Deep fascia iliaca block combined with sacral plexus block for hip fracture surgery: A retrospective series of cases.

This case series describes a novel anaesthetic approach for hip fracture surgery using the deep fascia iliaca block combined with the sacral plexus block. This single-centre, retrospective study involved 15 patients aged 85 years or older and having significant cardiac disease. All the patients were managed with single-shot deep fascia iliaca block (22 or 25 ml of ropivacaine 0.

Outcome of Children and Adolescents With Primary Intracranial Germinoma Treated With Chemotherapy and Reduced Dose-Field Irradiation: A Prospective Brazilian Experience.

Purpose: This prospective Brazilian single-arm trial was conducted to determine response to chemotherapy and survival after response-based radiotherapy in children with intracranial germinomas, in the setting of a multi-institutional study in a middle-income country (MIC) with significant disparity of subspecialty care.

Patients And Methods: Since 2013, 58 patients with histologic and/or serum and CSF tumor marker evaluations of primary intracranial germ cell tumors were diagnosed; 43 were germinoma with HCGβ levels ≤200 mIU/mL and five between 100 and 200 mIU/mL. The treatment plan consisted of four cycles of carboplatin and etoposide followed by 18 Gy whole-ventricular field irradiation (WVFI) and primary site(s) boost up to 30 Gy; 24 Gy craniospinal was prescribed for disseminated disease.

Low-dose spinal block combined with epidural volume extension in a high-risk cardiac patient: A case-based systematic literature review.

Background: Anesthetic management of patients with severe cardiac disease can be challenging during prolonged surgical procedures. Thus, alternative neuraxial anesthetic techniques have been described to avoid general anesthesia in these patients.

Methods: A case-based systematic literature review on low-dose spinal block combined with different methods of epidural block extension in high-risk cardiac patients was performed.

Bilateral quadratus lumborum block for management of persistent postoperative paralytic ileus: a case report.

We report the case of a 62-year-old female who suffered from a persistent postoperative paralytic ileus following an urgent open cholecystectomy. On the fifth postoperative day we performed a bilateral Quadratus Lumborum Block (QLB) type 1 which resulted in a progressive resolution of the condition. This case report highlights that QLB is not only limited to somatic pain control, but it can also be used to alleviate visceral pain, namely in the context of paralytic ileus management in the postoperative period.

Parascapular Sub-Iliocostalis Plane Block: Comparative Description of a Novel Technique for Posterior Rib Fractures.

We describe a new analgesic technique, parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures as an alternative to other regional techniques in a high-risk patient who suffered a decompensation of her cardiorespiratory function after posterior chest trauma. We performed a continuous ultrasound-guided left PSIP block in the sub-iliocostalis plane next to the fourth rib to optimize analgesia and minimize complications. The patient had total pain relief with marked improvement in her cardiorespiratory condition.

Continuous Bilateral Erector of Spine Plane Block at T8 for Extensive Lumbar Spine Fusion Surgery: Case Report.

Introduction: Supplementary strategies, in combination with conventional analgesia, for pain control after lumbar fusion surgery remain limited.

Case Description: Here, we describe a 79-year-old woman who experienced pain (10/10 on a numeric rating scale) on postoperative day 1 after undergoing L2 to S1 spine fusion. Erector spinae plane (ESP) blocks were performed at T8 and, after a bolus of ropivacaine 0.

Fascia iliaca block associated only with deep sedation in high-risk patients, taking P2Y12 receptor inhibitors, for intramedullary femoral fixation in intertrochanteric hip fracture: a series of 3 cases.

Objective: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome.

Case Reports: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF). All patients have been managed successfully through a deep sedation using a low-dose infusion of propofol and bolus of fentanyl without face mask ventilation, supraglottic device placement, or endotracheal intubation after an FIB.

Thyrotoxic crisis associated with gestational trophoblastic disease.

Background And Objectives: Human chorionic gonadotropin (HCG) and thyrotrophic hormone (TSH) have analogies in their structures, as well as in their receptors. The high levels of HCG seen in gestational trophoblastic diseases may induce secondary hyperthyroidism. The objective of this report was to present a case in which the administration of iodinated contrast triggered a thyrotoxic crisis.

Trigone ventricular meningiomas: surgical approaches.

Objective: Report our experience with trigone ventricular meningiomas and review the surgical approaches to the trigone.

Method: From 1989 to 2006, six patients with meningiomas of the trigone of the lateral ventricles underwent microsurgical resection. Their clinical features, image, follow up, and surgical approaches were retrospectively analyzed.