The First Case of Usutu Virus Neuroinvasive Disease in Austria, 2021.

Usutu virus (USUV) is a mosquito-borne flavivirus closely related to West Nile virus (WNV) that is endemic in many European countries. We report the first case of USUV neuroinvasive disease in Austria and discuss challenges in differentiating USUV from WNV infections in areas where both viruses are endemic.

Perioperative sedation requirements of infants aged 0 to 3 months subjected to lower-body surgery under caudal blockade: a randomized controlled trial.

Background: It remains unclear how much sedation is required for subumbilical surgery under caudal blockade, and sedatives may carry a poorly understood risk of late sequelae in infants. We designed a randomized controlled study to evaluate total propofol consumption and perioperative sedation quality with the avoidance of continuous perioperative sedation in infants undergoing surgery under caudal anesthesia.

Methods: Thirty-two infants (age: 0-3 months) were randomized to one of two groups in which perioperative administration of propofol was provided either "as needed" or by continuous infusion (5 mg kg h).

Vasopressor Therapy in Cardiac Surgery-An Experts' Consensus Statement.

Hemodynamic conditions with reduced systemic vascular resistance commonly are observed in patients undergoing cardiac surgery and may range from moderate reductions in vascular tone, as a side effect of general anesthetics, to a profound vasodilatory syndrome, often referred to as vasoplegic shock. Therapy with vasopressors is an important pillar in the treatment of these conditions. There is limited guidance on the appropriate choice of vasopressors to restore and optimize systemic vascular tone in patients undergoing cardiac surgery.

Impact of Antiplatelet Therapies on Patients Outcome in Osteosynthetic Surgery of Proximal Femoral Fractures.

Background: Proximal femoral fractures should be treated in a timely manner. Affected patients often require antiplatelet therapy (APT) due to cardiovascular diseases. Guidelines recommend 5-7 days APT interruption for elective surgery.

Club cell protein 16 and cytokeratin fragment 21-1 as early predictors of pulmonary complications in polytraumatized patients with severe chest trauma.

Background: Acute respiratory distress syndrome (ARDS) and pneumonia have a great impact on the treatment regimen of polytraumatized patients with severe chest trauma. The objective of our study was to determine whether biomarker levels assessed shortly after multiple trauma may predict the occurrence of these conditions.

Methods And Findings: Our patient population included 71 men and 30 women (mean age, 40.

The clinical benefit of a follow-up thoracic computed tomography scan regarding parenchymal lung injury and acute respiratory distress syndrome in polytraumatized patients.

Purpose: To evaluate the increase of parenchymal lung injury (PLI) volume between the initial and a follow-up computed tomography (CT) scan and to ascertain which of the 2 scans was more appropriate to predict acute respiratory distress syndrome (ARDS).

Material And Methods: From 2011 to 2015, polytraumatized patients (≥18 years; ISS ≥ 16) directly admitted to our level I trauma center were included in our prospective study if a follow-up CT scan was possible 24 to 48 hours after the trauma. The PLI volume was measured using volumetric analysis.

Feasibility and pharmacokinetics of caudal blockade in children and adolescents with 30-50 kg of body weight.

Background: Caudal blockade, although an important technique of pediatric regional anesthesia, is rarely used in children heavier than 30 kg. This reservation is due to anatomical concerns and lack of pharmacokinetic data. We therefore set out to evaluate, in pediatric patients weighing 30-50 kg, the feasibility of ultrasound-guided caudal blockade and the pharmacokinetics of caudally administered ropivacaine.

A pharmacodynamic evaluation of dexmedetomidine as an additive drug to ropivacaine for peripheral nerve blockade: A randomised, triple-blind, controlled study in volunteers.

Background: Previous data have indicated the efficacy of dexmedetomidine as an additive to peripheral regional anaesthesia. There are no pharmacodynamic data regarding the addition of dexmedetomidine to local anaesthetics for perineural administration.

Objective: The objective of this study is to assess the dose-dependency of dexmedetomidine when injected with ropivacaine for peripheral nerve blockade.

Magnetic resonance imaging analysis of the spread of local anesthetic solution after ultrasound-guided lateral thoracic paravertebral blockade: a volunteer study.

Background: This study was designed to examine the spread of local anesthetic (LA) via magnetic resonance imaging after a standardized ultrasound-guided thoracic paravertebral blockade.

Methods: Ten volunteers were enrolled in the study. We performed ultrasound-guided single-shot paravertebral blocks with 20 ml mepivacaine 1% at the thoracic six level at both sides on two consecutive days.

Interleukin 8 correlates with intestinal involvement in surgically treated infants with necrotizing enterocolitis.

Purpose: The aim of this study was to test the predictive value of interleukin (IL) 8 in the assessment of intestinal involvement in necrotizing enterocolitis (NEC).

Methods: Forty infants with surgically treated NEC were classified into 3 groups based on intestinal involvement during laparotomy: focal (n = 11), multifocal (n = 16), and panintestinal (n = 13). Preoperatively obtained serum levels of IL-8, C-reactive protein, white blood cell count, and platelet count were correlated with intestinal involvement using logistic regression models.

Ultrasound-guided upper extremity blocks - tips and tricks to improve the clinical practice.

Brachial plexus blockade in children can be used for a broad spectrum of clinical indications. Nevertheless, these regional anesthetic techniques are still underused in pediatric anesthesia that is mainly because of insufficient descriptions of the particular techniques. Ultrasound guidance enables direct visualization of neuronal and adjacent anatomical structures, the cannula, and the spread of local anesthetic.

Pediatric regional anesthesia: abdominal wall blocks.

Abdominal wall blocks are an effective regional anesthetic technique to provide sufficient analgesia in abdominal surgery. This article reviews the use of abdominal wall blocks in pediatric regional anesthesia.

High-resolution ultrasound accurately identifies the medial antebrachial cutaneous nerve at the midarm level: a clinical anatomic study.

Objectives: The present prospective volunteer study was designed to describe a technique for ultrasound identification of the medial antebrachial cutaneous nerve (MACN) and a technique for ultrasound-guided blockade of this sensory nerve of the upper limb.

Methods: Twenty male volunteers were included in this study. After cross-sectional ultrasound identification of the MACN at the upper arm, where it is closely adjacent to the basilic vein, a selective blockade via an in-plane needle guidance technique was performed with 0.

Management of hypertrophic pylorus stenosis with ultrasound guided single shot epidural anaesthesia--a retrospective analysis of 20 cases.

Aim: To retrospectively describe the performance of ultrasound guided thoracic epidural anaesthesia under sedation for anaesthesia management of open pyloromyotomy.

Background: Anaesthesia management for hypertrophic pylorus stenosis (HPS) is usually performed under general anaesthesia with tracheal intubation. Only a few publications describe avoidance of tracheal intubation in infants by using spinal or caudal anaesthesia.

Endobronchial intubation detected by insertion depth of endotracheal tube, bilateral auscultation, or observation of chest movements: randomised trial.

Objective: To determine which bedside method of detecting inadvertent endobronchial intubation in adults has the highest sensitivity and specificity.

Design: Prospective randomised blinded study.

Setting: Department of anaesthesia in tertiary academic hospital.

Current concepts and future trends in ultrasound-guided regional anesthesia.

Purpose Of Review: Ultrasound guidance for regional anesthesia has gained enormous popularity during the past several years. This review article highlights the importance of acquiring an understanding and knowledge of human anatomy for well tolerated and effective performance of regional anesthesia; includes description of some of the major principles of ultrasound-guided regional anesthesia techniques (adequate identification of neuronal and adjacent anatomical structures along with the procedure needle); use of adequate volumes of local anesthetic and the proper administration of local anesthetic; and discusses economical along with educational aspects of ultrasound-guided regional blocks.

Recent Findings: Recent studies by various authors have indicated that ultrasound-guided regional blocks can be performed by using smaller volumes of local anesthetics.

The anxiolytic effect of pregabalin in outpatients undergoing minor orthopaedic surgery.

Preoperative anxiety can increase postoperative pain and is therefore important to avoid. Different approaches have already been tested for preoperative anxiolysis. Gabapentinoids might be a useful alternative to benzodiazepines.

Minimal local anesthetic volume for peripheral nerve block: a new ultrasound-guided, nerve dimension-based method.

Background And Objectives: Nerve blocks using local anesthetics are widely used. High volumes are usually injected, which may predispose patients to associated adverse events. Introduction of ultrasound guidance facilitates the reduction of volume, but the minimal effective volume is unknown.

Ultrasound versus landmark-based technique for ilioinguinal-iliohypogastric nerve blockade in children: the implications on plasma levels of ropivacaine.

Background: Ilioinguinal-iliohypogastric nerve blockade (INB) is associated with high plasma concentrations of local anesthetics (LAs) in children. Ultrasonographic guidance enables exact anatomical administration of LA, which may alter plasma levels. Accordingly, we compared plasma levels of ropivacaine after ultrasonographic versus landmark-based INB.

Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade.

Background And Objectives: The use of ultrasonography in regional anesthetic blocks has rapidly evolved over the past few years. It has been speculated that ultrasound guidance might increase success rates and reduce complications. The aim of our study is to compare the success rate and quality of interscalene brachial plexus blocks performed either with direct ultrasound visualization or with the aid of nerve stimulation to guide needle placement.

Ilioinguinal/iliohypogastric blocks in children: where do we administer the local anesthetic without direct visualization?

Background: Ultrasonographic observation of peripheral nerve blocks enables direct visualization of the spread of local anesthetic around the targeted nerves. Similarly, ultrasonography may be used to determine the site of local anesthetic placement when landmark-based techniques are used. We performed a study to determine the actual location of local anesthetic when ilioinguinal/iliohypogastric nerve blocks are performed using landmark-based techniques in children in an attempt to explain a failed block.