Comparison of Bupivacaine plus Dexmedetomidine versus Bupivacaine plus Fentanyl for Caudal Block in Pediatric Infraumbilical Surgery.

Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility.

Initiation of Inhaled Nitric Oxide by an Air Transport Team in Adult Coronavirus Disease 2019 Respiratory Failure.

The coronavirus disease 2019 (COVID-19) pandemic has caused a significant increase in the volume of critical care flight transports between outlying referral hospitals and tertiary care facilities. Because of the tropism of severe acute respiratory syndrome coronavirus 2, flight crews are often asked to transport mechanically ventilated patients in refractory hypoxemic respiratory failure. The authors present a case series of 5 patients with COVID-19 acute respiratory distress syndrome (ARDS) who were initiated on inhaled nitric oxide (iNO) by the transport team before rotor wing transport and survived the journey in stable or improved condition upon arrival.

Return to Golf, Tennis, and Swimming After Elective Cervical Spine Surgery.

Background After surgery for degenerative cervical spine problems, most patients hope to return to non-competitive sports and other leisure activities. Limited data are available to counsel patients about return to play (RTP) in non-competitive sports after cervical surgery. Methods Participants had cervical surgery for degenerative diagnoses from April 1, 2007, to April 1, 2018.

Ninety-Day Readmission in Elective Revision Lumbar Fusion Surgery in the Inpatient Setting.

Study Design: Retrospective review.

Objectives: (1) Identify the 90-day rate of readmission following revision lumbar fusion, (2) identify independent risk factors associated with increased rates of readmission within 90 days, (3) and identify the hospital costs associated with revision lumbar fusion and subsequent readmission within 90 days.

Methods: Utilizing 2014 data from the Nationwide Readmissions Database, patients undergoing elective revision lumbar fusion were identified.

Multiple Subpial Transections in Eloquent Cortex for Refractory Epilepsy: 2-Dimensional Operative Video.

Although the epilepsy refractory to medical therapy can potentially be cured by the resection of epileptogenic tissue, many patients do not qualify for surgery, because epileptogenic tissue can arise from eloquent areas of the brain, where surgical resection would result in severe neurological deficits. Palliative surgical treatments currently used in these situations include deep brain stimulation, responsive neurostimulation, and vagal nerve stimulation.1 A previously developed technique, multiple subpial transections (MSTs), although used infrequently, is another effective tool.

Standardized Ventriculostomy Protocol without an Occlusive Dressing: Results of an Observational Study in Patients with Aneurysmal Subarachnoid Hemorrhage.

Background: Catheter-related infections are a potentially life-threatening complication of having an external ventricular drain (EVD). Patients with aneurysmal subarachnoid hemorrhage (aSAH) are at increased risk of infection associated with prolonged ventricular drainage, with a reported mean infection rate of 6%. We report the EVD-associated infection rate among patients with aSAH managed with a unique standardized treatment protocol without an occlusive EVD dressing.

90-day Readmission in Elective Primary Lumbar Spine Surgery in the Inpatient Setting: A Nationwide Readmissions Database Sample Analysis.

Study Design: Secondary analysis of a large administrative database.

Objective: The objectives of this study are to: 1) identify the incidence and cause of 90-day readmissions following primary elective lumbar spine surgery, 2) offer insight into potential risk factors that contribute to these readmissions, and 3) quantify the cost associated with these readmissions.

Summary Of Background Data: As bundled-payment models for the reimbursement of surgical services become more popular in spine, the focus is shifting toward long-term patient outcomes in the context of 90-day episodes of care.

Design and operation of the internal dosimetry program for the Chornobyl 'shelter implementation plan'.

The paper discusses the system of individual monitoring for internal exposure, deployed by the Ukrainian Radiation Protection Institute as an integral component of the Shelter Implementation Plan (SIP) at the Chornobyl industrial site. SIP anticipates involving of up to 10,00 workers of numerous SIP contractors. A typical daily shift comprises several hundred workers.