Flail chest injury-changing management and outcomes.

Purpose: The purpose of this study was to assess trends in management of flail chest injuries over time and to determine impact on patient outcomes.

Methods: A retrospective review of data from a prospectively collated database of all trauma patients admitted to a level 1 trauma service in Victoria was conducted. All trauma patients admitted to the hospital between July 2008 and June 2020 with an Abbreviated Injury Scale (AIS) code for flail chest injury were included.

Regional anaesthesia for rib fractures: A pilot study of serratus anterior plane block.

Objective: Rib fractures are not only painful but are associated with morbidity and mortality, especially in older patients. The serratus anterior plane block (SAPB) is a plane block distant from major neurovascular bundles and may provide anaesthesia to a substantial area of the hemithorax. This pilot study was designed to assess if the SAPB can be safely and efficiently incorporated to the trauma reception workflow of an adult, level 1 trauma centre.

Opiophobia in Cancer Biology- Justified? - The Role of Perioperative Use of Opioids in Cancer Recurrence.

Opioids remain the standard of care in the provision of analgesia in the patient undergoing cancer surgery preoperatively. The effects of opioids on tumor growth and metastasis have been discussed for many years. In recent years their use as part of the perioperative pain management bundle in the patients undergoing cancer surgery has been thought to promote cancer recurrence and metastasis.

Regional anesthesia and analgesia in cancer care: is it time to break the bad news?

Purpose Of Review: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics.

Recent Findings: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions.

Perioperative Anesthesia Care and Tumor Progression.

This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included.

Impact of infarct size on clinical and echocardiographic outcome in patients undergoing nonsurgical septal reduction therapy.

Background: Nonsurgical septal reduction therapy (NSRT) with ethanol improves clinical and hemodynamic parameters in patients with symptomatic hypertrophic obstructive cardiomyopathy. The purpose of this study was to examine the impact of infarct size induced by ethanol injection on clinical and echocardiographic outcome after the procedure.

Methods And Results: The first 261 consecutive patients were included.