Erector Spinae Plane Block Decreases Narcotic Requirements in Patients Undergoing Subcutaneous Implantable Cardioverter-defibrillator Placement Under Sedation.

Providing adequate analgesia perioperatively during subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation can be a challenge. The objective of our study was to assess the efficacy and safety of the erector spinae plane (ESP) block technique in providing analgesia and minimizing the risk of opioid use in high-risk patient populations. We enrolled consecutive patients >18 years of age undergoing S-ICD implantation from February 2020 to February 2022 at our center prospectively.

Postoperative Pain Management: Efficacy of Caudal Tramadol in Pediatric Lower Abdominal Surgery: A Randomized Clinical Study.

Background: One of the methods of pain control after pediatric surgical procedures is regional techniques, including caudal block, despite their limitations.

Objectives: In this study, the pain score and complications of caudal tramadol were evaluated in pediatrics following lower abdominal surgery.

Methods: In this study, 46 children aged 3 to 10 years were allocated into two equal groups (R and TR) for performing caudal analgesia after lower abdominal surgery.

High turnover for ambulatory orthopedic surgery.

Purpose Of Review: The trend in the perioperative management of patients having orthopedic surgery in the ambulatory setting emphasizes time-efficiency and rapid turnovers. Anesthetic techniques and management continue to evolve to increase efficiency and decrease time spent in recovery.

Recent Findings: Minimizing time patients spend in phase 1 recovery or bypassing phase 1 altogether, known as fast-tracking, has become an important goal in containing costs in high turnover, ambulatory settings.

Use of Serratus Anterior Plane and Transversus Thoracis Plane Blocks for Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) Implantation Decreases Intraoperative Opioid Requirements.

Objectives: The present study investigated whether regional anesthetic techniques, especially truncal blocks, can provide adjunct anesthesia without the additional risk of general anesthesia and neuraxial techniques for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation.

Design: Single-center, prospective, randomized study.

Setting: Holding area and operating room at a single-center tertiary care hospital.

Regional Analgesia for Cardiac Surgery. Part 2: Peripheral Regional Analgesia for Cardiac Surgery.

The introduction of regional analgesia in the past decades have revolutionized postoperative pain management for various types of surgery, particularly orthopedic surgery. Nowadays, they are being constantly introduced into other types of surgeries including cardiac surgeries. Neuraxial and paravertebral plexus blocks for cardiac surgery are considered as deep blocks and have the risk of hematoma formation in the setting of anticoagulation associated with cardiac surgeries.

The Effect of Add-on Buprenorphine to Matrix Program in Reduction of Craving and Relapse Among People With Methamphetamine Use Disorder: A Randomized Controlled Trial.

Background: Methamphetamine addiction is a global issue. Buprenorphine might have beneficial roles in reducing craving to methamphetamine use via altering neurotransmission signaling and dopaminergic system-related reward mechanisms.

Procedures: This clinical trial was performed in 2019 to 2020 in Khorshid Hospital, Isfahan, Iran.

Traditional and modern management strategies for rheumatoid arthritis.

Rheumatoid arthritis (RA) is a serious disorder of the joints affecting 1 or 2% of the population aged between 20 and 50 years worldwide. RA is the foremost cause of disability in developing and Western populations. It is an autoimmune disease-causing inflammation and pain involving synovial joints.

Revisiting a case of difficult airway with a rigid laryngoscope.

A cook airway exchange catheter is a long hollow and semirigid catheter which is routinely used for endotracheal tube (ETT) exchange in the intensive care unit setting or even in the operating room in an event of unexpected difficult airway. We describe a novel technique of using an ETT exchanger with the help of a rigid laryngoscope to facilitate intubation as a strategy in a patient with an anticipated difficult airway due to laryngeal cancer presenting as stridor with respiratory distress.

Continuous interscalene block in patients having outpatient rotator cuff repair surgery: a prospective randomized trial.

Background: We performed this randomized trial to compare the recovery profile of patients receiving single injection (SISB) and continuous interscalene brachial plexus block (CISB) or general anesthesia (GA) for arthroscopic rotator cuff repair surgery through the first postoperative week. Our primary hypothesis was that the highest pain numeric rating scale (NRS) (worst pain score) at the end of the study week would be lower for patients in the CISB group than for patients in the SISB or GA groups.

Methods: Seventy-one patients scheduled for elective outpatient arthroscopic rotator cuff repair were enrolled.

High-definition ultrasound imaging defines the paraneural sheath and the fascial compartments surrounding the sciatic nerve at the popliteal fossa.

Background And Objectives: The connective tissue layers that surround the sciatic nerve at the popliteal fossa are poorly defined. We present high-definition ultrasound images of the sciatic nerve, which were acquired during ultrasound-guided popliteal sciatic nerve block (SNB), that clearly demonstrate these fascial layers.

Methods: Four patients undergoing hallux valgus surgery received an ultrasound-guided popliteal SNB using a high-definition ultrasound system.

Comparison of the Shear Bond Strength of Resin Modified Glass Ionomer to Enamel in Bur-Prepared or Lased Teeth (Er:YAG).

Objective: The purpose of this study was to evaluate the effect of Er:YAG laser on the shear bond strength of resin modified glass ionomer (RMGI) to enamel.

Materials And Methods: Twenty extracted caries-free human premolars were selected. The teeth were embedded in acrylic resin.

Fascia lliaca block for analgesia after hip arthroplasty: a randomized double-blind, placebo-controlled trial.

Background And Objectives: Fascia iliaca block (FIB) is often used to treat pain after total hip arthroplasty (THA), despite a lack of randomized trials to evaluate its efficacy for this indication. The objective of this study was to assess the analgesic benefit of FIB after THA. Our primary hypothesis was administration of FIB decreases the intensity of postoperative pain (numeric rating scale [NRS-11] score) compared with sham block (SB) in patients after THA.

The sequence of administration of 1.5% mepivacaine and 0.5% bupivacaine does not affect latency of block onset or duration of analgesia in ultrasound-guided interscalene block.

Background: During peripheral nerve blockade, different local anesthetics may be sequentially administered. Typically, a short- or intermediate-acting local anesthetic is administered before a long-acting local anesthetic to achieve a block with rapid onset and long duration. However, there is a paucity of data on advantages of such sequencing.

The effect of mixing 1.5% mepivacaine and 0.5% bupivacaine on duration of analgesia and latency of block onset in ultrasound-guided interscalene block.

Background: Short- and long-acting local anesthetics are commonly mixed to achieve nerve blocks with short onset and long duration. However, there is a paucity of data on advantages of such mixtures. We hypothesized that a mixture of mepivacaine and bupivacaine results in a faster onset than does bupivacaine and in a longer duration of blockade than does mepivacaine.