Background: Pregnant women are more likely to suffer post-puncture symptoms such as headaches and nausea due to the outflow of cerebrospinal fluid after spinal anesthesia. Because ketamine has the effect of raising intracranial pressure, it may be able to improve the symptoms of perioperative hypocranial pressure and effectively prevent the occurrence of hypocranial pressure-related side effects.
Method: Keywords such as ketamine, cesarean section, and spinal anesthesia were searched in databases including Medline, Embase, Web of Science, and Cochrane from 1976 to 2021. Thirteen randomized controlled trials were selected for the meta-analysis.
Results: A total of 12 randomized trials involving 2099 participants fulfilled the inclusion criteria. There was no significant association between ketamine and the risk of headaches compared to the placebo (RR = 1.12; 95% CI: 0.53, 2.35; = 0.77; I² = 62%). There was no significant association between ketamine and nausea compared to the placebo (RR = 0.66; 95% CI: 0.40, 1.09; = 0.10; I² = 57%). No significant associations between ketamine or the placebo and vomiting were found (RR = 0.94; 95% CI: 0.53, 1.67; = 0.83; I² = 72%).
Conclusion: Intravenous ketamine does not improve the symptoms caused by low intracranial pressure after spinal anesthesia in patients undergoing cesarean section.
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http://dx.doi.org/10.3390/jcm11144129 | DOI Listing |
J Neurosurg Spine
January 2025
2Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida.
Objective: Awake, endoscopic spinal fusion has been utilized as an ultra-minimally invasive surgery technique to accomplish the goals of spinal fixation, fusion, and disc height restoration. While many techniques exist for this approach, this series represents a single institution's experience with a large cohort and the evolution of this method.
Methods: The medical records of a consecutive series of 400 patients treated over a 10-year period were retrospectively reviewed.
A A Pract
January 2025
From the Department of Anesthesiology, Sheba Medical Center, Ramat Gan, Israel.
This case series reviews surgeries involving elderly patients with femoral neck fractures on apixaban who underwent spinal anesthesia (SA) within 72 hours of their last dose. Despite patients being on anticoagulation, no neurological complications occurred, suggesting SA may be practical in cases where the benefits of timely surgery outweigh the potential risks, including apixaban discontinuation for a period of less than the recommended 72 hours with detectable levels of the drug remaining in the plasma. Quantitative apixaban measurements offered useful anticoagulation status insights, though safe thresholds remain undefined.
View Article and Find Full Text PDFCureus
December 2024
Radiology, Fernandez Hospital, Hyderabad, IND.
Urological malignancies during pregnancy are exceedingly rare, with bladder cancer posing significant diagnostic and management challenges. This study describes a 28-year-old pregnant woman diagnosed with non-invasive papillary urothelial carcinoma, presenting with painless hematuria at 22 weeks of gestation. The diagnostic process included ultrasound and MRI, both of which confirmed a solitary polypoidal lesion.
View Article and Find Full Text PDFClin J Pain
January 2025
Biostatistics Group, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Objectives: Postoperative pain, nausea and vomiting adversely affect postoperative rehabilitation after total knee arthroplasty (TKA). We aimed to identify factors associated with postoperative pain trajectory and postoperative nausea and vomiting (PONV) and evaluated the effects of different analgesic modalities.
Methods: We retrospectively reviewed patients undergoing unilateral primary TKA from 2017 to 2022.
Clin J Pain
January 2025
Department of Neurosurgery, University of Nebraska Medical Center. Omaha, Nebraska.
Objective: Posterior cervical spine surgery can result in significant discomfort in the post-operative period. Post-operative pain management presents a challenge, particularly in the elderly population which is more sensitive to adverse effects from analgesia. We aimed to compare outcomes after peri-operative posterior cervical muscle plane blocks versus patients who received general anesthesia only.
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