Erector Spinae Plane Blocks in Major Hepatopancreaticobiliary Surgery: A Case Series.

Hepatopancreaticobiliary (HPB) surgery is major upper abdominal surgery with considerable risk of pulmonary complications related to postoperative pain. While epidural analgesia remains an effective analgesic technique for upper abdominal surgery, HPB surgery poses challenges to its use due to coagulopathy. Erector spinae plane (ESP) blocks are a promising alternative to epidurals.

Interventions for protecting renal function in the perioperative period.

Background: Various methods have been used to try to protect kidney function in patients undergoing surgery. These most often include pharmacological interventions such as dopamine and its analogues, diuretics, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, N-acetyl cysteine (NAC), atrial natriuretic peptide (ANP), sodium bicarbonate, antioxidants and erythropoietin (EPO).

Objectives: This review is aimed at determining the effectiveness of various measures advocated to protect patients' kidneys during the perioperative period.

A prospective crossover comparison of neurally adjusted ventilatory assist and pressure-support ventilation in a pediatric and neonatal intensive care unit population.

Objective: To compare neurally adjusted ventilatory assist ventilation with pressure-support ventilation.

Design: Prospective, crossover comparison study.

Setting: Tertiary care pediatric and neonatal intensive care unit.

Health-related quality of life after prolonged pediatric intensive care unit stay.

Objective: To investigate the long-term health-related quality of life (HRQOL) outcomes for patients requiring at least 28 days of pediatric intensive care.

Design: Retrospective cohort and prospective follow-up study.

Setting: A 21-bed pediatric intensive care unit (PICU) in a university-affiliated, tertiary referral pediatric hospital.

Interventions for protecting renal function in the perioperative period.

Background: A number of methods have been used to try to protect kidney function in patients undergoing surgery. These include the administration of dopamine and its analogues, diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors and hydration fluids.

Objectives: For this review, we selected randomized controlled trials which employed different methods to protect renal function during the perioperative period.

Postthoracotomy paravertebral analgesia: will it replace epidural analgesia?

Thoracotomy is associated with significant acute postoperative pain and a high incidence of development of chronic pain. Thoracic epidural analgesia has long been standard treatment for postthoracotomy pain, but recently there has been increased interest in alternative regional techniques, particularly paravertebral analgesia. This article compares the analgesic efficacy, side effects, complications of, and contraindications for thoracic epidural and paravertebral analgesia techniques and discusses their effects on the development of chronic postthoracotomy pain.

Postoperative anemia and quality of life after primary hip arthroplasty in patients over 65 years old.

Background: It is uncertain whether anemia in elderly patients after primary hip arthroplasty has an effect on their quality of life.

Methods: We conducted a prospective observational study over 3 mo to investigate the association between discharge hemoglobin levels and subjective experience of quality of life at 2 mo postoperatively in patients aged over 65 yr who were scheduled for primary hip arthroplasty. Quality of life was measured preoperatively and at 2 mo postoperatively using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Functional Assessment of Cancer Therapy Anemia (FACT-Anemia) subscale.

Spontaneous hemothorax in a patient with neurofibromatosis type 1 and undiagnosed pheochromocytoma.

Spontaneous hemothorax in neurofibromatosis type 1 rarely occurs, is potentially life-threatening, and requires expedient management. We present a case of massive hemothorax in a patient with neurofibromatosis type 1 caused by spontaneous rupture of the right internal mammary artery. A subsequently diagnosed underlying pheochromocytoma may be implicated in rupture of the arterial wall.

The effect of leaving dentures in place on bag-mask ventilation at induction of general anesthesia.

Background: The optimum timing for denture removal in edentulous patients before anesthesia and surgery is uncertain.

Methods: We conducted a prospective, randomized, controlled trial to evaluate the effect of leaving dentures in during bag-mask ventilation at induction of general anesthesia. One hundred sixty-six edentulous patients were randomized to two groups.