Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Headache and low back pain are common minor complications after epidural anaesthesia. Headache is due to cerebrospinal leakage through the site of accidental dural puncture. Epidural blood patch is considered as the better curative treatment. Acute or long term backache is often reported after epidural anaesthesia. Different mechanisms are suggested: needle trauma, myotoxicity of local anaesthetic and postural problem. Large prospective randomized studies are yet necessary to clarify the role of epidural anaesthesia, the duration of symptoms and the therapeutic.
 ...
PMID:[Headache and low back pain after epidural anesthesia]. 808 42

A 58-year-old man underwent surgery for an inguinal hernia. Surgery was performed under epidural anaesthesia. The patient afterwards developed increasing low back pain. Magnetic resonance imaging showed an epidural abscess, which was drained by laminectomy. The patient recovered without neurological sequelae.
 ...
PMID:[An abscess as an unexpected complication following epidural anesthesia]. 813 25

We report two cases of successful pregnancy in women with chronic, infantile onset, or type II spinal muscular atrophy, both of whom delivered healthy, unaffected babies. The patients required concurrent management by a physiatrist, pulmonologist, and perinatologist throughout the pregnancy. Complications included recurrent urinary tract infections, dyspnea and worsening of pulmonary function, wheelchair seating and positioning problems, and musculoskeletal and low back pain. These problems resolved postpartum. One woman had vaginal delivery, the other had caesarean section, both of which were well-tolerated. Because of severe musculoskeletal deformity, pelvic assessment is necessary to determine the mode of delivery. The uterus has normal contractility and effective labor patterns can be established. Spinal/epidural anesthesia may be contraindicated because of spine deformity. The pregnancies had no deleterious effect on the progression of the disease in our patients, both of whom reported a positive experience with great personal fulfillment.
 ...
PMID:Successful pregnancies in the presence of spinal muscular atrophy: two case reports. 831 83

BACKGROUND. Pneumocephalus developed in a 45-year-old woman after epidural anesthesia was performed to treat her low back pain. The cause was thought to be the loss of resistance to air technique. The clinical symptoms were immediate headache independent of posture, pallor, bradycardia, and hypotension. These symptoms disappeared during the first 24 hours with no neurologic sequelae. CONCLUSION. This case suggests that using the loss of resistance technique with saline versus air should prevent this complication, especially after unintentional dural puncture or when, in difficult placements, the technique is repeated frequently in the same patient.
 ...
PMID:Pneumocephalus after accidental dural puncture during epidural anesthesia. 820 69

More than 410,000 people participated in the National Marrow Donor Program (NMDP) as of October 1, 1991, and more than 850 volunteers had donated marrow. While the incidence of serious morbidity as a result of bone marrow donation is rare, the incidence of lesser complications and the long-term consequences of marrow donation are not known. To determine the incidence of donor complications and measure the recovery time of volunteer, unrelated marrow donors, we analyzed the results of surveys of the first 493 persons who donated marrow through the NMDP. The marrows were collected at 42 centers. The median age of the donors was 37.9 years (range 19.1 to 55.6 years). The median volume of marrow collected was 1,050 mL (range 180 to 2,983 mL). Autologous red blood cells were transfused to 89.8% (439) of donors but only 0.6% (3) of donors received allogeneic blood. Acute complications related to the collection procedure occurred in 5.9% of donors; but a serious complication, apnea during anesthesia, occurred in only one donor. When donors were questioned approximately 2 days following discharge from their hospitalization, most donors described symptoms related to the collection; 74.8% experienced tiredness, 67.8% experienced pain at the marrow collection site, and 51.6% of the donors experienced low back pain. Donors were surveyed repeatedly until they felt that they had recovered completely. Mean recovery time was 15.8 days; however, 42 (10%) donors felt that it took them > or = 30 days to recover fully. The duration of the marrow collection procedure and duration of anesthesia both positively correlated with donor pain and/or fatigue following the collection; but the duration of the collection procedure had the highest correlation with post-collection pain and fatigue. The volume of marrow collected per unit of donor weight was more weakly correlated with donor pain and/or fatigue than the anesthesia and collection times. When multivariate analysis was used to analyze the correlation between donor recovery time and these variables, only the duration of the collection was found to correlate significantly with donor recovery time (P = .001). This analysis demonstrates that marrow donation is well tolerated with few complications. To decrease further the incidence of donor discomfort and recovery time following donation, the duration of the collection procedure, and probably the duration of anesthesia, and the volume of marrow collected, should be kept to a minimum.
 ...
PMID:Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program. 846 78

We reviewed the out-patient consultation notes of 136 pregnant women seen at the Ottawa Civic Hospital from 1985 to 1991 to evaluate the efficacy of an Obstetric Anaesthesia Assessment Clinic (OAC). In addition, their anaesthetic records from labour and delivery were reviewed. For each patient the reason for referral was recorded according to the involved organ system. The anaesthetic management at delivery was compared with the proposed anaesthetic plan by the OAC consultant (obstetric anaesthetist). The majority of women 84 (62%) had complaints related to the musculo-skeletal system. In addition, 18 patients were referred because of previous anaesthetic problems, ten with a history of cardiac disease, and eight with neurological disease. Lumbar epidural analgesia (LEA) was a safe and effective choice for parturients with low back pain, history of lumbar fractures or single level discectomies without lumbar fusion. Parturients with posterior instrumentation experienced an increased incidence of inadequate pain relief from LEA. Individualized anaesthetic management plans were executed for parturients with spina bifida occulta, neurological, cardiac, and haematological disease as well as for women, with a history of adverse drug reactions and previous problems with regional or general anaesthesia. It is concluded that the OAC has provided a valuable service to obstetricians and anaesthetists for the anaesthetic management of pregnant women with co-existing disease. The OAC gave an opportunity for patient education regarding anaesthetic options for labour and delivery. The attending anaesthetist was provided with a risk assessment and anaesthetic management plan which was adhered to with only two exceptions. Finally, the obstetrician was given consistent advice regarding anaesthesia management that may affect obstetrical decisions.
 ...
PMID:The obstetrical anaesthesia assessment clinic: a review of six years experience. 848 95

This audit study took place in ten outpatient pain clinics and focused on the management of low back pain and nerve-damage pain. The objective was to identify and promote appropriate changes in management. An analysis of the treatment of 1236 patients with low back pain and/or nerve-damage pain highlighted wide variations in practice. Presentation of these data to the clinics was used as a means of promoting change. Data on a further 1791 patients were used to assess the extent of any changes in practice. Prior to the audit feedback, treatments were used often in some clinics, but only rarely in other clinics, for seemingly similar patients. During the feedback sessions three treatments were identified for more frequent use by several of the clinics: antidepressant and anticonvulsant drugs, and transcutaneous electrical nerve stimulation. Many changes in practice occurred after the audit intervention, with large increases in the utilisation of these three treatments. Since there is reasonable evidence to support the use of these treatments for chronic pain this represents an improvement in the process of care. The audit demonstrated that patient management can be improved by a combination of active feedback and discussions based around comparisons between centres.
Anaesthesia 1996 Jul
PMID:Audit in pain clinics: changing the management of low-back and nerve-damage pain. 875 55

A comparison of a 25 G with a 29 G Quincke needle was performed in paediatric day case surgery. Sixty healthy children aged 1 year to 13 years were randomly allocated to have spinal anaesthesia with either 25 G or 29 G Quincke needle without an introducer needle. There was a failure rate of 10% with the 29 G spinal needle compared with 0% with the 25 G needle. The time needed to perform dural puncture was shorter using 25 G than 29 G needle, 22 (+/- 31)(SD) vs 59 (+/- 63) s. The time taken for cerebrospinal fluid to appear at the needle hub was also longer, 4 (+/- 3) vs 8 (+/- 5) s. The number of puncture attempts was similar, 1.2 (+/- 0.6) vs 1.4 (+/- 0.8), with 25 G and 29 G needle. Low back pain, 5 vs1, and nonpositional headache, 2 vs 4, after 25 G and 29 G needles, respectively, were the most frequent postoperative complaints. Mild postdural puncture headache occurred in one eight year old male patient in the 25 G group. In conclusion, lumbar puncture without introducer needle was possible with both needles. The puncture characteristics favoured the 25 G needle. A shorter needle could partly alleviate the difficulties with the 29 G needle.
 ...
PMID:Comparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints. 884 76

202 children aged 2 months to 17 years, undergoing elective paediatric operations below the umbilicus, were allocated randomly to receive either spinal (SA) or epidural anaesthesia (EA). SA was more efficacious since 8 children of 102 needed supplementation with general anaesthesia, in contrast to EA where 24 children of 100 were supplemented with general anaesthesia and 6 with fentanyl. The haemodynamic stability was maintained during EA, whereas during SA 6 patients were given medication to increase heart rate/blood pressure. EA provided longer pain relief than SA in the recovery room. The incidence of postoperative side effects was similarly low following SA and EA. Complaints after discharge were also similar. General weakness (7% vs 8% after SA and EA, respectively), low back pain (6% vs 6%), headache (7% vs 4%), fever (6% vs 4%) and positional headache (PDPH) (5% vs 3%) were the most frequent side effects. PDPH was only observed following SA in children aged 11 years or older. Following EA, PDPH was also observed in the younger age group after accidental dural puncture. In conclusion, we prefer SA for minor paediatric operations due to its high efficacy.
 ...
PMID:Comparison of spinal anaesthesia with epidural anaesthesia in paediatric surgery. 884 88

Anesthesia providers spend a considerable amount of time sitting in poorly designed chairs. In the majority of hospitals, anesthesia providers are reluctant to request ergonomically designed chairs for the operating room. Multiple studies have given conclusive evidence that properly designed chairs reduce low back pain, improve lower extremity circulation, and relieve muscle tension, thus increasing overall comfort. Continual use of poorly designed chairs and stools in the operating room will cause eventual health complaints. Ergonomically designed chairs will be a wise purchase for the anesthesia provider, especially those who are aging or have physical complaints related to the back, muscle tension, and other lower extremity problems.
 ...
PMID:Chair design and the anesthesia provider. 909 97


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>