Background: Paravertebral perineural blocks are used to prevent pain in the thoracoabdominal dermatomes. Traditionally, a landmark-based technique is used in children, while ultrasound-guided (UG) techniques are being employed in adult patients.
Objective: To describe an UG technique for placement of thoracic paravertebral nerve block (TPVNB) catheters in pediatric patients.
Methods: Retrospective chart review of a series of 22 pediatric patients' ages 6 months to 17 years with weights from 6.25 kg to 135 kg using a transverse in-plane technique. Catheters were placed both bilateral and unilateral for a variety of thoracic and abdominal procedures. A linear ultrasound transducer was used in all cases with frequency of oscillation and transducer length chosen based on individual patient characteristics of age, weight, and BMI.
Results: The median pain scores at 12, 24, 36, and 48 h were 1.2 (interquartile range, 4.5), 0.84 (interquartile range 3.0), 1.6 (interquartile range 2.9), and 0.83 (interquartile range 1.74), respectively. The median dose of opioid expressed as morphine equivalents consumed during the first 24 h after surgery was 0.14 mg·kg(-1) (interquartile range, 0.78 mg·kg(-1) ) and from 24 to 48 h the median dose was 0.11 mg·kg(-1) (interquartile range 0.44 mg·kg(-1) ). No complications were noted, and catheters were left an average of 3 days with a range of 1-5 days with good pain relief.
Conclusion: This technical description demonstrates the feasibility of placing PVNB catheters using a transverse in-line ultrasound-guided technique in a wide range of pediatric patients.
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http://dx.doi.org/10.1111/pan.12238 | DOI Listing |
Insights Imaging
January 2025
Department of Radiology, Peking University First Hospital, Beijing, 100034, China.
Objectives: To evaluate the performance of a 3D V-Net-based segmentation model of adrenal lesions in characterizing adrenal glands as normal or abnormal.
Methods: A total of 1086 CT image series with focal adrenal lesions were retrospectively collected, annotated, and used for the training of the adrenal lesion segmentation model. The dice similarity coefficient (DSC) of the test set was used to evaluate the segmentation performance.
World J Urol
January 2025
Department of Urology, Saint Marianna University School of Medicine, Kawasaki, Japan.
Purposes: This study aimed to clarify the clinical outcomes of Bacillus Calmette-Guérin (BCG) treatment in patients with urothelial carcinoma (UC) of the prostatic urethra.
Methods: Between August 2003 and January 2023, 428 patients with non-muscle-invasive UC received BCG treatment (Tokyo strain, 80 mg, ≥ 5 times) in our hospital; 39 had UC of the prostatic urethra. We evaluated the cumulative incidence of intravesical recurrence, progression (muscle-invasive bladder cancer [MIBC] or metastasis), and subsequent radical cystectomy after BCG treatment in patients with UC of the prostatic urethra.
Front Neurol
December 2024
Brain and Development Research Axis, Azrieli CHU Ste-Justine Research Center, Montreal, QC, Canada.
Epileptic spasms (ES) are a unique seizure type typically presenting in the form of infantile epileptic spasms syndrome (IESS) with characteristic hypsarrhythmia on scalp EEG and a preponderance with developmental delay or regression. While pharmacotherapy is the mainstay of treatment, surgical options, including disconnective or resective procedures, are increasingly recognized as viable therapeutic options for recurrent or persistent ES. However, limited data on safety, effectiveness, and prognostic factors hinder informed decision-making regarding surgery indications, timing, and intervention type.
View Article and Find Full Text PDFOncol Lett
March 2025
Department of Anesthesiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
Flurbiprofen axetil is a nonsteroidal anti-inflammatory drug used for analgesia. Its combination with dezocine has previously shown a superior postoperative analgesic effect compared with that of opioids. The present study compared the analgesic effect between dezocine plus flurbiprofen axetil (DFA) and sufentanil in patients with colorectal cancer (CRC) following resection of the tumor.
View Article and Find Full Text PDFClin Exp Emerg Med
January 2025
Department of General Surgery, Anaesthesiology, Resuscitation and Emergency Medicine, Medical Institute named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation.
Objectives: Prompt activation of emergency medical services (EMS) constitutes the fundamental component of bystander response to time-dependent health crises. A clear understanding of the public ability to access EMS may help to guide interventions aimed at enhancing community preparedness for emergencies. This review was conducted to summarise studies that examined public knowledge of emergency phone numbers.
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