Superficial parasternal intercostal plane blocks in cardiac surgery: a systematic review and meta-analysis.

Purpose: Traditional multimodal analgesic strategies have several contraindications in cardiac surgery patients, forcing clinicians to use alternative options. Superficial parasternal intercostal plane blocks, anesthetizing the anterior cutaneous branches of the thoracic intercostal nerves, are being explored as a straightforward method to treat pain after sternotomy. We sought to evaluate the literature on the effects of superficial parasternal blocks on pain control after cardiac surgery.

Design of personalized scoliosis braces based on differentiable biomechanics-Synthetic study.

This work describes a computational methodology for the design of braces for adolescent idiopathic scoliosis. The proposed methodology relies on a personalized simulation model of the patient's trunk, and automatically searches for the brace geometry that optimizes the trade-off between clinical improvement and patient comfort. To do this, we introduce a formulation of differentiable biomechanics of the patient's trunk, the brace, and their interaction.

Association of intraoperative dexmedetomidine use with postoperative hypotension in unilateral hip and knee arthroplasties: a historical cohort study.

Purpose: Dexmedetomidine is frequently used as a sedative agent for orthopedic surgery patients undergoing total hip or knee arthroplasty. Although the benefits of dexmedetomidine are well described in the literature, there is also potential for harm, especially regarding the hemodynamic effects of dexmedetomidine in the postoperative setting.

Methods: This historical cohort study included all primary unilateral total hip or knee arthroplasties conducted from April 2017 to February 2020 in a single, university-affiliated, tertiary care centre (Jewish General Hospital, Montreal, QC, Canada).

Single-dose premedication enhances multimodal analgesia after knee arthroplasty.

Background: With the current trend to reduce postoperative opioid use to enhance recovery and address perioperative opioid addiction concerns, the challenge of managing pain after total knee arthroplasty has increased. This study examined the effect of adding a preoperative medication regime to a multimodal postoperative analgesia protocol that included regional anaesthesia.

Materials And Methods: Sixty patients undergoing elective first-time unilateral knee arthroplasty received celecoxib 100mg, gabapentin 600mg and dexamethasone 10mg po one hour before skin incision.

A study of the sensitivity of biomechanical models of the spine for scoliosis brace design.

Background And Objective: The development of biomechanical models of the torso and the spine opens the door to computational solutions for the design of braces for adolescent idiopathic scoliosis. However, the design of such biomechanical models faces several unknowns, such as the correct identification of relevant mechanical elements, or the required accuracy of model parameters. The objective of this study was to design a methodology for the identification of the aforementioned elements, with the purpose of creating personalized models suited for patient-specific brace design and the definition of parameter estimation criteria.

Temozolomide in glioblastoma treatment: 15-year clinical experience and analysis of its efficacy.

Aim: To analyze retrospectively the efficacy of temozolomide (TMZ) in various treatment regimens in glioblastoma patients accounting for varying parameters of their treatment.

Materials And Methods: 302 glioblastoma patients were treated at the State Institution "Romodanov Institute of Neurosurgery of the National Academy of Medical Sciences of Ukraine" from 2003 through 2017. All the patients were surgically treated.

Intraoperative Pneumothorax Presenting as Abdominal Distention.

A 74-year-old man with a history of lung cancer presented for right upper lobectomy. After induction of anesthesia, it was noted that the abdomen became progressively more distended. Soon afterward, there was a significant decrease in tidal volume.

Functional outcome of femoral versus obturator nerve block after total knee arthroplasty.

Unlabelled: Patients undergoing total knee arthroplasty often experience substantial postoperative pain, which may delay functional recovery and hospital discharge. We recently reported the short-term analgesic efficacy of a single-injection femoral nerve block after spinal anesthesia in total knee arthroplasty. We have now followed 30 patients a minimum of 1 year to determine the functional outcome and pain relief after femoral and obturator nerve block after total knee arthroplasty.

Perioperative dexamethasone does not affect functional outcome in total hip arthroplasty.

Unlabelled: Current trends in orthopaedic surgery have explored different forms of adjuvant treatments to minimize postoperative pain and the risk of nausea and vomiting. A small single preoperative dose of dexamethasone, as part of a comprehensive multimodal analgesic regimen in low-risk patients undergoing total hip arthroplasty (THA), provides antiemetic and opioid-sparing effects but the longer-term effects on pain, complications, or function are not known. We therefore asked whether such a routine would affect longer-term pain, complications, or function.

Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty.

Background: Preoperative glucocorticoids reduce postoperative nausea but may also improve analgesia and decrease opioid consumption.

Methods: Fifty consecutive patients undergoing elective, unilateral, primary total hip arthroplasty under spinal anesthesia with propofol sedation received in a randomized, double-blind, placebo-controlled manner either 40 mg of dexamethasone or saline placebo i.v.

Obturator versus femoral nerve block for analgesia after total knee arthroplasty.

Background: Both femoral and obturator nerve blocks have been suggested to be useful in relieving pain after total knee arthroplasty (TKA). We sought to compare their efficacy.

Methods: Sixty patients undergoing elective unilateral TKA under spinal anesthesia received in a randomized, double-blind manner a femoral, obturator, or sham nerve block at the end of surgery.

Blood gas measurements using the Bayer Rapid Point 405: are we basing our decisions on accurate data?

Objective: Therapeutic decisions in the Operating Room (OR) are often made based solely upon results obtained from arterial blood gas machines. We evaluated how precise and accurate the results obtained from Bayer Rapid Point 405 (RP405) were vis-à-vis those of our blood gas laboratory and if they met the standards of the members of the anesthesia department.

Methods: About 3 ml of blood from an indwelling arterial catheter were drawn into a heparinized syringe (FIMS Portex Inc.

Electrical stimulation of the epidural space using a catheter with a removable stylet.

Background And Objectives: Electrical stimulation can be used to verify the location of epidural catheters. With the traditional technique, the latter must be primed with saline to allow for electrical conduction: any air lock will, thus, hinder the flow of current. Therefore, we set out to explore an alternative mode of stimulation by use of a catheter containing a removable stylet.

Documentation on the anesthetic record: Correlation with clinically important variables.

Purpose: A survey was undertaken at a single Academic Health Sciences Centre to document the opinions of anesthesiologists regarding what variables are important to document on the anesthetic record. A subsequent chart review of anesthetic records was undertaken to determine the extent to which these anesthesiologists record the variables they consider important.

Methods: A survey form was mailed to all practicing staff anesthesiologists at the four adult McGill University affiliated hospitals.

Documentation on the anesthetic record: correlation with clinically important variables : [Documentation sur le dossier anesthésique : corrélation avec les variables cliniques importantes].

Purpose: A survey was undertaken at a single Academic Health Sciences Centre to document the opinions of anesthesiologists regarding what variables are important to document on the anesthetic record. A subsequent chart review of anesthetic records was undertaken to determine the extent to which these anesthesiologists record the variables they consider important.

Methods: A survey form was mailed to all practicing staff anesthesiologists at the four adult McGill University affiliated hospitals.

Ketorolac analgesia for inguinal hernia repair is not improved by peripheral administration.

Purpose: It has been suggested that ketorolac, a non-steroidal anti-inflammatory drug (NSAID) available for parenteral use, may result in prolonged (24 hr) postoperative analgesia through a peripheral mechanism when added to local anesthetic infiltration. Our objective was to assess this effect by controlling for systemic absorption of the drug.

Methods: This randomized, double-blind trial studied 40 men undergoing elective inguinal hernia repair under spinal anesthesia.

Seizures after epidural blood patch with undiagnosed subdural hematoma.

Objective: We present a case of new-onset seizures in a parturient who received an epidural blood patch (EBP) in the presence of an undiagnosed cerebral subdural hematoma. We review the relevant literature and examine the implications for management.

Case Report: A 33-year-old parturient developed symptoms of postdural puncture headache 16 hours after initiation of epidural analgesia for labor.

The performance of spinal anesthesia is marginally more difficult in the elderly.

Background And Objectives: We sought to determine if spinal anesthesia is more difficult to perform in the elderly.

Methods: All spinal anesthetics administered over 18 months by 18 anesthesiologists were eligible. We excluded anesthetics for hip fractures and cesarean deliveries.

Videotape feedback in teaching laryngoscopy.

Purpose: To evaluate if videotape feedback provides educational insights for students learning laryngoscopy that they would not otherwise perceive.

Methods: Twenty-six medical students were videotaped while performing laryngoscopy for oral intubation. Before and after reviewing their performance on the videotape, they answered a standardized questionnaire assessing the adequacy of positioning, head movement during laryngoscopy, degrees of neck flexion and head extension, time elapsed, and whether the laryngoscope contacted the upper lip or teeth.