The efficacy of the psoas compartment block versus the intrathecal combination of morphine, fentanyl and bupivacaine for postoperative analgesia after primary hip arthroplasty: a randomized single-blinded study.

Purpose: Intrathecal morphine and psoas compartment block represent two accepted techniques to provide postoperative analgesia after hip arthroplasty. We designed a prospective, randomized, single-blinded study to compare these two techniques.

Methods: Forty patients scheduled for primary hip arthroplasty under general anesthesia were randomized to receive either an intrathecal administration of 0.

Ropivacaine induced acute neurotoxicity after epidural injection.

Ropivacaine is an amide-type long acting local anaesthetic. According to experimental and human data, its toxicity for Central Nervous System (CNS) and Cardiovascular System (CVS) is considered lower than toxicity related to bupivacaine, the now-a-days accepted golden standard for long acting local anaesthetics. Nevertheless, reports about this kind of accidents are fairly numerous.

Midazolam as an anti-emetic.

Benzodiazepines have been involved during the years in the prevention and treatment of Post-Operative Nausea and Vomiting (PONV). Midazolam, a short acting benzodiazepine widely used as a premedicant before surgery, for induction of anaesthesia, and for conscious sedation, has been particularly studied, sometimes with conflicting results. This paper will discuss the possible mechanisms of action of midazolam in PONV management and its fields of application (adults and children undergoing surgery, treatment of persistent postoperative emesis), as far as potentialities of other non-traditional anti-emetics, maybe ready to get out the arena of case reports, and the need of further studies on postoperative anti-emetics in their efficacy in treating established PONV.

[Anaesthesia for shock wave therapy in orthopaedics].

Shock wave therapy (orthotripsy) is a non-invasive method to treat or ameliorate many musculoskeletal disorders. When higher energies are applied on bones pain is associated with treatment, and anaesthesia is necessary, but there is no need of analgesia after shock wave application. Patients usually receive treatments during a short hospital stay: therefore, short duration drugs and techniques should be preferred, avoiding those causing unpleasant postanaesthetic sequelae.