background: accidental dural puncture during epidural blockade is a rare complication. since postdural puncture headache (pdph) is the most frequent complication, a wisely management method will also reduce the incidence of pdph. methods: five patients who had inadvertent dural puncture during the epidural procedure before hip or knee arthroplasty were included in this study. after dural punctu...

Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesi...

Twenty-five symptomatic postlumbar surgery patients had findings on lumbar spinal noncontrast CT that were equivocal for distinguishing recurrent disk herniation from postoperative epidural fibrosis (scar). Contrast-enhanced CT and lumbar MR imaging were performed to differentiate these two conditions. Of the 14 levels, surgically explored, the diagnosis of scar or recurrent disk herniation was...

BACKGROUND Percutaneous lysis of epidural adhesions is done worldwide. Over 1.7 million of these procedures were done in the U.S.A. by 2006. This interventional pain management technique is used to treat chronic low back pain (LBP) and/or radiculopathy. The primary object of the approach is to target drug delivery to areas of pathology in the spinal epidural space. The procedure involves removi...

PURPOSE Since receiving a warning from the US Food and Drug Administration (FDA) about injection of corticosteroids into the epidural space having serious adverse events, we have sought alternative medications for injection at this site. Hyaluronic acid (HA) has anti-adhesive, anti-inflammatory, and lubricating properties, so could potentially be useful for spinal pain. The exact mechanism by w...

Objective- To compare the lidocaine-MgSO4 combination with lidocaine-Distilled water inthe epidural of indigenous awake dogs.Design- Prospective experimental study.Animals- Five young (12±2 months) female indigenous dogs weighting (10.74 ± 0.44 kg).Procedures- Epidural anesthesia was produced in all dogs with 2% lidocaine (1ml/4.5 kgbody weight) with 1 ml distilled water and two weeks later rep...

BACKGROUND A lipo-prostaglandin E1 agonist is effective for the treatment of neurological symptoms of spinal stenosis when administered by an oral or intravenous route. we would like to reveal the therapeutic effect of an epidural injection of lipo-prostaglandin E1 on hyperalgesia in foraminal stenosis. METHODS A total of 40 male Sprague-Dawley rats were included. A small stainless steel rod ...