda equina syndrome and requires urgent surgical referral.
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PMID:Low back pain. 787 88

A 36-year-old woman was scheduled for Cesarean section under spinal anesthesia. She was a carrier of hepatitis-B-virus and diabetic. She was complaining of low back pain. Spinal anesthesia was performed in the left lateral decubitus position. Because lumbar puncture in the midline was difficult, left paramedian approach was tried. Then she began to complain of right leg pain. Another attempt was made at other site, but her pain was not relieved. After confirming drop of blood-tinged cerebrospinal fluid, 0.3% dibucaine 2.0 ml was injected. Sensory anesthesia was assessed by pin-prick, but anesthesia was not effective. Then epidural catheter was inserted at Th12-L1 using median approach. She received 1.0% lidocaine 15 ml. However, sensory anesthesia was insufficient (Th4-Th12). Therefore O2-N2O was administered in addition to regional anesthesia. After the delivery, she still complained of low back pain. Later examination revealed metastatic bone tumor of L2 from hepatoma. This case suggests that in a patient with such incomplete spinal or epidural anesthesia and neurological finding, vertebral metastatic tumor should be ruled out.
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PMID:[A case of vertebral metastasis revealed by incomplete spinal analgesia for cesarean section]. 793 77


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