Icosapent ethyl (VASCEPA) as treatment for post-acute sequelae of SARS CoV-2 (PASC) vaccine induced injury and infection.

Objectives: As the COVID-19 pandemic continues, a prolonged post-infectious syndrome or "long COVID" has been reported. This is a multi-organ post viral syndrome that persists well after infection. Currently, there is no available treatment.

Spinal Cord Stimulation for Post Total Knee Replacement Pain: A Case Series.

It is not uncommon for orthopedic patients to experience pain following a total knee replacement (TKR). Use of oral pain medications, nerve blocks, and periarticular injections are implemented to provide multimodal analgesia and to reduce postoperative chronic pain. Spinal cord stimulation (SCS) can also be used to control pain in patients who are refractory to conservative measures.

Superior Block Length and Reduced Opioid Use with Dexmedetomidine and Dexamethasone regional block versus plain Ropivacaine: a retrospective trial.

Purpose: The purpose of this study is to determine if using a combination of dexamethasone and dexmedetomidine (Dex-Dex) in a single-shot perineural local anesthestic provides an increased duration of pain relief and reduced consumption of opioids for patients undergoing shoulder surgery.

Patients And Methods: This is a retrospective trial of adult patients without major comorbidities undergoing elective, upper arm orthopedic procedures with regional nerve block for post-operative analgesia. Patients underwent nerve block with either 0.

Intraoperative Administration of Dexmedetomidine and Dexamethasone in Local Anesthetic Infiltration to Improve Postoperative Pain Control After Posterior Cervical Fusion.

Dexmedetomidine, a selective and potent α2-adrenoceptor agonist, is used for its anxiolytic, sedative, and analgesic properties. Dexamethasone is a high-potency, long-acting glucocorticoid that has been shown to provide analgesic and anti-inflammatory effects. At present, little has been published with regard to the effectiveness of these drugs as dual agents with local anesthetics for analgesia.

Synergistic Effects of Dexamethasone and Dexmedetomidine in Extending the Effects of Pectoral I and Pectoral II Blocks for Postoperative Analgesia Following Total Mastectomy with Lymph Node Dissection.

Regional anesthesia is an important aspect of the overall anesthetic plan for patients. It has the potential to offer superior benefits compared to opioid-based treatment and is an important component of Enhanced Recovery after Surgery (ERAS) protocols. The use of the pectoral type I (PECS I) and pectoral type II blocks (PECS II) has been shown to reduce postoperative pain and opioid consumption in patients undergoing complete mastectomy and breast surgery.

Pain Alleviation and Opioid Weaning in an 80-Year-Old with Chronic Foot Pain Following Injection Therapy with Perineural Dexmedetomidine and Dexamethasone.

Opiates are routinely used for chronic pain patients, and up to 44% of them will have a prescription for an opiate medication for pain alleviation. However, of the 76 million adults prescribed opiates for pain management, about 12% report misuse, and a large number of these may find themselves addicted to opioid medications. Opioid addiction is an ongoing epidemic, costing many lives.

Use of Dexmedetomidine With Dexamethasone for Extended Pain Relief in Adductor Canal/Popliteal Nerve Block During Achilles Tendon Repair.

The use of regional anesthetic techniques in the peri-operative period has increased as a means to improve analgesia and patient outcomes. Traditionally, various local anesthetics are used and addition of adjuncts such as epinephrine, clonidine, and dexamethasone has shown to prolong the block effect. There has been ongoing research to support the prolongation of a regional block with the addition of dexamethasone and dexmedetomidine (Dex-Dex), providing analgesia for multiple days.

Icosapent Ethyl (Vascepa®) for the Treatment of Acute, Severe Pancreatitis.

Acute pancreatitis is the most common gastrointestinal pathology that warrants hospital admission, with an estimated incidence of 13-45/100,000 annually in the US. The overall mortality is low but is significantly increased in 15-25% of patients that develop severe disease, likely secondary to an increase in inflammation and an exaggerated response, sometimes referred to as a cytokine storm. Management is largely supportive, and no specific cure exists to hasten recovery.

Three Cases of COVID-19 Pneumonia That Responded to Icosapent Ethyl Supportive Treatment.

BACKGROUND Icosapent ethyl, a form of eicosapentaenoic acid with anti-inflammatory activity, has been approved as an adjunctive treatment with statins in patients with hypertriglyceridemia. Icosapent ethyl is currently undergoing clinical trials to determine its anti-inflammatory effects in patients with coronavirus disease 2019 (COVID-19). This report describes 3 intensive care unit (ICU) patients with moderate to severe COVID-19 pneumonia treated with icosapent ethyl as part of their supportive care who had favorable outcomes.

Correction: Synergistic Effect of Perineural Dexamethasone and Dexmedetomidine (Dex-Dex) Prolong Analgesic Effect of a Preoperative Interscalene Block.

[This corrects the article DOI: 10.7759/cureus.9473.

Correction: Adductor Canal Block Duration of Analgesia Successfully Prolonged With Perineural Dexmedetomidine and Dexamethasone in Addition to IPACK Block for Total Knee Arthroplasty.

[This corrects the article DOI: 10.7759/cureus.10566.

Fascia Iliaca Block Successfully Prolonged With Dexmedetomidine and Dexamethasone for Pain Control in a Patient Undergoing Total Hip Arthroplasty.

Regional anesthesia has found many advocates as enhanced recovery after surgery continues to become a more popular option for procedures such as total hip arthroplasty. Among the many benefits is the better pain control with a reduction or complete elimination of the need for opioids for perioperative pain management. With aims to improve the multi-modal approach to pain management, we present a case demonstrating further improvements in the regional anesthetic technique with the addition of a dexamethasone and dexmedetomidine adjuvant to the local anesthetic injectate.

Synergistic Effect of Perineural Dexamethasone and Dexmedetomidine (Dex-Dex) in Extending the Analgesic Duration of Pectoral Type I and II Blocks.

Pectoral type I and II (Pecs I and II) blocks are regional anesthesia methods that have shown to decrease postoperative analgesia after breast surgery. Typically, these blocks consist only of a local anesthetic. We performed preoperative Pecs I and II blocks in a female patient undergoing surgical excision and biopsy of a breast mass.

Adductor Canal Block Duration of Analgesia Successfully Prolonged With Perineural Dexmedetomidine and Dexamethasone in Addition to IPACK Block for Total Knee Arthroplasty.

Total knee arthroplasty (TKA) is among the most commonly performed orthopedic procedures. Controlling the pain of this patient population is essential in improving outcomes such as opioid consumption, hospital length of stay, overall function, and rehabilitation participation following their procedure. Local anesthetic infiltration of the interspace between the popliteal artery and capsule of the posterior knee, known as the IPACK block, combined with an adductor canal block (ACB) can be used to reduce pain in the challenging area of the posterior knee after knee surgery without compromising motor function of the quadriceps muscles.

Icosapent Ethyl - A Successful Treatment for Symptomatic COVID-19 Infection.

COVID-19 is a fatal, universal pandemic caused by the SARS-CoV-2 virus that has directly caused at least 95,235 deaths in the US by May 2020. It has a poor prognosis with a mortality rate as high as 21% in the general population at the height of the pandemic, a rate that is much higher in elderly patients, as well as those requiring intensive care unit (ICU) care. The role of inflammation in symptomatic COVID-19 is being studied, and it is hypothesized that hyper-inflammation is a causative factor in severe COVID-19 disease.

Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia.

Fibromyalgia is a complex disease process that is as prevalent as it is poorly understood. Research into the pathophysiology is ongoing, and findings will likely assist in identifying new therapeutic options to augment those in existence today that are still insufficient for the care of a large population of patients. Recent evidence describes the use of cannabinoids in the treatment of fibromyalgia.

Cognitive behavioral therapy for the treatment of chronic pelvic pain.

Chronic pelvic pain (CPP) in women is defined as noncyclical and persistent pain lasting more than six months perceived to be related to the pelvis. There are many etiologies that can cause CPP, including gynecologic, urologic, gastrointestinal, musculoskeletal, neurologic, and psychosocial. There is a strong association between psychological factors and CPP.

Use of Erector Spinae Plane Block for Perioperative Pain Control in a Patient Undergoing Spinal Surgery.

Regional anesthetic techniques have become a vital part of the perioperative pain control process. The opioid crisis remains a major obstacle in the medical field today and many practitioners have looked upon regional nerve blocks to decrease opioid usage. The erector spinae plane block (ESPB) has gained prominence as a viable option for perioperative pain control for numerous procedures.

Synergistic Effect of Perineural Dexamethasone and Dexmedetomidine (Dex-Dex) Prolong Analgesic Effect of a Preoperative Interscalene Block.

The brachial plexus is often a target of regional anesthesia for procedures involving the upper extremities. These include the supraclavicular, infraclavicular, interscalene, and axillary blocks. The cases we present involve the use of an ultrasound-guided interscalene block using 20 mL 0.

Cannabidiol (CBD) as a treatment of acute and chronic back pain: A case series and literature review.

Objective: Two patient case reports are presented describing the use of cannabidiol (CBD) for the symptomatic relief of a lumbar compression fracture and in the mitigation of thoracic discomfort and dysesthesia secondary to a surgically resected meningioma.

Discussion: CBD appears to have antisnociceptive and anti-inflammatory effects on opioid-naive patients with neuro-pathic and radicular pain. Of note, the patients in this case series used the same CBD cream: Baskin Essentials Body Wellness Cream (400 mg CBD per two oz.

Methemoglobinemia in the Operating Room and Intensive Care Unit: Early Recognition, Pathophysiology, and Management.

The objectives of this review are to describe the acquired and hereditary causes of methemoglobinemia, to recommend the most sensitive diagnostic tests, and to enable critical care clinicians to rapidly detect and treat methemoglobinemia. To meet these objectives, Internet search engines were queried with the keywords to select articles for review that included case reports, case series, observational, longitudinal, and surveillance studies. The most common causes of methemoglobinemia include oxidizing reactions to cocaine-derived anesthetics, such as benzocaine and lidocaine, to antibiotics, such as dapsone and other sulfonamides, and to gases, such as nitric oxide.