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Postdural puncture headache: Beyond the evidence.
Best Pract Res Clin Anaesthesiol
September 2024
Yale Medicine/Yale New Haven Health System, USA. Electronic address:
Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.
View Article and Find Full Text PDFComparing the Efficacy of Transforaminal and Caudal Epidural Injections of Calcitonin in Treating Degenerative Spinal Canal Stenosis: A Double-Blind Randomized Clinical Trial.
Anesth Pain Med
February 2024
Department of Anesthesiology and Pain Medicine, Minimally Invasive Surgery Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: Lumbar spinal stenosis (LSS) is the most common indication for lumbar surgery in elderly patients. Epidural injections of calcitonin are effective in managing LSS.
Objectives: This study aimed to compare the efficacy of transforaminal and caudal injections of calcitonin in patients with LSS.
Influence of different intraoperative fluid management on postoperative outcome after abdominal tumours resection.
Radiol Oncol
June 2024
Department of Anesthesiology and Surgical Intensive Care, University Medical Centre Ljubljana, Slovenia.
Article Synopsis
- The study investigates the impact of intraoperative multimodal monitoring on reducing postoperative complications and hospital stay for patients undergoing major abdominal cancer surgeries.
- A total of 88 high-risk surgical patients were split into two groups: one received standard monitoring (control group) while the other had advanced monitoring techniques (protocol group).
- Results showed no significant difference in hospital stay or rates of postoperative complications, but the protocol group exhibited better intraoperative fluid management and lower levels of procalcitonin, indicating a potentially improved immune response.
Metformin-grafted polycaprolactone nanoscaffold targeting sensory nerve controlled fibroblasts reprograming to alleviate epidural fibrosis.
J Control Release
March 2024
Spine Center, Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai 200003, China. Electronic address:
Epidural fibrosis (EF), associated with various biological factors, is still a major troublesome clinical problem after laminectomy. In the present study, we initially demonstrate that sensory nerves can attenuate fibrogenic progression in EF animal models via the secretion of calcitonin gene-related peptide (CGRP), suggesting a new potential therapeutic target. Further studies showed that CGRP could inhibit the reprograming activation of fibroblasts through PI3K/AKT signal pathway.
View Article and Find Full Text PDFEpidural administration of large dose of opioid μ receptor agonist may impair cardiac functions and myocardial viability via desensitizing transient receptor potential vanilloid 1.
Toxicol Appl Pharmacol
February 2024
College of Anaesthesia, Shanxi Medical University, 86 Xinjiannan Road, Taiyuan 030001, Shanxi, China.
The incidence of postoperative myocardial injury remains high as the underlying pathogenesis is still unknown. The dorsal root ganglion (DRG) neurons express transient receptor potential vanilloid 1 (TRPV1) and its downstream effector, calcitonin gene-related peptide (CGRP) participating in transmitting pain signals and cardiac protection. Opioids remain a mainstay therapeutic option for moderate-to-severe pain relief clinically, as a critical component of multimodal postoperative analgesia via intravenous and epidural delivery.
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