Group A (GAS), particularly (), is a significant human pathogen responsible for infections often ranging from mild superficial conditions to severe, life-threatening diseases like necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS). This case report details the rapid deterioration of a previously healthy 49-year-old woman who presented with localized symptoms in her left thigh, later escalating to septic shock and multi-organ failure related to GAS infection. Initial evaluations indicated significant inflammation and acute kidney injury, prompting broad-spectrum antibiotic treatment.
View Article and Find Full Text PDFBackground: Spinal cord stimulation (SCS) is effective in treating chronic neuropathic pain. A screening trial is typically conducted prior to implantation to evaluate whether a patient is a good candidate for SCS. However, the need for a screening trial has been debated.
View Article and Find Full Text PDFGiven the differing mechanisms thought to underlie therapeutic sub- and supra-perception-based neurostimulative modalities, Spinal Cord Stimulation (SCS) systems designed for combined delivery of these approaches may help improve analgesic outcomes and quality of life, and reduce treatment failures. This multicenter, observational case-series evaluated 188 patients with chronic back and/or leg pain implanted with an SCS device capable of sequential or simultaneous delivery of sub-perception and supra-perception stimulation programming (i.e.
View Article and Find Full Text PDFThis article summarizes recommendations made by six pain specialists who discussed the rationale for ziconotide intrathecal analgesia (ITA) and the requirement for evidence-based guidance on its use, from a European perspective. Riemser Pharma GmbH (Greifswald, Germany), which holds the European marketing authorization for ziconotide, hosted the meeting. The group agreed that ITA is under-used in Europe, adding that ziconotide ITA has potential to be a first-line alternative to morphine; both are already first-line options in the USA.
View Article and Find Full Text PDFBackground: One-lung ventilation (OLV) in thoracic anesthesia is required to provide good surgical exposure. OLV is commonly achieved through a double lumen tube (DLT) or a bronchial blocker (BB). Malposition is a relevant issue related to these devices use.
View Article and Find Full Text PDFBackground: Open colorectal cancer (CRC) surgery induces severe and prolonged postoperative pain. The optimal method of postoperative analgesia in CRC surgery has not been established. We evaluated the efficacy of preperitoneal continuous wound infusion (CWI) of ropivacaine for postoperative analgesia after open CRC surgery in a multicenter randomized controlled trial.
View Article and Find Full Text PDFObjective: Vertebroplasty (PV) and balloon kyphoplasty (KP) are minimally invasive vertebral augmentation procedures involving injection of polymethyl methacrylate cement under radiologic control into a fractured vertebral body. They strengthen the bone and improve the intense pain caused by fracture secondary to osteoporosis, metastasis, or trauma and refractory to conservative therapies such as analgesic use, bed rest, and bracing. Aim of the study is to investigate and compare safety and efficacy of KP and PV on pain and mobility in patients with vertebral fractures due to osteoporosis or trauma.
View Article and Find Full Text PDFPurpose Of Review: To evaluate the relevance of new local anesthetics in pediatric regional anesthesia.
Recent Findings: Several studies evaluate the pharmacokinetics of new local anesthetics, like ropivacaine and levobupivacaine, and compare their safety and efficacy with the old but widely used bupivacaine.
Summary: The goal of anesthetists using regional anesthesia is to use local anesthestics that are as safe and effective as possible, with a rapid onset and a long duration.
In this prospective, randomized, observer-blinded clinical trial, we compared the incidence of unwanted lower extremity motor blockade and the analgesic efficacy between small-dose (0.125%; 0.2 mg x kg(-1) x h(-1)) postoperative epidural infusions of bupivacaine (Group B; n = 28), levobupivacaine (Group L; n = 27), and ropivacaine (Group R; n = 26) in children after hypospadias repair.
View Article and Find Full Text PDFUnlabelled: We investigated three different concentrations of levobupivacaine (0.125%, 0.20%, and 0.
View Article and Find Full Text PDFIn spite of improvements in anesthesia techniques, the 'big little problem' of postoperative nausea and vomiting (PONV) still exists. PONV can prolong recovery room stay and hospitalization, and is one of the most common causes of hospital readmission after day surgery. While there is little evidence to support prophylactic administration of antiemetics in patients at low risk of PONV, the higher risk population could benefit from the use of adequate antiemetic drugs.
View Article and Find Full Text PDFBackground And Objectives: To compare ropivacaine, levo-bupivacaine, and racemic bupivacaine for caudal blockade in children.
Methods: Using a prospective observer blinded design, 60 sevoflurane anesthetized children (1 to 7 years) undergoing minor subumbilical surgery, were randomized to receive a caudal block (1 mL/kg) with either ropivacaine 0.2%, racemic bupivacaine 0.