A randomized, controlled, blinded evaluation of augmenting point-of-care ultrasound and remote telementored ultrasound in inexperienced operators.

Background: Handheld ultrasound devices present an opportunity for prehospital sonographic assessment of trauma, even in the hands of novice operators commonly found in military, maritime, or other austere environments. However, the reliability of such point-of-care ultrasound (POCUS) examinations by novices is rightly questioned. A common strategy being examined to mitigate this reliability gap is remote mentoring by an expert.

Sedation methods for intra-articular corticosteroid injections in Juvenile Idiopathic Arthritis: a review.

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. Intra-articular corticosteroid injection (IASI), one of the cornerstones of treatment for this disease, is usually associated with anxiety and pain. IASI in JIA may be performed under general anesthesia, conscious sedation, or local anesthesia alone.

Naval casualty management training using human patient simulators.

Background: Extended-evacuation or austere environments (e.g. naval immature or depleted combat zones) are characterized by the lack of resources to facilitate medical evacuation in the "Golden Hour" from moment of injury.

Continuous lumbar/thoracic epidural analgesia in low-weight paediatric surgical patients: practical aspects and pitfalls.

Purpose: Continuous epidural anaesthesia attenuates perioperative stress and avoids the need for systemic opioids. In addition, it may prevent the need for postoperative mechanical ventilation. The aim of the study was to prospectively follow the perioperative course of young infants treated with continuous thoracic/lumbar epidural anaesthesia for major surgery.

The frequency and timing of respiratory depression in 1524 postoperative patients treated with systemic or neuraxial morphine.

Study Objective: To describe the frequency and timing of intravenous patient-controlled analgesia (IV-PCA) or neuraxial morphine-induced postoperative respiratory depression.

Design: Audit of data captured by routine quality assurance of the acute pain protocols that were implemented by nurses performing routine postoperative care.

Setting: The surgical wards of a university-affiliated, 700-bed, tertiary hospital.

The effects of general vs spinal anesthesia on frontal cerebral oxygen saturation in geriatric patients undergoing emergency surgical fixation of the neck of femur.

Study Objective: To assess the effect of regional vs general anesthesia on transcranial cerebral oxygen saturation (rSo2).

Design: Prospective, randomized, open-label study.

Setting: Large referral hospital.

The postoperative analgesic efficacy of wound instillation with ropivacaine 0.1% versus ropivacaine 0.2%.

Study Objectives: To assess the influence of ropivacaine concentration on wound instillation-induced postoperative analgesia following total abdominal hysterectomy with bilateral salpingo-oophorectomy.

Design: Prospective, randomized, double-blind study.

Setting: Large referral hospital.

[Lumbar epidural anesthesia in a very-low-birth-weight infant].

In this case study two combined, light-general and lumbar epidural anesthetics were administered to a premature neonate for the repair of gastroschisis. The female infant's body weight was 1400 grams (first operation) and 1700 grams (second operation). The epidural catheter was inserted between the low-lumbar vertebrae using the "loss of resistance" for saline technique.

The distance from the skin to the subarachnoid space can be predicted in premature and former-premature infants.

Purpose: Spinal anesthesia can be technically challenging in young infants. We studied whether the distance between the skin and the lumbar subarachnoid space in premature and former-premature young infants could be predicted prior to lumbar puncture.

Methods: The distance from skin entry point to tip of the spinal needle was measured using a caliper after lumbar spinal anesthesia at the L4-5 interspace.

A comparison of three techniques for acute postoperative pain control following major abdominal surgery.

Study Objectives: To compare the analgesic efficacy of a nonsteroidal antiinflammatory drug (NSAID) alone (basic pain treatment) with that of NSAID in conjunction with either intravenous (IV) patient-controlled analgesia (IV-PCA) or intermittent epidural morphine (epidural morphine), among patients recovering from major intraabdominal surgery; and to assess the fixed and variable costs of providing the respective acute pain treatment modalities.

Design: Prospective, nonrandomized study.

Setting: Postanesthesia care unit (PACU) and surgical departments of a large referral hospital.

Preoperative ultrasound and intraoperative findings of inguinal hernias in children: A prospective study of 642 children.

Background/purpose: Preoperative sonographic studies of the groins have become a routine evaluation of inguinal hernia in children. Its value is not only to confirm the clinical diagnosis, but also to accurately assess the opposite side and to prevent an unnecessary exploration or additional operation at a later stage. The purpose of this study is to report more definitive criteria of inguinal hernias (IH) and patent process vaginalis (PPV) established from 1,284 groin examinations.

Spinal anesthesia in 62 premature, former-premature or young infants--technical aspects and pitfalls.

Purpose: To highlight technical aspects and pitfalls of spinal anesthesia (SA) in infants.

Methods: The medical history and perioperative course of all infants who underwent SA over a 28-month period were collected (retrospectively in the first 20).

Results: Sixty-two infants underwent surgery under SA.