Spinal epidural hematoma following neuraxial anesthesia is a rare condition that usually presents with acute and, if any, progressive neurological symptoms including pain, sensory/motor impairment, and bladder/ rectal disturbance. Although possible pathogenesis is mainly considered to be a direct injury of Batson's venous plexus, preoperative coagulation status and anticoagulant therapy also play some role in its development. Therefore, to prevent such a disastrous complication, one must choose an appropriate anesthetic technique and monitor neurological function of the patient at a regular time interval. In addition, it is highly recommended to carefully follow the recently revised regional anesthesia guideline for the patient receiving antithrombotic or thrombolytic therapy, although we still need further understanding and investigation of the complexity around this issue.
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Scand J Trauma Resusc Emerg Med
December 2024
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Background: The prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test.
View Article and Find Full Text PDFJ Vasc Surg
December 2024
Department of Surgery; Baptist Health South Florida at Boca Raton Regional Hospital, Boca Raton, Florida. Electronic address:
Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways have demonstrated improved perioperative outcomes after major surgery. However, its adoption within vascular surgery has been limited. In this study, we examined the impact of an ERAS protocol with multimodal anesthesia on open abdominal aortic aneurysm (AAA) repair by comparing early outcomes before and after its implementation.
View Article and Find Full Text PDFPediatr Pulmonol
December 2024
Department of Pediatrics & Kawasaki Disease Research Center, University of California San Diego (UCSD) & Rady Children's Hospital, San Diego, California, USA.
Importance: There is growing understanding that Social Determinants of Health (SDH) impact on the outcomes of different pediatric conditions. We aimed to determine whether SDH affect the severity of MIS-C.
Design: Retrospective cohort study, 2021-2023.
Ann Ital Chir
December 2024
Department of Anesthesiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 317000 Taizhou, Zhejiang, China.
Aim: There is a lack of consensus regarding the efficacy of thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) for postoperative pain in randomized controlled trials (RCTs). The comparison of TPVB and ESPB was explored through a systematic review and meta-analysis (MA) of relevant RCTs.
Methods: A comprehensive search of relevant literature was conducted using databases such as PubMed, Embase, and MEDLINE, from 2019 to June 2024.
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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