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Overcoming Anatomical Challenges: Epidural Blood Patch and Plica Mediana Dorsalis Case Report.
Cureus
December 2024
Anesthesiology, South Brooklyn Health, Brooklyn, USA.
The efficacy of epidural blood patch (EBP) is highly variable, and often, clinicians are unable to identify the underlying reasons for treatment failure. A 36-year-old parturient underwent a "blind" epidural blood patch (EBP) without image guidance but failed to obtain relief from a postural headache related to the labor epidural. During the second EBP, an intact plica mediana dorsalis (PMD) was visualized in the anterior-posterior fluoroscopic view after injection of contrast, and autologous blood was injected on both sides of the PMD, leading to the complete resolution of headache symptoms.
View Article and Find Full Text PDFA randomized sequential allocation study on the optimum programmed intermittent epidural boluses interval time with different concentrations of ropivacaine combined with the dural puncture epidural technique for labor analgesia.
Front Pharmacol
January 2025
Department of Anesthesiology, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huaian, China.
Background: The combined technique of programmed intermittent epidural boluses (PIEB) and dural puncture epidural (DPE) is currently considered a more effective mode for labor analgesia. We investigated the optimal interval time for PIEB administration with different concentrations of ropivacaine combined with the DPE for labor analgesia.
Methods: Ninety patients with cervical dilation of <5 cm and a VAS score >5 were randomly assigned to receive labor analgesia with ropivacaine at concentrations of 0.
Background: The primary objective of this study was to compare the efficacy of lignocaine-dexamethasone and lignocaine-triamcinolone infiltration, along the spinal-epidural needle insertion pathway, to prevent backache after lower abdominal surgeries.
Methods: This prospective, double-blind randomized controlled study included a total of 150 patients, scheduled for elective lower abdominal surgery under combined spinal-epidural (CSE) anaesthesia. The patients were randomised into three groups Group L (Lignocaine, n=50), Group DL (Dexamethasone, Lignocaine, n=50), and Group TL (Triamcinolone, Lignocaine, n=50).
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.
Epidural Hydroxyethyl Starch in Treatment of Post Epidural Puncture Headache: A Case Series and Literature Reviews.
Int Med Case Rep J
January 2025
Department of Anesthesiology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, Guangxi, People's Republic of China.
Background: Post-dural puncture headache (PDPH) is a common complication of obstetric anesthesia. There are still no convenient and effective methods to control the PDPH.
Case Presentation: Three cases of parturients with accidental dural puncture who suffered post-dural puncture headache (PDPH) after labor analgesia or cesarean section.
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