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Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial.
Anesth Pain Med (Seoul)
January 2025
Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.
Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.
Effect of Anesthetic Modality on Decision-to-Delivery Interval and Maternal-Neonatal Outcomes in Category 2 and 3 Cesarean Deliveries.
J Clin Med
December 2024
Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. : This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries.
View Article and Find Full Text PDFCesarean delivery: Clinical updates.
Best Pract Res Clin Anaesthesiol
September 2024
K. Bicetre School of Medicine, Paris-Saclay University, Département d'Anesthésie, Hôpital Antoine Béclère - APHP.Université Paris-Saclay, 157 rue de la porte de Trivaux, 92140, CLAMART, France. Electronic address:
This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed.
View Article and Find Full Text PDFEffect of Clonidine on Duration of High-Volume, Low-Concentration Caudal Epidurals.
Cureus
December 2024
Anesthesiology and Perioperative Medicine, Medical University of South Carolina, Charleston, USA.
Article Synopsis
- Caudal blocks are a pediatric anesthesia technique used to manage pain after circumcision; this study aimed to compare the duration of the block when using a high-volume, low-concentration (HVLC) local anesthetic with and without the addition of clonidine.
- The study included 129 children aged 0-3 years and measured the effectiveness of pain relief based on how long patients waited before needing additional acetaminophen; no significant differences were found between the clonidine and no-clonidine groups regarding pain management or emergence agitation.
- Overall, the addition of clonidine did not significantly improve the outcomes of HVLC caudal blocks for children undergoing circumcision.
Comparison of Bupivacaine plus Dexmedetomidine versus Bupivacaine plus Fentanyl for Caudal Block in Pediatric Infraumbilical Surgery.
Mymensingh Med J
January 2025
Dr Md Khairul Kabir Khan, Junior Consultant, Department of Anaesthesiology and Intensive Care Unit, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility.
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