To the Editor: Recently, I was asked to co-author a review of the scientific evidence for, or against, the use of epidural steroid injections to treat pain. Although there have been many studies published over the years showing efficacy for interlaminar epidural injections, none met the criteria for our report because most were not randomized and none evaluated injections using fluoroscopy. On ...

BACKGROUND Epidural alpha2-adrenergic agonists produce analgesic effects in children and adults, but efficacy and safety have not been established in neonates and infants. The aim of this study was to determine the effect of epidural dexmedetomidine on sensory processing, reversal of inflammatory hyperalgesia, and sedation during early development in rats. METHODS In rat pups aged 3, 10, and ...

BACKGROUND Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. METHODS In this study, the loss-of-resistance technique was used and an...

non of the intervertebral disc space, a gas-containing cyst in the epidural space is a rare disease entity. Intervertebral gas can migrate to the epidural space through ruptures in the annulus fibrosus, and it manifests as squeezed air in the herniated disc, as contained air in the pseudocyst that is without a larger amount of disc material, or as free air. There have been several reports about...

OBJECTIVES To evaluate patient attitudes about epidural services in labour and correlate them with patient options and actual usage of epidural analgesia. DESIGN Questionnaire survey. SETTING Eight Hospital Authority obstetrics units. PARTICIPANTS A cohort of new antenatal patients and a cohort of postnatal in-patients over 1 calendar month. MAIN OUTCOME MEASURES Antenatal patient aware...

Background The rationale for injection of epidural medications through the needle is to promote sooner onset of pain relief relative to dosing through the epidural catheter given that needle injection can be performed immediately after successful location of the epidural space. Some evidence indicates that dosing medications through the epidural needle results in faster onset and improved quali...

BACKGROUND Epidural analgesia is an effective and popular way to relieve labour pain but it may interfere with normal mechanism of labour. The objective of this study was to evaluate the outcome of labour in women with effective epidural analgesia in terms of duration of labour, mode of delivery and neonatal outcome. METHODS This was a quasi-experimental study conducted in the Department of O...

OBJECTIVE To examine the status of obstetric epidural analgesia services in Hong Kong public hospitals in 2001, and to compare findings with those from a similar survey conducted in 1995. DESIGN Postal questionnaire survey. SETTING Hospital Authority hospitals in Hong Kong offering an obstetric and delivery service. PARTICIPANTS Chiefs of Service of departments of anaesthesia and coordina...

OBJECTIVE Analgesia and early quality of recovery may be improved by epidural analgesia. We aimed to assess the effect of receiving epidural analgesia on surgical adverse events and quality of life after laparotomy for endometrial cancer. METHODS Patients were enrolled in an international, multicentre, prospective randomised trial of outcomes for laparoscopic versus open surgical treatment fo...

BACKGROUND Adverse effects may still limit the use of continuous epidural and intravenous analgesia in surgical wards. This study postulated that postoperative epidural analgesia was more efficient, and had fewer side-effects than intravenous morphine. The aim was to investigate efficacy, adverse effects and safety of the treatments in a large patient population. METHODS During a five-year pe...