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Neuraxial Blockade
Neuraxial anesthesia is local anaesthesia placed around the nerves of the central nervous system, such as spinal anaesthesia, caudal anaesthesia, epidural anaesthesia, and combined spinal and epidural anaesthesia. The technique is used in surgery, obstetrics, and for postoperative and chronic pain relief. See also * History of neuraxial anesthesia References Anesthesia {{surgery-stub ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Local Anaesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Central Nervous System
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all parts of the bodies of bilaterally symmetric and triploblastic animals—that is, all multicellular animals except sponges and diploblasts. It is a structure composed of nervous tissue positioned along the rostral (nose end) to caudal (tail end) axis of the body and may have an enlarged section at the rostral end which is a brain. Only arthropods, cephalopods and vertebrates have a true brain (precursor structures exist in onychophorans, gastropods and lancelets). The rest of this article exclusively discusses the vertebrate central nervous system, which is radically distinct from all other animals. Overview In vertebrates, the brain and spinal cord are both enclosed in the meninges. The meninges provide a barrier to chemicals ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Spinal Anaesthesia
Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually long. It is a safe and effective form of anesthesia usually performed by anesthesiologists that can be used as an alternative to general anesthesia commonly in surgeries involving the lower extremities and surgeries below the umbilicus. The local anesthetic with or without an opioid injected into the cerebrospinal fluid provides locoregional anaesthesia: true analgesia, motor, sensory and autonomic (sympathic) blockade. Administering analgesics (opioid, alpha2-adrenoreceptor agonist) in the cerebrospinal fluid without a local anaesthetic produces locoregional analgesia: markedly reduced pain sensation (incomplete analgesia), some autonomic blockade (parasympathetic plexi), but no s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Caudal Anaesthesia
Caudal anaesthesia (or caudal anesthesia), is a form of neuraxial regional anaesthesia conducted by accessing the epidural space via the sacral hiatus. It is typically used in paediatrics to provide peri- and post-operative analgesia for surgeries below the umbilicus. In adults it is used for chronic low back pain management. It can be used as an alternative to general anaesthesia or as adjunct to it. Indications Caudal anaesthesia is a relatively low-risk technique commonly used, either on its own or in combination with sedation or general anaesthesia. Caudal anesthesia may be favored for sub-umbilical region surgeries in the pediatric population, such as inguinal hernia repair, circumcision, hypospadias repair, anal atresia, or to immobilise newborns with hip dysplasia. Success rate is limited when used for mid-abdominal interventions such as umbilical hernia repair. This is due to the unpredictable cephalad spread of the local anesthetics. It may also be used in p ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Epidural Anaesthesia
Epidural administration (from Ancient Greek ἐπί, , upon" + ''dura mater'') is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by Spanish military surgeon Fidel Pagés. In the United States, over 50% of childbirths involve the use of epidural anesthesia. Epidural anaesthesia causes a loss of sensation, including pain, by blocking the transmission of signals through nerve fibres in or near the spinal cord. For this reason, epidurals are commonly used for pai ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Combined Spinal And Epidural Anaesthesia
Combined spinal and epidural anaesthesia (CSE) is a regional anaesthetic technique, which combines the benefits of both spinal anaesthesia and epidural anaesthesia and analgesia. The spinal component gives a rapid onset of a predictable block. The indwelling epidural catheter gives the ability to provide long lasting analgesia and to titrate the dose given to the desired effect. Indications This technique also allows for better post operative pain relief. The epidural catheter may be left in place for up to 72 hours if required. In labouring women, the onset of analgesia is more rapid with CSE compared with epidural analgesia.Simmons SW, Cyna AM, Dennis AT et al. Combined spinal-epidural versus epidural analgesia in labour. pdate of Cochrane Database of Systematic Reviews 2003; 4. CD003401 Cochrane Database of Systematic Reviews 2007; 4. CD003401 CSE in labour was formerly thought to enable women to mobilise for longer compared with epidural analgesia, but this is not support ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
UpToDate
UpToDate, Inc. is a company in the Wolters Kluwer Health division of Wolters Kluwer whose main product is UpToDate, a software system that is a point-of-care medical resource. The UpToDate system is an evidence-based clinical resource. It includes a collection of medical and patient information, access to Lexi-comp drug monographs and drug-to-drug interactions, and a number of medical calculators. UpToDate is written by over 7,100 physician authors, editors, and peer reviewers. It is available both via the Internet and offline on personal computers or mobile devices. It requires a subscription for full access. The company was launched in 1992 by Dr. Burton Rose along with Dr. Joseph Rush out of Rose's home. They started with nephrology and have since added over twenty other specialties, with more in development. Controversies UpToDate's articles are anonymously peer-reviewed and it mandates the disclosure of conflicts of interest by the authors of its articles. In 2014, an ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hemoly ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Chronic Pain
Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continues at three months and six months since onset, but some theorists and researchers have placed the transition from acute to chronic pain at twelve months. Others apply the term ''acute'' to pain that lasts less than 30 days, ''chronic'' to pain of more than six months duration, and ''subacute'' to pain that lasts from one to six months. A popular alternative definition of ''chronic pain'', involving no fixed duration, is "pain that extends beyond the expected period of healing". Chronic pain may originate in the body, or in the brain or spinal cord. It is often difficult to treat. Epidemiological studies have found that 8–11.2% of people in various countries have chronic widespread pain. Various non-opioid medicines are initially recommen ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
History Of Neuraxial Anesthesia
The history of neuraxial anesthesia goes back to 1885. 19th century In 1855, Friedrich Gaedcke (18281890) became the first to chemically isolate cocaine, the most potent alkaloid of the coca plant. Gaedcke named the compound "erythroxyline". In 1884, Austrian ophthalmologist Karl Koller (18571944) instilled a 2% solution of cocaine into his own eye and tested its effectiveness as a local anesthetic by pricking the eye with needles. His findings were presented a few weeks later at annual conference of the Heidelberg Ophthalmological Society. The following year, William Halsted (18521922) performed the first brachial plexus block. Also in 1885, James Leonard Corning (18551923) injected cocaine between the spinous processes of the lower lumbar vertebrae, first in a dog and then in a healthy man. His experiments are the first published descriptions of the principle of neuraxial blockade. On August 16, 1898, German surgeon August Bier (18611949) performed surgery under spinal a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
