Neuraxial Anesthesia for an Open Low Anterior Rectal Resection: Tip the Scales in Patient's Favor.

We present the case of a successful application of combined spinal-epidural anesthesia for a geriatric patient undergoing open cancer surgery. The patient, affected by multiple comorbidities, was proposed for an open anterior rectal resection. The implementation of a tailored protocol, incorporating neuraxial techniques such as epidural and spinal anesthesia, facilitated optimal pain management and expedited postoperative recovery improving perioperative outcomes, and highlighting the potential benefits of such strategies in selected cases.

Thoracic Erector Spinae Plane (T-ESP) Block Together With Intertransverse Process (ITP) Block for Laparoscopic Abdominal Surgery: A Case Report.

Laparoscopy has become a milestone with reduced surgical stress and postoperative pain. Evidence promotes erector spinae block for laparoscopic abdominal surgery, in particular for cholecystectomy. The thoracic paravertebral space block is the administration of local anesthetic into a wedge-shaped space on the antero-lateral thoracic spine and provides abdominal analgesia.

Segmental Thoracic Spinal Anesthesia for Laparoscopic Cholecystectomy with the "Hypobaric" Technique: A Case Series.

Purpose: Several studies have applied lumbar spinal anesthesia (SA) with isobaric/hyperbaric bupivacaine and opioids in elective laparoscopic cholecystectomy (LC), documenting a superiority of the methodic over general anesthesia (GA) in terms of perioperative pain, nausea, and vomiting, though with a notable incidence of intraoperative right shoulder pain, potentially responsible for conversion to GA. This case series presents an opioid-free scheme of segmental thoracic spinal anesthesia (STSA) with hypobaric ropivacaine, reporting its benefits mainly in terms of shoulder pain occurrence.

Patients And Methods: Hypobaric STSA was performed in nine patients undergoing elective LC between May 1 and September 1, 2022.

Continuous thoracic spinal anesthesia with local anesthetic plus midazolam and ketamine is superior to local anesthetic plus fentanyl in major abdominal surgery.

Background: Limited studies have applied thoracic continuous spinal anesthesia in abdominal surgery, relying exclusively on opioids. This retrospective study analyzes 2 different schemes of thoracic continuous spinal anesthesia and postoperative analgesia in elderly patients undergoing major abdominal surgery.

Methods: A total of 98 patients aged ≥ 75 years were divided into 2 groups.

Thoracic continuous spinal anesthesia for high-risk comorbid older patients undergoing major abdominal surgery: one-year experience of an Italian geriatric hospital.

Background: General anesthesia is associated with high morbidity/mortality in comorbid older adults. Thoracic continuous spinal anesthesia/analgesia (TCSA) may be an alternative for major abdominal surgery. We report a one-year experience of the use of TCSA in an Italian geriatric center.

Radical cystectomy in frail octogenarians in thoracic continuous spinal anesthesia and analgesia: a pilot study.

Background: Radical cystectomy (RC) is the gold standard therapy in nonmetastatic muscle-invasive bladder cancer and is usually performed under general anesthesia (GA). GA is high risk in most older patients due to comorbidities. Continuous spinal anesthesia (CSA) may be an alternative solution to reduce postoperative morbidity in elderly.