Background And Objectives: We sought to determine if spinal anesthesia is more difficult to perform in the elderly.
Methods: All spinal anesthetics administered over 18 months by 18 anesthesiologists were eligible. We excluded anesthetics for hip fractures and cesarean deliveries. We recorded time to completion, number of spinal needles used, and number of approaches. The patients were prospectively divided into three age categories: patients <50 years of age (group 1); 50-70 years of age (group 2); and >70 years of age (group 3). Descriptive statistics and chi-square test were performed.
Results: Nine hundred and ninety-nine anesthetics were analyzed. There were 368, 336, and 295 entries in groups 1, 2, and 3, respectively. Although the mean +/- SD (in min) times to accomplish the spinal technique were not significantly different (4.3 +/- 4.1, 4.4 +/- 3.2, and 4.6 +/- 3.4 for groups 1, 2, and 3), there was a statistically greater frequency of more than one spinal needle used and more than one approach needed in the elderly.
Conclusions: We conclude that patient age is a minor independent predictor of increased technical difficulty with spinal anesthesia.
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http://dx.doi.org/10.1016/s1098-7339(99)90072-x | DOI Listing |
Cureus
December 2024
Urology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND.
General anesthesia is the gold standard for breast cancer surgeries. Considering the nature of the surgery and its associated pain, various regional techniques are used as an adjunct to general anesthesia. Regional anesthesia as a sole anesthetic technique for breast cancer surgery is an upcoming technique - especially in high-risk patients considering the risk-benefit ratio, various regional blocks like pectoralis major block, pectoralis minor block, and erector spinae block - in which thoracic segmental spinal anesthesia is the recent one.
View Article and Find Full Text PDFEur J Anaesthesiol
January 2025
From the Department of Anaesthesiology, Wilhelmina Children's Hospital (OFCvdB, SR, LvB, WB), Pain Clinic, Department of Anaesthesiology (MR), Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (TPS) and Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA (PS).
Background: Optimising a mother's quality of recovery following caesarean delivery is of paramount importance as it facilitates maternal care of the newborn and affects physical, psychological and emotional well being. Intrathecal morphine (ITM) reduces postoperative pain and may improve quality of recovery: however its widespread use is limited.
Objective: To assess the effects of implementing ITM for caesarean delivery on postoperative quality of recovery.
J Anesth Analg Crit Care
January 2025
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", via Sergio Pansini 5, Naples, 80100, Italy.
Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature.
View Article and Find Full Text PDFReg Anesth Pain Med
January 2025
Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Hemorrhagic complications associated with regional anesthesia are extremely rare. The fifth edition of the American Society of Regional Anesthesia and Pain Medicine's Evidence-Based Guidelines on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy reviews the published evidence since 2018 and provides guidance to help avoid this potentially catastrophic complication.The fifth edition of the American Society of Regional Anesthesia and Pain Medicine's Evidence-Based Guidelines on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy uses similar methodology as previous editions but is reorganized and significantly condensed.
View Article and Find Full Text PDFCureus
December 2024
Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Background Currently, there is no data on the prevalence of urethral stricture illness in India. For short-segment bulbar urethral stricture, end-to-end anastomosis is the gold standard of care. The purpose of this study was to find where the direct vision internal urethrotomy (DVIU) exists in today's era.
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