Background: Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality in the United States. Subcutanous unfractionated heparin (UFH) has been used for decades for VTE prophylaxis and under many obstetric quality of care initiatives, hospitalized antepartum patients now receive doses as high as 10,000 units every 12 hours. This practice increases the likelihood of UFH administration around the time that epidural labor analgesia is requested or neuraxial analgesia for cesarean delivery is needed.
View Article and Find Full Text PDFIndirect and direct methods have been used to localize the stellate ganglion. Identifying the C6 and C7 transverse process can be a technical challenge for practitioners when performing an ultrasound-guided stellate ganglion block. Following the nerve roots from the interscalene plexus into the corresponding foramen can serve as a reconfirmation for identifying the C6 and C7 transverse process.
View Article and Find Full Text PDFSpinal subarachnoid hemorrhage (SSH) is a rare yet potentially devastating complication of neuraxial procedures. We present a case of SSH after inadvertent lumbar spinal drain removal while on clopidogrel. The contrast between the patient's mild clinical symptoms compared to his impressive magnetic resonance imaging (MRI) highlights the variable presentations that can be seen with spinal and epidural hematomas.
View Article and Find Full Text PDFJ Arthroplasty
September 2017
Total joint arthroplasty is one of the most common surgical procedures performed for end-stage osteoarthritis. The increasing demand for knee and hip arthroplasties along with the improvement in life expectancy has created a substantial medical and economic impact on the society. Effective planning of health care for these individuals is vital.
View Article and Find Full Text PDFSUMMARY Neuropathic pain is a complex pain syndrome that remains difficult to treat. Patients fail to obtain satisfactory relief despite receiving pharmacological agents. Neuropathic pain has a significant impact on health-related quality of life.
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