Evaluation of the effectiveness of artificial intelligence for ultrasound guided peripheral nerve and plane blocks in recognizing anatomical structures.

Background: We aimed to assess the accuracy of artificial intelligence (AI) based real-time anatomy identification for ultrasound-guided peripheral nerve and plane block in eight regions in this prospective observational study.

Methods: After obtaining ethics committee approval and written informed consent from 40 healthy volunteers (20 men and 20 women, between 18 and 72 years old), an ultrasound device installed with AI software (Nerveblox, SmartAlfa, Turkey) were used to scan regions of the cervical plexus, brachial plexus, pectoralis (PECS), rectus sheet, femoralis, canalis adductorius, popliteal, and ESP by three anesthesiology trainees. During scanning by a trainee, once software indicates 100 % scan success of associated anatomic landmarks, both raw and labeled ultrasound images were saved, assessed, and validated using a 6-point scale between 0 and 5 by two expert validators.

Retrospective evaluation of the effects of traditional interscalene block alone versus combined with superior truncus block-associated diaphragm paralysis during arthroscopic shoulder surgery.

Objectives: The aim of this study was to investigate the effects of traditional interscalene block (ISB) alone and ISB combined with superior truncus block (STB)-associated diaphragm paralysis evaluated by ultrasound, duration of analgesia, and rate of complication in patients undergoing arthroscopic shoulder surgery.

Patients And Methods: Between January 2020 and December 2022, a total of 285 patients (158 males, 127 females; mean age: 48.0±15.

Management of Postpartum Haemorrhage.

Postpartum haemorrhage is the leading cause of maternal mortality worldwide. However, postpartum haemorrhage-related deaths are potentially preventable with timely diagnosis and management. The present review addresses the management of postpartum haemorrhage algorithm that includes the use of uterotonics, non-surgical (balloon tamponade) or surgical (sutures, artery ligations, and/or hysterectomy) techniques, and/or endovascular radiologic interventions, antifibrinolytic (tranexamic acid), and procoagulant (fibrinogen concentrate) drugs based on the international and national guidelines updated with recent evidences.

Management of an Uncorrected Tetralogy of Fallot for Caesarean Section Using Low-Dose Combined Spinal Epidural Anaesthesia Under Advanced Haemodynamic Monitorization.

Since management of parturients with uncorrected tetralogy of Fallot reported until now lacks advanced cardiac haemodynamic monitoring, we aimed to present anaesthetic management of a parturient with uncorrected tetralogy of Fallot scheduled for caesarean section by addressing the challenges in the management based on the advanced haemodynamic monitoring due to the expected high-risk maternal morbidity and mortality in this particular case. Hereby, we provided haemodynamic stability with little requirement for vasopressor medication by using low-dose combined spinal epidural anaesthesia in a parturient with uncorrected tetralogy of Fallot scheduled to undergo caesarean delivery.

A real-time anatomy ıdentification via tool based on artificial ıntelligence for ultrasound-guided peripheral nerve block procedures: an accuracy study.

We aimed to assess the accuracy of an artificial intelligence (AI)-based real-time anatomy identification software specifically developed to ease image interpretation intended for ultrasound-guided peripheral nerve block (UGPNB). Forty healthy participants (20 women, 20 men) were enrolled to perform interscalene, supraclavicular, infraclavicular, and transversus abdominis plane (TAP) blocks under ultrasound guidance using AI software by anesthesiology trainees. During block practice by a trainee, once the software indicates 100% scan success of each block associated anatomic landmarks, both raw and labeled ultrasound images were saved, assessed, and validated using a 5-point scale by expert validators.

Postoperative Acute Parotitis After Cesarean Delivery Under Spinal Anaesthesia.

Postoperative acute painless parotid gland swelling, which is a rare complication has been reported after caesarian section (CS) under neuraxial anaesthesia. Hereby, we aimed to present a parturient suffering from acute parotitis complication for her elective CS under spinal anaesthesia who had a previous history of acute parotitis after epidural anaesthesia.

Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: a systematic review and individual participant data meta-analysis.

Background: Ursodeoxycholic acid is commonly used to treat intrahepatic cholestasis of pregnancy, yet its largest trial detected minimal benefit for a composite outcome (stillbirth, preterm birth, and neonatal unit admission). We aimed to examine whether ursodeoxycholic acid affects specific adverse perinatal outcomes.

Methods: In this systematic review and individual participant data meta-analysis, we searched PubMed, Web of Science, Embase, MEDLINE, CINAHL, Global Health, MIDIRS, and Cochrane without language restrictions for relevant articles published between database inception, and Jan 1, 2020, using search terms referencing intrahepatic cholestasis of pregnancy, ursodeoxycholic acid, and perinatal outcomes.

Retrospective Evaluation of Effects of Preoperative Anaemia Treatment in Gynaecological and Obstetric Surgical Patients.

Objective: In anemic patients undergoing surgery, there is an increase in the requirement of blood transfusion, longer hospital stay and higher intensive care unit adimission. In this study we aimed to evaluate the efficacy of iv iron treatment before elective obstetric or gynecological operations retrospectively.

Methods: After obtaining approval of ethics committee, records of 5688 patients underwent either obstetric or gynecological surgery between January 1st of 2016 to December 31st of 2018 were documented retrospectively and 241 anemic cases were identified.

Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses.

Background: Intrahepatic cholestasis of pregnancy is associated with adverse perinatal outcomes, but the association with the concentration of specific biochemical markers is unclear. We aimed to quantify the adverse perinatal effects of intrahepatic cholestasis of pregnancy in women with increased serum bile acid concentrations and determine whether elevated bile acid concentrations were associated with the risk of stillbirth and preterm birth.

Methods: We did a systematic review by searching PubMed, Web of Science, and Embase databases for studies published from database inception to June 1, 2018, reporting perinatal outcomes for women with intrahepatic cholestasis of pregnancy when serum bile acid concentrations were available.

Antinociceptive Effect of Liposomal Bupivacaine Formulations After Intrathecal Administration in Rats.

Background/aim: Based on our previous in vitro study with multilamellar liposomal bupivacaine (MLB) versus bupivacaine alone in artificial cerebrospinal fluid, we aimed to investigate in vivo antinociceptive effect of intrathecal MLB by determining tail flick latency (TFL) time after thermal stimulation in rats.

Materials And Methods: After preparing MLB and high-yield drug entrapment in liposome (HYDEL) bupivacaine, 18 female Wistar rats were assigned to 3 groups as control (bupivacaine) and study groups (MLB and HYDEL bupivacaine) including 6 rats in each group to administer these drugs intrathecally. Antinociceptive activity was determined in terms of TFL time after thermal stimulation.

How neuraxial labor analgesia differs by approach: dural puncture epidural as a novel option.

Background And Aim: Neuraxial analgesia techniques are not limited to just standard epidural and CSE blocks. A novel approach called dural puncture epidural (DPE) which is a modification of CSE in terms of practice has gained popularity after its description and use in the obstetric population.  The aim of this review is to address the practice of DPE technique as a novel option by reviewing its benefits as well as side and/or adverse effects and to understand how neuraxial labor analgesia differs by approach based on the information available in the current literature DISCUSSION: Despite controversies and concerns, more rapid onset of analgesia, early bilateral sacral analgesia, lower incidence of asymmetric block and fewer maternal and fetal side effects are provided with DPE when compared to epidural.

Unique Liver Disease of Pregnancy Requiring Anaesthesia Support: A Case with Severe Hyperemesis Gravidarum.

Hyperemesis gravidarum (HG) is one of the common unique liver diseases that occurs during pregnancy. Mild cases can be spontaneously resolved in time but severe cases usually require supportive medical treatment to relieve symptoms. Moreover, differential diagnosis may be required in severe cases that manifest with persistent nausea-vomiting, dehydration and weight loss refractory to treatment.

Epidural patch with autologous platelet rich plasma: a novel approach.

We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. Cranial MRI with contrast showed diffuse pachymeningeal thickening and contrast enhancement with enlarged pituitary consistent with intracranial hypotension.

Retrospective analysis of maternal, fetal, and neonatal outcomesof intrahepatic cholestasis of pregnancy at Gazi University.

Background/aim: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period.

Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.

Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia.

Release Pattern of Liposomal Bupivacaine in Artificial Cerebrospinal Fluid.

Objective: We aimed to compare the possible controlled release profile of multilamellar liposomal bupivacaine formulations with non-liposomal forms in artificial cerebrospinal fluid (CSF) under in vitro conditions.

Methods: Liposome formulations were prepared using a dry-film hydration method. Then, an artificial CSF-buffered solution was prepared.

Single Shot Spinal Anaesthesia for Caesarean Delivery of Two Achondroplasic Parturients.

Because of structural defects in achondroplasia, as one of the dwarfism types, the choice of an anaesthetic technique and management for caesarean delivery presents a challenge. We aimed to discuss our successful single-shot spinal anaesthesia approach for caesarean section for one urgent and one elective achondroplasic parturient based on the literature.

Popliteal Sciatic Nerve Block in a Pregnant Patient in the Last Trimester.

Although regional anaesthesia is a commonly preferred anaesthesia technique for pregnant patients undergoing non-obstetric surgery, peripheral nerve blocks are relatively less administered. The use of popliteal sciatic nerve block for foot-ankle surgery has been presented for a nulliparous parturient at 32 weeks of gestation scheduled to undergo surgical exploration of an arterial pseudoaneurysm on her right plantar surface due to a penetrating stab injury. Since surgery did not require pneumatic tourniquet, the sciatic nerve was blocked via the popliteal approach with a single shot injection of 30 mL of 0.