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ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.
Eur J Anaesthesiol
February 2025
From the Servicio de Anestesia y Reanimación, Hospital Universitario Gregorio Marañón, Calle de O'Donnell, 48, 28009 Madrid, Madrid, Spain (NB), the Servicio de Anestesia, Hospital Universitario Sanitas La Zarzuela, Madrid, c/ Pleyades, 25, 28023 Madrid, Spain (NB), the Servicio de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, P° de la Castellana, 261, 28046 Madrid, Spain (IVG), the Department of Paediatric and Obstetric Anaesthesiology, Juliane Marie Centre, Rigshospitalet & Institute of Clinical Medicine, University Hospital of Copenhagen, Copenhagen, Denmark (AA, KL), the University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany (PK, SR), the Division of Anesthesia Critical Care and Pain, Tel Aviv Sourasky Medical Center affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv Israel (CFW), the London North West NHS University Trust, Watford Road, London, UK HA1 3UJ (NL), the Department of Anesthesia & Intensive Care Medicine, Liège University Hospital, Belgium (PYD), the Servicio de Anestesia y Reanimación. Hospital Universitario Fundación Jiménez Díaz. Av. de los Reyes Católicos, 2. 28040 Madrid. Spain (EGA), the Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Shmuel Beyth St 12, Jerusalem, 9103102 Israel (AI), the Department of Anesthesia and Intensive Care, Akademiska Sjukhuset, Sjukhusvägen, 75185, Uppsala, Sweden (AK), the Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel affiliated with Tel Aviv University Medical School (SOZ), the Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (OvdB), the Department of Cardiovascular Sciences, KU Leuven, and Department of Anaesthesiology, UZ Leuven, Belgium (MvdV), the Department of Anaesthesia, Intensive Care and Pain Medicine, University General Hospital of Valencia, Methodology Department, European University of Valencia, Valencia, Spain (CSR).
Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.
Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.
Spinal Cord Stimulator Implantation for Complex Regional Pain Syndrome in Patient With Extensive Vertebral Surgical History: A Case Report.
Cureus
September 2024
Anesthesiology, Baylor College of Medicine, Houston, USA.
Spinal cord stimulation (SCS) has emerged as a novel therapeutic option for refractory complex regional pain syndrome (CRPS). However, SCS placement is often complicated by a prior history of surgical manipulation and hardware implantation along the spinal column. Through this case exploration, we aim to expand the technical approach to SCS implantation in CRPS and encourage further research into innovative approaches for this treatment modality.
View Article and Find Full Text PDFCircumferential correction of spinal deformity and instability secondary to bacterial spondylodiscitis.
N Am Spine Soc J
September 2024
Department of Neurosurgery, Rush University Medical Center, Chicago, IL.
Article Synopsis
- Spinal deformity resulting from nontuberculous spondylodiscitis is a complex medical issue that leads to significant limitations in patients' quality of life due to overlapping factors like infection and instability, making treatment challenging.
- A study involving 23 patients who underwent vertebrectomy and long-segment fixation showed a very poor preoperative quality of life, with 87% bedridden due to pain, but substantial surgical correction was achieved with a significant decrease in kyphosis.
- Despite successful surgical outcomes, complications were common, including severe anemia and one case of in-hospital mortality due to pulmonary embolism, highlighting the risks involved in operating on this vulnerable patient population.
Brain death (BD) leads to complex hemodynamic and inflammatory alterations which may compromise organ perfusion and induce morphologic and functional damage in various organs. The intestine is particularly sensitive to hypoperfusion and donor hypotension usually precludes intestinal donation. Previous studies reported inflammatory intestinal changes following BD but information on mucosal integrity and perfusion are lacking.
View Article and Find Full Text PDFBackground: Little data exist on pregnancy and childbirth for adolescent idiopathic scoliosis (AIS) patients treated with a spinal fusion. The current literature relies on data from patients treated with spinal fusion techniques and instrumentation, such as Harrington rods, that are no longer in use. The objective of our study is to understand the effects of spinal fusion in adolescence on pregnancy and childbirth.
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