Background: Caudal epidural block (CEB) has become increasingly important for pediatric analgesia in recent years. However, data regarding CEB in adult ambulatory surgery are scarce. The aim of this study was to verify whether CEB could be applied as a simple, safe and economic method of anesthesia for adult patients undergoing minor gynecologic procedures (MGP).
Methods: One hundred and seventy-two female patients were enrolled in this study. Each patient received a 20-mL bolus of 1.5% lidocaine caudal epidural injection. The efficacy of CEB was evaluated. Types and duration of surgery, success rate, sensory level of analgesia, caudal epidural depth, complications and duration in the postanesthesia care unit (PACU) were also under investigation.
Results: No side effects occurred and only few hemodynamic changes were noted in the study. All patients experienced excellent surgical anesthesia except seven patients, who required rescue supplement opioids (4.1% of failure rate). The success rate of CEB was 95.9% (165/172). Duration of anesthesia and surgery were 46.66 +/- 11.76 min and 23.08 +/- 9.54 min, respectively. The highest sensory dermatome level reached below T10. The average epidural depth was 3.06 +/- 0.23 cm. No postoperative anti-emetic was given in the study. Only three patients required postoperative narcotics. Four patients had spontaneous voiding before discharge. The average PACU stay was 74.30 +/- 10.80 min.
Conclusion: Single-dose CEB with 1.5% lidocaine 20-mL was an easy and simple technique. It provided satisfactory anesthesia for MGP and did not prolong patients' discharge time. CEB may be another choice of anesthetic technique in such cases of clinical practice.
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Med Ultrason
November 2024
Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding.
Aim: To evaluate the efficacy of ultrasound-guided ilioinguinal and iliohypogastric nerve block (IIHB) in children undergoing surgery for inguinal hernias.
Material And Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched to January 4, 2024. For continuous data, the effect sizes were presented as weighted mean differences (WMDs), and for categorical data, they were reported as relative ratios (RR), each accompanied by 95% confidence intervals (CIs).
Pain Physician
December 2024
Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Background: The analysis of epidural procedure utilization has revealed several notable trends over recent years. Utilization increased significantly until 2004, then rose minimally until 2011, followed by gradual declines up to 2019 in the Medicare population. The COVID-19 pandemic led to a marked 19% decline in usage from 2019 to 2020.
View Article and Find Full Text PDFExp Neurol
December 2024
Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China. Electronic address:
Epidural electrical stimulation (EES) could restore motor function of paralyzed limbs of patients with spinal cord injury (SCI). However, its invasiveness limits its application in early stage of injury. Photobiomodulation (PBM) utilizes infrared light for percutaneous irradiation of the spinal cord to protect nerve tissue, delay muscle atrophy, and can be applied in early stage of SCI due to its non-invasiveness.
View Article and Find Full Text PDFBrain Sci
November 2024
Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Roma, Italy.
Cureus
October 2024
Orthopaedics, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Lumbar radiculopathy is one of the most common disorders encountered by a spine surgeon. The condition involves back pain, which may radiate to the lower limbs, and neurological symptoms, which involve a specific nerve root. Caudal epidural steroid injections (CESIs) and selective nerve root blocks (SNRBs) are two of the most common interventions, which are used to control the pain and neurological symptoms associated with chronic lumbar radiculopathy.
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