Literature on anesthetic management of juvenile myasthenia gravis (JMG) for thymectomy is limited. Recently, use of inhalational agents and total intravenous anesthesia with propofol and remifentanyl has been reported. All these techniques individually or in combination have been tried to avoid the use of muscle relaxant. We report successful use of sevoflurane as sole anesthetic agent for intubation and in combination with thoracic epidural anesthesia for intraoperative anesthetic management in a 5-year-old child with JMG.
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http://dx.doi.org/10.4103/0970-9185.130088 | DOI Listing |
J Clin Med
December 2024
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, Aberdeen AB24 3UE, UK.
Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, and complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies in thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane blocks (ESPBs), intercostal blocks, and serratus anterior blocks.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
June 2024
Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
Background: Paravertebral block (PVB) is effective in controlling postoperative pain after video-assisted thoracoscopic surgery (VATS) lobectomy but is subject to a high rate of failure because of incorrect site of injection. We compared methylene blue PVB with thoracic epidural anesthesia (TEA) for postoperative pain after VATS lobectomy.
Methods: We conducted a prospective randomized trial of patients undergoing VATS lobectomy; 120 patients were randomly assigned to the PVB or TEA group.
Br J Anaesth
January 2025
Department of Anaesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Background: Spread of local anaesthetic solution in the paravertebral space after erector spinae plane block (ESPB) is variable. We evaluated whether paravertebral spread of local anaesthetic is affected by patient position after ESPB.
Methods: We randomised 84 patients to receive ESPB at T with a mixture of 0.
Cureus
December 2024
Anesthesiology, Showa University Northern Yokohama Hospital, Yokohama, JPN.
Flail chest is a life-threatening condition characterized by multiple rib fractures that result in a partially free rib cage. Thoracic paravertebral block (TPVB) allows visualization of the needle tip under ultrasound guidance and can be safely performed, unlike epidural anesthesia where the needle tip cannot be visualized. Here, we describe a case of flail chest in whom TPVB was used, as it provides the same level of analgesia as epidural anesthesia and has a perfect analgesic effect.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
: Esophagectomy is a key component of esophageal cancer treatment, with minimally invasive esophagectomy (MIE) increasingly replacing open esophagectomy (OE). Effective postoperative pain management can be achieved through various analgesic modalities. This study compares the efficacy of thoracic epidural anesthesia (TEA) with non-TEA methods in managing postoperative pain following MIE.
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