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Real-time ultrasound-guided thoracic epidural placement: Illustrating the techniques and reporting on prospective observational study.
J Perioper Pract
January 2025
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Background: This study aimed to assess the feasibility of real-time ultrasound-guided thoracic epidural placement.
Methods: A prospective observational study was conducted in 20 patients undergoing elective abdominal and thoracic surgery. The procedure, performed with patients in a lateral position, involved three sequential steps: (1) identification of the interlaminar gap, (2) advancement of the Touhy needle, and (3) identification of the epidural space.
Outcome of utilizing real-time contrast medium to detect the fistulas in spinal epidural arachnoid cysts and treat with minimally invasive surgery.
Eur Spine J
January 2025
Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Background: Spinal epidural arachnoid cysts (SEACs) are rare, non-neoplastic pathologies that can cause compressive myelopathy. Preoperative identification of the exact fistula location is crucial for minimally invasive management.
Methods: This single-center retrospective study included 27 patients with SEACs who underwent "double-needle puncture myelography" to precisely localize the fistula before minimally invasive surgery.
Novel bimanual haptic simulator for epidural loss-of-resistance detection: a pilot study assessing movement strategies and performance across anesthesiologist experience levels.
Int J Obstet Anesth
December 2024
Department of Biomedical Engineering and the School of Brain Sciences and Cognition, Ben Gurion University of the Negev, Beer Sheva, Israel.
Background: Correct identification of the epidural space requires extensive training for technical proficiency. This study explores a novel bimanual haptic simulator designed for the precise insertion of an epidural needle based on loss-of-resistance (LOR) detection, providing realistic dual-hand force feedback.
Methods: The simulator, equipped with two haptic devices connected to a Tuohy needle and an LOR syringe, was designed to simulate the tissues' resistive forces felt by the user during the procedure, offer anatomical variability and record detailed performance metrics for personalized feedback.
Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter: A prospective, double-blinded, randomised clinical trial.
Eur J Anaesthesiol
February 2025
From the Department of Anesthesia, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China (XC, YT, QY, LS, HL, LW, CJ, XC).
Background: Rapid onset of epidural analgesia is an important concern for the parturient. Commonly, the local anaesthetic mixture is administered through the epidural catheter. Drugs administered through the epidural needle might decrease the onset time and enhance the spread of medication within the epidural space.
View Article and Find Full Text PDFBeyond Risk Factors: Spinal Epidural Abscess in a Young, Healthy Patient.
Cureus
November 2024
Anesthesiology, Unidade Local de Saúde do Alentejo Central, Évora, PRT.
Epidural abscess is a rare complication of neuraxial techniques, which, when left unnoticed, can lead to significant neurological deficits and poor outcomes. Identification of patients at high risk and the conduct of a strict aseptic technique are some of the measures that play an important role in epidural abscess prevention. Prompt recognition and treatment of epidural abscesses are essential.
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