An opioid-free anaesthetic using nerve blocks enhances rapid recovery after minor hand surgery in children.

Background And Objective: The aim of this prospective randomized study was to evaluate the quality of analgesia, postoperative comfort and subsequent duration of hospitalization after distal hand surgery and peripheral nerve block at the wrist for paediatric outpatients.

Methods: Sixty consecutive ASA I or II children were randomly assigned to the following groups: in group B (block), intraoperative and postoperative analgesia was provided by peripheral nerve block; and in group O (opioids), intraoperative and postoperative analgesia was provided by intravenous opioids. The patients' age, sex and type of surgery were recorded as were the postoperative pain management and postoperative vomiting.

Retrospective analysis of the risk factors and pathogens associated with early-onset ventilator-associated pneumonia in surgical-ICU head-trauma patients.

Background: Early-onset ventilator associated pneumonia (EOVAP) are frequent in head-trauma patients, but specific risk factors are poorly studied in this population.

Methods: We conducted a retrospective cohort study in a surgical intensive care unit. Consecutive severe head-trauma patients admitted from January 2000 to December 2002 were studied.

Epidural analgesia after scoliosis surgery: electrophysiologic and clinical assessment of the effects of bupivacaine 0.125% plus morphine versus ropivacaine 0.2% plus morphine.

Study Objective: To study the electrophysiologic and clinical effects of epidural morphine combined with either bupivacaine 0.125% or ropivacaine 0.2%.

Is there any need for expanding the perineural space before catheter placement in continuous femoral nerve blocks?

Background And Objective: There is debate regarding the benefit of perineural space expansion before catheter placement in continuous femoral nerve block. This question is addressed in this prospective, comparative, and randomized study.

Methods: Sixty patients scheduled for total knee replacement were randomly assigned to receive continuous femoral nerve block with or without perineural space expansion using 10 mL dextrose 5% in water (D5W) flush before stimulation-guided catheter placement.

Single-breath vital capacity rapid inhalation induction with sevoflurane: feasibility in children.

Background: Single-breath vital capacity technique is currently administered for inhalation induction of anesthesia with sevoflurane in adults. Because sevoflurane is used in children, the aim of this open nonrandomized trial was to explore the feasibility and acceptance of this technique in midazolam premedicated patients aged from 4 to 15 years old.

Methods: A pediatric population (n = 118) was instructed in the vital capacity technique after their arrival in the induction room in a standardized and playful manner.

The value of adding sciatic block to continuous femoral block for analgesia after total knee replacement.

Background And Objectives: The benefit of adding a sciatic nerve block to the femoral block to improve analgesia after total knee replacement is controversial. The aim of this study is to address this controversy in a prospective, comparative, and randomized study.

Methods: Patients were allocated randomly to receive a continuous femoral nerve block or continuous blocks of both the femoral and sciatic nerves.

Prolongation of epidural bupivacaine effects with hyaluronic acid in rabbits.

To assess the prolongation of epidural bupivacaine by hyaluronic acid viscous formulations we designed a cross-over study in rabbits. Different doses of bupivacaine (3 or 6 mg) either as a solution (bupivacaine hydrochloride), or as viscous formulations with hyaluronic acid (bupivacaine base and bupivacaine hydrochloride) were administered in a rabbit model of epidural anesthesia. In the first part of the study, in vitro release characteristics were determined.

Computed tomography scanning of the sciatic nerve posterior to the femur: Practical implications for the lateral midfemoral block.

Background And Objectives: Using computed tomography (CT) scans of the thighs, this study addresses sciatic nerve anatomy at the injection site for the lateral midfemoral sciatic nerve block. It addresses the recommendation of neutral leg rotation to facilitate block placement.

Method: This prospective and descriptive study involves 21 patients scheduled for CT scan imaging of the lower limbs.

Continuous peripheral nerve blocks with stimulating catheters.

Background And Objectives: This study evaluated the efficacy of stimulating catheters used for continuous peripheral nerve blocks as a means of immediate verification and confirmation of correct catheter position.

Methods: This observational study presents our experience with 130 stimulating catheters used in 40 intersternocleidomastoid, 24 axillary, 47 femoral, and 19 lateral midfemoral sciatic nerve blocks. Placement characteristics (amperage, depth of introducer needle or catheter insertion, elicited motor responses), subsequent postoperative analgesia, and catheter position evaluated with the radiopaque dye analysis were all studied.

Nalbuphine reverses urinary effects of epidural morphine: a case report.

We report the successful use of nalbuphine, a mu-receptor antagonist-kappa-receptor agonist, to reverse the adverse effects on the bladder of epidural morphine.

Intrathecal ropivacaine in rabbits: pharmacodynamic and neurotoxicologic study.

Background: Ropivacaine is available for spinal or intrathecal use in humans, although data on neurotoxicity after spinal injection are not yet available. The authors experimentally determined the relationship between doses of intrathecal ropivacaine and spinal effects and local neurotoxic effects.

Methods: Eighty rabbits equipped with an intrathecal lumbar catheter were studied.

Is haemostasis biological screening always useful before performing a neuraxial blockade in children?

Background: Because of the lack of controlled studies, there is no consensus of opinion about the practice of routine haemostasis tests before neuraxial blockade in children. The purpose of this study was to compare the influence of two different strategies of coagulation evaluation on the incidence of diagnosed coagulopathies leading to a modification of the preoperative or anaesthetic management in children who were scheduled for caudal, epidural or intrathecal block.

Methods: For a 24-month period (period 1, retrospective study, n=751), haemostasis screening was undertaken only after family and personal history and physical examination in all patients.