Background And Objectives: Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia and complications.
Methods: This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery. Study participants were randomized to the ALT group or USG group. Ipsilateral PVB was performed with the respective technique from T1 to T6. Five milliliters of local anesthetic mixture (0.5% ropivacaine, 5 μg/mL adrenaline, 1 μg/kg clonidine) was administered at each level. Paravertebral catheter was inserted at T4/T3 level. After confirming sensory loss, patients were taken up for surgery with propofol sedation (20-50 μg/kg per minute).
Results: More patients in the USG group (34/36 [94.44%]) had a successful block as compared with the ALT group (26/36 [72.22%]) (P = 0.024). Difference in proportion was 18.1 (95% confidence interval, 0.15-36.0) (P = 0.024) after adjustment for age. More dermatomes were blocked in the USG group (P = 0.0018) with less sparing of upper T2 and T3 dermatomes (P = 0.003, P = 0.006, respectively). Median time to first postoperative analgesic requirement was 502.5 minutes (range, 195-1440 minutes) in the USG group versus 377.5 minutes (range, 215-1440 minutes) in the ALT group. Pain at rest and movement 2 and 4 hours postoperatively and number of catheter top-ups in 24 hours postoperatively were lesser in the USG group (P = 0.012). Complications were comparable.
Conclusions: Ultrasound-guided PVB provided better anesthesia and perioperative analgesia than the landmark technique for breast surgery.
Clinical Trial Registration: The trial was registered retrospectively at the Clinical Trial Registry of India, CTRI/2015/05/005774.
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http://dx.doi.org/10.1097/AAP.0000000000000746 | DOI Listing |
Cesk Slov Oftalmol
December 2024
Purpose: To analyze patients with optic disc drusen (ODD), with emphasis on modern diagnostics.
Materials And Methods: Research of the literature was conducted, together with a retrospective statistical analysis of patients with ODD. The group included individuals with ODD diagnosed using at least one of the following (ultrasound - USG, optical coherence tomography - OCT, fundus autofluorescence - FAF).
Cureus
November 2024
Anesthesiology and Reanimation, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TUR.
Purpose: Postoperative pain is an acute pain that begins with surgical trauma and decreases as the tissue heals. The transversus abdominis plane (TAP) block is one of the abdominal field blocks used in the treatment of acute postoperative pain after lower abdominal surgery. This study aims to investigate the effects of dexamethasone added to a local anesthetic solution on postoperative analgesia in ultrasonography-guided TAP block.
View Article and Find Full Text PDFRotator cuff lesions are common causes of shoulder pain. When not treated effectively, the functional loss associated with pain affects the quality of life and brings about psychosocial issues. In this study, prospective observational comparison of the effects of ultrasonography (USG) guided subacromial injection (SAI) versus subacromial injection combined with suprascapular nerve block (SSNB) on pain, functionality and sleep quality in the treatment of shoulder pain unresponsive to conservative treatments due to rotator cuff lesions is made.
View Article and Find Full Text PDFTurk J Anaesthesiol Reanim
December 2024
Süleyman Demirel University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Isparta, Turkey.
Objective: We intended to research the efficacy of pericapsular nerve group (PENG) block performed with preoperative ultrasonography (USG) in patients who underwent hip fracture repair under spinal anaesthesia and whether it affects the success of spinal anaesthesia.
Methods: The files of 100 patients were analysed, and 60 patients were enrolled in the study. The patients were assigned into two groups: Group P (n = 30) consisted of patients who underwent USG-guided PENG block before the start of surgery and the control group (Group C; n = 30) consisted of patients in whom tramadol infusion was initiated.
Urol Oncol
December 2024
Department of Surgical Oncology, The Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.
Objective: To prospectively validate the diagnostic performance of Clino-radio-pathological Risk Scoring System (CRiSS) for prediction of inguinal lymph-node metastasis (ILNM) in squamous cell carcinoma of penis.
Materials And Methods: A prospective observational study of all patients with SCC penis was conducted between January 1, 2021, and December 31, 2023, at our institute. Data regarding all CRiSS parameters and MRI features of >8mm size and presence of necrosis or irregular outline were recorded, and patients were assigned CRiSS scores and groups.
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