Here we present the case of a 76-year-old woman with pancreatic cancer receiving epidural analgesia for chronic cancer pain treatment. Attempts of running the epidural catheter sequentially resulted in unexpected and extensive sensory block together with sympathicolysis but insufficient pain control. Finally, after 3 failed attempts of epidural catheter placements with insufficient pain control and uncommon neurological signs, a magnetic resonance imaging (MRI) scan of the spine was ordered. The MRI showed subdural catheter displacement with extensive liquid accumulation in the subdural space and consequent significant spinal cord compression. Findings normalized after removing the subdural catheter.
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http://dx.doi.org/10.1213/XAA.0000000000001124 | DOI Listing |
Cureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFIntroduction: Pain control following Nuss thoracoplasty remains a challenge. Cryoanalgesia of the intercostal nerves has been demonstrated to reduce postoperative pain in these patients. The objective of this study was to understand how and how widely cryoanalgesia is used in pediatric patients undergoing funnel chest surgery in Spain.
View Article and Find Full Text PDFInt 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.
J 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.
Pain Ther
January 2025
Department of Anaesthesia, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates.
Introduction: This review aimed to investigate the inadvertent administration of antibiotics via epidural and intrathecal routes. The secondary objective was to identify the contributing human and systemic factors.
Methods: PubMed, Scopus and Google Scholar databases were searched for the last five decades (1973-2023).
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