OBJECTIVE The purpose of this study was to compare the reliability of the lateral fluoroscopic view and several contralateral oblique (CLO) views at different angles in visualizing and accurately predicting the position of the needle tip at the point of access in the posterior cervical and cervicothoracic epidural space. DESIGN After the epidural space was accessed but before confirmation wit...

BACKGROUND Despite widespread use, little is known about the comparative pharmacokinetics of intrathecally administered opioids. The present study was designed to characterize the rate and extent of opioid distribution within cerebrospinal fluid, spinal cord, epidural space, and systemic circulation after intrathecal injection. METHODS Equal doses of morphine and alfentanil, fentanyl, or sufe...

BACKGROUND In the midthoracic region, a fluroscope guided epidural block has been proposed by using a pedicle as a landmark to show the height of the interlaminar space (Nagaro's method). However, clinical implication of this method was not fully evaluated. We studied the clinical usefulness of a fluoroscope guided thoracic epidural block in the midthoracic region. METHODS Twenty four patient...

Anesthetic management of the pregnant achondroplastic patient for cesarean section poses significant challenges for anesthetists when coupled with anesthetic risks encountered during the third trimester of pregnancy. We report the case of a 25-year-old, 107 cm in height, and 37-week woman with achondroplasia who underwent neuraxial anesthesia for an elective cesarean section. Due to lumbar hype...

Morbidity after paediatric epidural anaesthesia is unusual. We report a case of transient motor nerve root block in an eleven years old girl receiving epidural analgesia postoperatively following anterior instrumented spinal fusion for scoliosis. The epidural catheter was placed within the T8-T9 inter-space under general anaesthesia. Postoperatively the child developed unilateral paradoxical ch...

Epidural anesthesia is a common anesthesia method yet up to 10% of procedures fail to provide adequate analgesia. This is usually due to misinterpreting the tactile information derived from the advancing needle through the complex tissue planes. Incorrect placement also can cause dural puncture and neural injury. We developed an optic system capable of reliably identifying tissue planes surroun...

Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or impor...

BACKGROUND Traumatic placement of a needle during a neuraxial blockade has been related to many complications such as postdural puncture headache, trauma to neural structures and even spinal hematoma, causing permanent neurologic deficits. Although efforts to minimize the complications caused by traumatic neuraxial blockade have been made, nothing was found to be clear. The authors investigated...

The caudal approach to the epidural space was first reported in 1901. Injection of steroids to treat low back pain was introduced in 1952. Caudal epidural steroid injection is a safe, effective technique when performed with appropriate care under fluoroscopic visualization. Caudal epidural injections are associated with inaccurate needle placement when performed blindly in a substantial number ...

Submit Manuscript | http://medcraveonline.com Introduction Ewing sarcoma is a bone tumor that has a predilection for long bones in teenagers. It accounts to approximately 6–10 % of all primary bone tumors in children; however, it seldom occurs outside of the bone, and very rarely in the epidural space [1]. Ewing sarcoma is composed of uncharacterized mesenchymal cells. The most common sites are...