scholarly journals Guidelines on skin antisepsis before central neuraxial blockade

Anaesthesia ◽  
2014 ◽  
Vol 69 (11) ◽  
pp. 1193-1196 ◽  
Author(s):  
M. H. Nathanson
Keyword(s):  
Neuraxial Blockade ◽  
Skin Antisepsis

scholarly journals Safety guideline: skin antisepsis for central neuraxial blockade

Anaesthesia ◽  
2014 ◽  
Vol 69 (11) ◽  
pp. 1279-1286 ◽  
Author(s):  
◽  
J. P Campbell ◽  
F. Plaat ◽  
M. R. Checketts ◽  
D. Bogod ◽  
...  
Keyword(s):  
Neuraxial Blockade ◽  
Skin Antisepsis

Avoid suboptimal perioperative analgesia during major surgery by enhancing thoracic epidural catheter placement and hemodynamic performance

2021 ◽  
pp. rapm-2020-102352
Author(s):  
Sarah A Bachman ◽  
Johan Lundberg ◽  
Michael Herrick
Keyword(s):  
Epidural Catheter ◽  
Treatment Strategies ◽  
Preventive Treatment ◽  
Catheter Placement ◽  
Major Surgery ◽  
Perioperative Analgesia ◽  
Neuraxial Blockade ◽  
Epidural Catheter Placement ◽  
Thoracic Epidural ◽  
Catheter Failure

Thoracic epidural analgesia (TEA) is an established gold standard for postoperative pain control especially following laparotomy and thoracotomy. The safety and efficacy of TEA is well known when the attention to patient selection is upheld. Recently, the use of fascial plane blocks (FPBs) has evolved as an alternative to TEA most likely because these blocks avoid problems such as neurological comorbidity, coagulation disorders, epidural catheter failure and hypotension due to sympathetic denervation. However, if an FPB is performed, postoperative monitoring and adjuvant treatments are still necessary. Also, the true efficacy of FPBs is questioned. Thus, should we prioritize less efficient analgesic regimens with FPBs when preventive treatment strategies for epidural catheter failure and hypotension exist for TEA? It is time to promote and underscore the benefits of TEA provided to patients undergoing major open surgical procedures. In our mind, FPBs and landmark-guided techniques should be limited to less extensive surgery and when either neuraxial blockade is contraindicated or resources for optimal epidural catheter placement and maintenance are not available.

scholarly journals Ultrasound Imaging of the Spine for Central Neuraxial Blockade: a Technical Description and Evidence Update

2021 ◽  
Author(s):  
Hari Kalagara ◽  
Harsha Nair ◽  
Sree Kolli ◽  
Gopal Thota ◽  
Vishal Uppal
Keyword(s):  
Ultrasound Imaging ◽  
Spine Surgery ◽  
Postoperative Analgesia ◽  
Spinal Deformity ◽  
Ultrasound Examination ◽  
Technical Difficulty ◽  
Vertebral Level ◽  
Reliable Technique ◽  
Neuraxial Blockade ◽  
Preprocedural Imaging

Abstract Purpose of Review This article describes the anatomy of the spine, relevant ultrasonographic views, and the techniques used to perform the neuraxial blocks using ultrasound imaging. Finally, we review the available evidence for the use of ultrasound imaging to perform neuraxial blocks. Recent Findings Central neuraxial blockade using traditional landmark palpation is a reliable technique to provide surgical anesthesia and postoperative analgesia. However, factors like obesity, spinal deformity, and previous spine surgery can make the procedure challenging. The use of ultrasound imaging has been shown to assist in these scenarios. Summary Preprocedural imaging minimizes the technical difficulty of spinal and epidural placement with fewer needle passes and skin punctures. It helps to accurately identify the midline, vertebral level, interlaminar space, and can predict the depth to the epidural and intrathecal spaces. By providing information about the best angle and direction of approach, in addition to the depth, ultrasound imaging allows planning an ideal trajectory for a successful block. These benefits are most noticeable when expert operators carry out the ultrasound examination and for patients with predicted difficult spinal anatomy. Recent evidence suggests that pre-procedural neuraxial ultrasound imaging may reduce complications such as vascular puncture, headache, and backache. Neuraxial ultrasound imaging should be in the skill set of every anesthesiologist who routinely performs lumbar or thoracic neuraxial blockade. We recommend using preprocedural neuraxial imaging routinely to acquire and maintain the imaging skills to enable success for challenging neuraxial procedures.

Skin antisepsis survey in Australia-New Zealand neonatal nurseries

2013 ◽  
Vol 49 (7) ◽  
pp. 601-602 ◽  
Author(s):  
Dharmesh Shah ◽  
Mark Tracy
Keyword(s):  
New Zealand ◽  
Skin Antisepsis

Central Neuraxial Blockade Promotes External Cephalic Version Success After a Failed Attempt

2002 ◽  
Vol 94 (6) ◽  
pp. 1589-1592 ◽  
Author(s):  
Gerald Cherayil ◽  
Bruce Feinberg ◽  
Julian Robinson ◽  
Lawrence C. Tsen
Keyword(s):  
External Cephalic Version ◽  
Neuraxial Blockade ◽  
Failed Attempt
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