Perirenal nerve plexus block for CT-guided Renal tumor ablation: A case series

Abstract Postoperative pain management is of major importance and the existence of a device that ensures a good analgesia in the immediate postoperative period and also removes the side effects of the systemic drugs, is becoming a necessity. Objectives: The goal was to obtain a good quality anaesthesia and also a good postoperative analgesia by inserting a perineural catheter at the brachial plexus site. Material and method: This study included adult patients who underwent brachial plexus anaesthesia through a perineural catheter inserted at the brachial plexus site. The perineural catheter was introduced by ultrasound guidance with neurostimulation control. After insertion, a quantity of a an-aesthetic admixture of 0.4mg/kg is administered. The anaesthetic admixture contained Ropivacaine and Lidocaine, equimolar concentration of 0.5% In the postoperative period, the analgesia was ensured trough the already installed catheter. The analgesic mixture contained Ropivacaine and Lidocaine, equivalent concentrations of 0.25%. The administration rate was 5 ml every 4 hours, starting 6 hours postoperatively. Results: The anaesthesia, obtained through the perineural catheter, was a good quality anaesthesia ensuring both, good sensory and motor block. The feedback regarding postoperative analgesia was positive, this type of pain management being efficient and without the systemic drug side effects. This approach of brachial plexus block was accepted easily by the patients and was rated as a very satisfactory method. Conclusions: The insertion of a perineural catheter for anaesthesia and postoperative analgesia represents a safe and efficient method of achieving both analgesia and anaesthesia.

Download Full-text

Planning of renal tumor ablation aided by numerical modeling

2017 10th International Symposium on Advanced Topics in Electrical Engineering (ATEE) ◽

10.1109/atee.2017.7905110 ◽

2017 ◽

Cited By ~ 1

Author(s):

Alin A. Dobre ◽

Alexandru M. Morega ◽

Larisa D. Virlan ◽

Alina M. Sandoiu ◽

Mihaela Morega

Keyword(s):

Numerical Modeling ◽

Renal Tumor ◽

Tumor Ablation

Download Full-text

CT-Guided Celiac Plexus Block with Absolute Alcohol: the Anterior Approach

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1997.37.1.101 ◽

1997 ◽

Vol 37 (1) ◽

pp. 101

Author(s):

Jeong Min Lee ◽

Mi Suk Lee ◽

Young Ik Jang ◽

Jeong Hoi Kim ◽

Seong Hee Ym ◽

...

Keyword(s):

Anterior Approach ◽

Celiac Plexus ◽

Celiac Plexus Block ◽

Absolute Alcohol ◽

Ct Guided ◽

Plexus Block

Download Full-text

Transesophageal endoscopic ultrasound fine needle aspiration of vertebral body osteolytic tumors – a novel diagnostic approach. Case series.

Medical Ultrasonography ◽

10.11152/mu-2618 ◽

2020 ◽

Author(s):

Romeo Ioan Chira ◽

Alina Florea ◽

Vlad Ichim ◽

Liliana Rogojan ◽

Alexandra Chira ◽

...

Keyword(s):

Vertebral Body ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Histopathological Examination ◽

Traditional Approach ◽

Case Series ◽

Lumbar Vertebrae ◽

Needle Aspiration ◽

Ct Guided ◽

Fine Needle

Aims: Vertebral lesions, either primary or more frequently metastasis, are difficult targets for percutaneous guided biopsies and surgical biopsies and are associated with greater risks of complications. We investigated the feasibility of endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsy in the assessment of vertebral osteolytic tumors as an alternative to CT guided biopsy which is the technique currently used.Material and methods: Four patients with osteolytic tumors of the vertebral bodies identified by imaging methods (CT or MRI) – 3 patients, and one with a tumor detected primarily during EUS procedure were included in order to evaluate the feasibility of the procedure. The lesions were located either at the dorsal or lumbar vertebrae. In all cases we performed EUS FNA of the osteolytic vertebral body lesions with 22G needles using the transesophageal or transgastric approach.Results: In all cases EUS FNA provided enough tissue for an accurate histopathological report, with no procedural complication. We diagnosed lung adenocarcinoma, hepatocarcinoma and a pancreatic adenocarcinoma vertebral metastasis and one case of lymphoma.Conclusions: EUS FNA is a valuable technique which should be considered in selected cases, when a “traditional approach” is not applicable or associated with a higher risk. Treatment guidelines are based on the histology of the tumor, histopathological examination being nowadays mandatory. Therefore, we propose for selected cases a feasible technique, with significantly lower procedural risks, as an alternative for open surgical biopsies or computed tomography guided biopsies

Download Full-text

Worth a second look: outcomes of patients with initial finding of regular renal tissue in CT-guided renal tumor biopsies

World Journal of Urology ◽

10.1007/s00345-017-2170-x ◽

2018 ◽

Vol 36 (5) ◽

pp. 789-792 ◽

Cited By ~ 2

Author(s):

M. Sadat-Khonsari ◽

M. Papayannis ◽

P. Schriefer ◽

L. Kluth ◽

C. Meyer ◽

...

Keyword(s):

Renal Tumor ◽

Renal Tissue ◽

Initial Finding ◽

Ct Guided ◽

Second Look ◽

Tumor Biopsies

Download Full-text

Intra-discal drain insertion for culture and drainage of pyogenic spondylodiscitis: A one-step diagnostic and therapeutic procedure

Interventional Neuroradiology ◽

10.1177/1591019919885557 ◽

2019 ◽

Vol 26 (1) ◽

pp. 105-110

Author(s):

Tal Ackerman ◽

Jonathan Singer-Jordan ◽

Adi Shani ◽

Nimrod Rahamimov

Keyword(s):

Complete Resolution ◽

Treatment Guidelines ◽

Clinical Laboratory ◽

Case Series ◽

Retrospective Case ◽

Disc Space ◽

Ct Guided ◽

Pyogenic Spondylodiscitis ◽

Continuous Drainage ◽

One Step

Background Pyogenic spondylodiscitis is diagnosed in recent years at higher rates due to the aging population, increased survival of chronic and immune suppressed patients, and the higher rate of invasive procedures leading to bacterial seeding or direct contamination of the disc space. Treatment guidelines encourage bacterial sampling before initiation of antibiotic therapy, and drainage of pus collections. We present our experience with percutaneous CT-guided drain insertion into the disc space itself as a one-step procedure for both culturing and subsequent continuous drainage of the infected disc space. Materials and methods We retrospectively reviewed all cases of pyogenic spondylodiscitis admitted to our spine surgery unit during the past five years and treated with CT-guided percutaneous drain insertion into the infected disc space. All patients were followed until complete resolution of the infection. Results We retrieved electronic records of 12 patients, none presenting with neurological compression symptoms. Cultures taken at the time of drain insertion were positive in 10 patients (83.3%), much higher than the reported yield for needle aspiration (14–48%) and comparable to the yield of open biopsy. In all patients complete resolution of the infection was reached, determined by clinical, laboratory, and imaging parameters. Conclusions Our retrospective case series demonstrates the feasibility and effectiveness of intra-discal CT-guided drainage of an infected disc space. The procedure does not add much burden to current practice as disc-space sampling for culture is commonly performed anyway, and adds the benefit of direct drainage of the pus at its source.

Download Full-text