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El-Tallawy SN, Pergolizzi JV, Albasher MJ, Alghamdi NS, Salem GI, Ahmed RS, KaKi AM, Thallaj AK, Alwahabi AH, Amer AM, Ahmed RH. Non-adherence to Clinical Practice Guidelines in Regional Anesthesia and Pain Interventions: Insights From a Comprehensive Case Series Review. Cureus 2024; 16:e75847. [PMID: 39822475 PMCID: PMC11736337 DOI: 10.7759/cureus.75847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 12/17/2024] [Indexed: 01/19/2025] Open
Abstract
Adhering to established guidelines, regional anesthesia (RA) and pain interventions are essential for preventing or minimizing the risk of complications. This study examines neurological complications that may arise when RA or pain interventions are performed without adherence to the clinical practice guidelines. This article aimed to emphasize the relationship between deviations from standards of care in RA and neurological outcomes. Specifically, it focuses on neurological deficits associated with RA and pain interventions. This retrospective study analyzed five cases, selected from 18 cases meeting the inclusion criteria, reviewed over a period from 2012 to 2023. The data collected included patient demographics, anesthesia details, neurological deficits, diagnostic findings, management approaches, and outcomes at three- to six-month follow-ups. The article presents five cases, each examining the techniques used, clinical diagnosis, radiological imaging, neurophysiological studies, and the management protocols involved. Furthermore, it highlights the consequences of deviations from the standard of care and their impacts on neurological outcomes. Outcomes and key lessons learned from each case are discussed. Five cases were analyzed, revealing deviations from the standard of care such as incorrect spinal needle placement, injection despite warning signs, inadequate patient evaluation, and procedures performed by inexperienced anesthetists. While some patients achieved full recovery, others experienced lasting deficits. The study emphasizes the critical importance of strict adherence to clinical practice guidelines in RA and pain interventions to minimize neurological complications. It highlights the essential roles of proper training, precise technique, thorough patient evaluation, patient-centered care, informed consent, and the use of advanced diagnostic tools to mitigate risks and improve patient safety and outcomes.
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Affiliation(s)
- Salah N El-Tallawy
- Anesthesia and Pain Management, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, SAU
- Anesthesia and Pain Management, Faculty of Medicine, Minia University and NCI, Cairo University, Cairo, EGY
| | | | - Marium J Albasher
- Anesthesiology, King Khalid University Hospital, King Saud University, Riyadh, SAU
| | - Nawwaf S Alghamdi
- Anesthesiology, King Khalid University Hospital, King Saud University, Riyadh, SAU
| | - Gehan I Salem
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, EGY
| | - Rania S Ahmed
- Family Medicine and Polyclinics, Alfaisal University College of Medicine, Riyadh, SAU
| | - Abdullah M KaKi
- Pain Medicine, Alsalama Hospital, Jeddah, SAU
- Pain Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Ahmed K Thallaj
- Anesthesia, College on Medicine, King Saud University, Riyadh, SAU
| | - Ali H Alwahabi
- Anesthesiology, King Khalid University Hospital, King Saud University, Riyadh, SAU
| | - Amro M Amer
- Neurophysiology, King Khalid University Hospital, King Saud University, Riyadh, SAU
| | - Radwa H Ahmed
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, EGY
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Thioub M, Mbaye M, Cissé ME, Ndoye N, Thiam AB, Badiane SB. [Narrow lumbar channel due to epidural lipomatosis: case report and literature review]. Pan Afr Med J 2018; 28:187. [PMID: 29599885 PMCID: PMC5871247 DOI: 10.11604/pamj.2017.28.187.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 10/05/2017] [Indexed: 11/11/2022] Open
Abstract
La lipomatose épidurale est une pathologie caractérisée par une l'accumulation anormale de graisse non encapsulée dans l'espace épidural. Bien que rare, elle est une cause possible de lombosciatique ou de canal lombaire étroit. Elle est souvent associée à des facteurs favorisants tels qu'une corticothérapie prolongée, ou une obésité. Nous rapportons une observation d'un patient qui a présenté des lombosciatalgies invalidantes et dont l'exploration radiologique a confirmé une lipomatose épidurale compressive. L'évolution a été favorable après décompression chirurgicale.
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Affiliation(s)
- Mbaye Thioub
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
| | - Maguette Mbaye
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
| | - Mohamed Elhassimi Cissé
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
| | - Ndaraw Ndoye
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
| | - Alioune Badara Thiam
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
| | - Seydou Boubakar Badiane
- Université Cheikh Anta Diop de Dakar, Centre Hospitalier National Universitaire de FANN, Sénégal
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