scholarly journals Anesthetic considerations in patients with implantable devices and chronic pain surgery

2021 ◽  
Author(s):  
Francisco Javier Camargo Cárdenas ◽  
Alejandra Valencia Cataño ◽  
Juan Felipe Vargas
Keyword(s):  
Chronic Pain ◽  
Pulse Generator ◽  
Infusion Pump ◽  
Implantable Devices ◽  
Invasive Technique ◽  
Anesthetic Considerations ◽  
Management Alternative ◽  
Invasive Techniques ◽  
Intrathecal Space ◽  
Implantable Drug Delivery Systems

The use of advanced invasive techniques for the control of chronic pain in patients with multiple comorbidities is becoming increasingly common. Neuromodulation offers a new management alternative involving the infusion of one or more drugs into the epidural or intrathecal space through a fully implantable infusion pump. It also involves spinal stimulation, a minimally invasive technique in which electrodes are positioned in the epidural space and connected to a pulse generator that is implanted subcutaneously and generates pulses designed to suppress the noxious stimulus. This article will describe the anesthetic considerations in cases of implantable drug delivery systems, and spinal and peripheral nerve stimulation devices. Additionally, patients with electrical or drug neuromodulation devices may present to anesthetic practice for surgical indications unrelated to their chronic pain pathology. Hence the importance of being familiar with the basic components of these devices, how they work, what drugs they use and the potential associated complications in the perioperative context, in order to ensure proper management and patient safety.

scholarly journals Achilles Tendon Ruptures: Comparison between the Clinical Results of Classical Versus Mini-Invasive or Percutaneous Surgical Treatment

2015 ◽  
Vol 20 (3) ◽  
pp. 135-138
Author(s):  
Obada B. ◽  
Serban Al. O.
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Clinical Results ◽  
Needle Insertion ◽  
Invasive Technique ◽  
Percutaneous Technique ◽  
Degree Of Satisfaction ◽  
Invasive Techniques

Abstract The aim of the study is to evaluate the surgical treatment comparing the results obtained with different techniques. We revised 68 cases with acute Achilles tendon rupture who underwent surgical correction between 2004 and 2011, with a 40 month average follow-up. 34 of these were submitted to a classical open repair using the Kessler or Krakow technique, 25 to a mini-invasive technique (Achilon) and 9 to a percutaneous technique (Tenolig). We report a 29% rate of complications when using the classical technique: the major complications were one re-rupture, two surgical wound dehiscences, one infection and one sural nerve injury. In the mini-invasive/percutaneous techniques, two re-ruptures occurred (5.9% total, one in each technique) and one fistula at the needle insertion location. In regards to the percutaneous and mini-invasive techniques, the functional results and degree of satisfaction were higher, with fewer complications, reflecting a trend that has been expressed in the international literature.

scholarly journals Immediate and delayed effect of dry needling in musculoskeletal disorders: a quasi experimental study

2018 ◽  
Vol 6 (8) ◽  
pp. 2746
Author(s):  
Riyas Basheer K. B. ◽  
Jazeel N. M. ◽  
Harish S. Krishna ◽  
Veena K. S. ◽  
Madhuripu P. ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Disorders ◽  
Tender Point ◽  
Research Centre ◽  
Invasive Technique ◽  
Delayed Response ◽  
Dry Needling ◽  
Delayed Effect ◽  
Treatment Area ◽  
College Hospital

Background: The roles of physiotherapists in managing the chronic and acute pain in musculoskeletal (Msk) conditions are inevitable now days. Physiotherapists work across the time period aiding patients with their pain in medical care settings with the aim of decreasing pain, rising quality of life wherever attainable and preventing acute and sub-acute painful conditions developing into chronic pain. Dry needling, an invasive technique in the hand of Physios is a new trend in managing acute and chronic pain. Purpose of the study is to identify the immediate and delayed response of pain and presence of soreness after the dry needling in common Msk conditions which can be managed in association with other conventional physical therapy techniques. Objective was to find out the immediate and delayed effects of dry needling over pain in musculoskeletal disorders.Methods: This study was carried out in the department of physiotherapy, Malabar medical college hospital and research centre. Patient was prepared and identified the extreme tender point over the muscle affected and needle removed after 3-5 twitch response elicited. Sterility of the treatment area and needle was well maintained. Prior to the treatment again confirmed with the NPRS score and procedure was done. After few seconds of insertion of needle subjects NPRS score assessed. After removal of needling pain score was assessed after 5 mins, 30 mins, 1 hour and after one day.Results: Study showed a marked reduction in pain after dry needling at each intervals and this suggesting promoting dry needling as an adjunct to pain relief technique in physiotherapy.Conclusions: Dry needling is effective over pain in musculoskeletal disorders.

scholarly journals Neurospinal Surgery Innovations

2017 ◽  
Vol 3 (3) ◽  
pp. 121-122
Author(s):  
James Wang
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Treatment Plan ◽  
Invasive Technique ◽  
Surgical Trauma ◽  
The Past ◽  
The World ◽  
Spine Diseases ◽  
Invasive Techniques ◽  
Important Branch

Over the past few decades, majority of neurosurgeons only specialize in spinal cord diseases. However, with the advances in spine surgery, more and more neurosurgeons focus on spine diseases. Precision minimally invasive technique in surgery of spine and spinal cord is an important branch of neurosurgery. As traditional surgery has been gradually replaced by precision surgery, open surgery has been gradually replaced by minimally invasive surgery (MIS), the diagnosis and treatment of spine diseases has been benefiting from minimally invasive techniques. With minimal surgical trauma, precise localization, MIS has become the inevitable trend of new neurosurgery. The model of multidisciplinary team is gradually becoming universal in the world in order to make the best treatment plan for the patient with spine diseases on the basis of the comprehensive disciplinary opinion.

scholarly journals Mid-stream clean catch urine collection in newborns: a non-invasive and safe technique

2019 ◽  
Vol 6 (2) ◽  
pp. 349 ◽  
Author(s):  
Rajendra Kumar ◽  
Nithin . ◽  
Sudha Rudrappa
Keyword(s):  
Success Rate ◽  
Urine Sample ◽  
Invasive Technique ◽  
Urine Collection ◽  
Non Invasive ◽  
Invasive Method ◽  
Safe Technique ◽  
The Mean ◽  
Invasive Techniques ◽  
Mean Time

Background: The aim of this study is to determine the success rate and safety of a non-invasive technique to obtain clean-catch midstream urine samples in newborns.Methods: Prospective bedside clinical study. After obtaining written informed consent,120 consecutive newborns admitted in NICU with no dehydration, poor feeding, need for immediate urine sample by invasive method  for whom urine collection was advised for various reasons who met the inclusion criteria were included in the study with consent being taken from the parents. After adequate milk intake supra pubic and lumbar para vertebral areas were stimulated in repeated cycles of 30 s until micturition began.Results: Success rate in obtaining a midstream urine sample within 5 min. The success rate was 90%. The mean time taken to collect urine was 64.24s, for males it was 62.55s and for females 65.93s.Conclusions: The technique has been demonstrated to be safe, quick and effective. The discomfort and time consumption usually associated with bag collection methods as well as invasive techniques can be avoided.

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

Do Implantable Devices Improve Mood? Comparisons of Chronic Pain Patients With or Without an Implantable Device

2008 ◽  
Vol 11 (4) ◽  
pp. 260-266 ◽  
Author(s):  
Robert N. Jamison ◽  
Tabitha A. Washington ◽  
Gilbert J. Fanciullo ◽  
Edgar L. Ross ◽  
Gregory J. McHugo ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Implantable Devices ◽  
Implantable Device ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Three-port retroperitoneoscopic necrosectomy in management of acute necrotic pancreatitis

Medicina ◽  
2010 ◽  
Vol 46 (3) ◽  
pp. 176 ◽  
Author(s):  
Audrius Šileikis ◽  
Virgilijus Beiša ◽  
Gintaras Simutis ◽  
Albinas Tamošiūnas ◽  
Kęstutis Strupas
Keyword(s):  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
University Hospital ◽  
Invasive Technique ◽  
Infected Necrosis ◽  
First Choice ◽  
Necrotic Pancreatitis ◽  
Vilnius University ◽  
Fluid Collections ◽  
Invasive Techniques

Introduction. Because of major morbidity and mortality after open surgery in acute necrotic pancreatitis, an interest in minimally invasive necrosectomy approaches has increased. We report the results of a recently developed minimally invasive technique that we adopted in 2007. Material and methods. This article contains a retrospective analysis of cases and description of original retroperitoneoscopic necrosectomy technique. There were eight patients aged 25–58 years, who underwent retroperitoneoscopic pancreatic necrosectomy in the Center of Abdominal Surgery, Vilnius University Hospital Santariškių Klinikos, between 2007 and 2009. All patients had at least 30% pancreatic necrosis with extensive retroperitoneal fl uid collections on the left side, proved by CT scan. Operations were performed on the 21st–56th days of illness (median, 36th day). Results. The mean postoperative hospital stay was 49 days (range, 14–99 days). All patients survived. Two patients underwent three additional procedures; two patients, one additional procedure due to remaining infected necrosis. Three patients had no requirement for additional procedures. One patient underwent laparotomy because of bleeding. Conclusions. We assume that minimally invasive techniques should be considered a first-choice surgical option in patients with acute necrotic pancreatitis, whenever it is possible. Pancreatic necrosis less than 30% with large fluid collections in the left retroperitoneal space facilitates employment of three-port retroperitoneoscopic necrosectomy.

scholarly journals Using Thermal Imaging to Monitor Body Temperature of Koalas (Phascolarctos cinereus) in A Zoo Setting

Animals ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. 1094 ◽  
Author(s):  
Edward Narayan ◽  
Annabella Perakis ◽  
Will Meikle
Keyword(s):  
Body Temperature ◽  
Thermal Imaging ◽  
Native Species ◽  
The Body ◽  
Invasive Technique ◽  
Phascolarctos Cinereus ◽  
Non Invasive ◽  
Imaging Tool ◽  
Potential Applicability ◽  
Invasive Techniques

Non-invasive techniques can be applied for monitoring the physiology and behaviour of wildlife in Zoos to improve management and welfare. Thermal imaging technology has been used as a non-invasive technique to measure the body temperature of various domesticated and wildlife species. In this study, we evaluated the application of thermal imaging to measure the body temperature of koalas (Phascolarctos cinereus) in a Zoo environment. The aim of the study was to determine the body feature most suitable for recording a koala’s body temperature (using coefficient of variation scores). We used a FLIR530TM IR thermal imaging camera to take images of each individual koala across three days in autumn 2018 at the Wildlife Sydney Zoo, Australia. Our results demonstrated that koalas had more than one reliable body feature for recording body temperature using the thermal imaging tool—the most reliable features were eyes and abdomen. This study provides first reported application of thermal imaging on an Australian native species in a Zoo and demonstrates its potential applicability as a humane/non-invasive technique for assessing the body temperature as an index of stress.

scholarly journals Experience of using scleroobliteration in venous angiodysplasia (results of 12-month follow-up)

2021 ◽  
Vol 29 (3) ◽  
pp. 410-418
Author(s):  
Sergey V. Sapelkin ◽  
Natal'ya A. Druzhinina ◽  
Alexander F. Kharazov ◽  
Andrey V. Chupin
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Laser Coagulation ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Local Spread ◽  
Initial Symptoms ◽  
Radiofrequency Obliteration ◽  
Invasive Techniques

AIM: To evaluate the results of using the minimally-invasive technique of scleroobliteration in patients with venous malformations. MATERIALS AND METHODS: From 2006 to 2020, 41 interventions were performed for venous-cavernous angiomatosis of various localization through scleroobliteration. Nineteen patients (46.3%) underwent complex treatment, which included a combination of this minimally-invasive technique with other surgical interventions (resection of angiomatous tissues, laser coagulation, and radiofrequency obliteration). RESULTS: Clinical improvement was achieved in 38 (92.7%) patients. According to the data of ultrasound control, 25 patients (61%) experienced no blood flow in the obliteration zone, and there was regression of the initial symptoms within 1 year of observation following intervention. The results of treatment were better due to the local spread of the angiomatous process. With diffuse forms, it was not possible to achieve a positive effect in 3 patients (11.1%). CONCLUSION: Scleroobliteration can provide a positive result in the treatment of patients with venous-cavernous angiodysplasia, both as an independent method and in combination with other minimally-invasive techniques.

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