Somatosensory evoked potentials (SEPs) to various combinations of two independent brain compression modalities (localized epidural pressure and intracerebral pressure evoked by an inserted balloon) were investigated in 24 rats. The SEP pattern in response to gradually expanding volume without additional epidural pressure remained unchanged for a certain period. SEP changes occurred only shortly prior to death. On the other hand, remarkable SEP changes were observed in a gradually expanding intracerebral mass, when combined with epidural pressure application at about 50% of the lethal volume. SEP changes in response to intermittent and continuous epidural pressure, in addition to a small intracerebral mass, were investigated too. Intermittent application of minor epidural pressure led to specific P1 changes, which recovered after each pressure step. The same pressure, administered continuously, evoked SEP changes with only partial recovery in some instances. Severe epidural pressure, administered intermittently, gave rise to severe SEP changes with only partial recovery after each step. The same epidural pressure delivered continuously led to SEP changes with very small recovery. SEPs have proved to be a reliable method for signalling brain dysfunction corresponding to various modalities and degrees of intracranial pressure.
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http://dx.doi.org/10.1016/0168-5597(90)90017-8 | DOI Listing |
J Int Med Res
January 2025
Department of Anesthesiology and Pain Medicine, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).
Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.
Cureus
December 2024
Anesthesiology, Centro Hospitalar Universitário de São João, Porto, PRT.
Background Lung resection is a complex surgical procedure performed in children to address various pulmonary conditions. The success of this surgical intervention in these patients lies in a multidisciplinary approach, with anesthetic management playing a critical role in ensuring the safety and efficacy of the procedure. Methods After approval by the local ethics committee, clinical data of 17 pediatric patients who underwent lung resection in our hospital from January 2012 to December 2022 were retrospectively analyzed.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology, Jikei University School of Medicine, Tokyo, JPN.
Background Femoral neuropathy is a significant postoperative complication in gynecological surgery that can severely impact patient mobility and quality of life. Among various mechanisms of nerve injury, retractor-induced compression against the pelvic sidewall has been identified as a particularly crucial causative factor. Despite this well-recognized mechanism and its clinical importance, few studies have investigated specific preventive strategies for this iatrogenic complication.
View Article and Find Full Text PDFJ Med Ultrasound
April 2024
Department of Anesthesiology, The School of Clinical Medicine, Fujian Madical University, The First Hospital of Putian City, Fujian, China.
Background: To test the novel ultrasound (US)-guided bilateral anterior quadratus lumborum block (QLBA) at the lateral supra-arcuate ligament (supra-LAL) technique combined with postoperative intravenous analgesia was a viable alternative approach of conventional thoracic epidural analgesia (TEA) for laparoscopic radical gastrectomy (LRG).
Methods: Three hundred and four patients scheduled for LRG were randomized 1:1 into QLBA group: receiving a novel pathway of US-guided bilateral QLBA at the supra-LAL before general anesthesia (GA) and patient-controlled intravenous analgesia (PCIA) after surgery, and TEA group: receiving TEA before GA and patient-controlled epidural analgesia following surgery. The difference in procedure time between the treatment groups was set as the primary endpoint.
Sci Rep
January 2025
Department of Anaesthesiology, Affiliated Hospital of North Sichuan medical college, Nanchong, Sichuan, China.
The effect of epidural infusion of dexmedetomidine on haemodynamics is unclear. This study aimed to explore the effects of epidural or intravenous infusion of dexmedetomidine on haemodynamics during lower extremity varicose veins surgery (saphenectomy) under epidural anaesthesia. Ninety patients were randomly allocated to three groups: ED group (epidural: 0.
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