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Anesthesia and Pain Management for Scoliosis Surgery: A Narrative Review.
Clin Spine Surg
January 2025
Chair and Department of Palliative Medicine, University of Medical Sciences, Poznań, Poland.
Study Design: This was a narrative review.
Objective: The objective of this review was to summarize the current evidence and knowledge gaps regarding anesthesia and pain management for scoliosis surgery, including multimodal analgesia, and identify the best anesthetic approach to scoliosis surgery that ensures patient safety and pain relief even in the postoperative period, with minimal influence on SSEP monitoring.
Summary Of Background Data: Spinal surgeries and fusions for scoliosis are associated with high pain levels.
Improving Thoracic Trauma Care: Locoregional Analgesia in the Intensive Care Unit.
Cureus
December 2024
Intensive Care Unit, Unidade Local Saúde Viseu Dão-Lafões, Viseu, PRT.
Introduction: Pain management in thoracic trauma patients has, historically, relied heavily on systemic analgesic approaches, mostly opioids, associated with numerous adverse effects. Locoregional anesthesia/analgesia (LRAA), presents a promising alternative by specifically targeting pain pathways at the injury site.
Methods: This study investigates the impact of LRAA on pain management and clinical outcomes in thoracic trauma patients within an ICU setting.
Regional anesthesia modalities in blunt thoracic trauma: A systematic review and Bayesian network meta-analysis.
Am J Emerg Med
December 2024
Department of Anesthesia and Intensive care, University of Pisa, Pisa, Italy.
Background: Various regional anesthesia techniques have been studied for blunt chest wall trauma over the past decades, but their impact on patient outcomes remains unclear. This systematic review and Bayesian network meta-analysis aimed to identify the most effective regional anesthesia techniques for different outcomes in blunt thoracic trauma patients.
Methods: We searched Medline, EMBASE, Scopus, and Cochrane databases for randomized controlled trials comparing regional anesthesia techniques (thoracic epidural, erector spinae plane block, serratus anterior plane block, intercostal block, paravertebral block, intrapleural block, retrolaminar block) and standard intravenous analgesia.
Preliminary study on the preparation of lyophilized acellular nerve scaffold complexes from rabbit sciatic nerves with human umbilical cord mesenchymal stem cells.
World J Stem Cells
December 2024
Department of Orthopedics, Children's Hospital of Fudan University & National Children's Medical Center, Shanghai 201102, China.
Background: The gold standard of care for patients with severe peripheral nerve injury is autologous nerve grafting; however, autologous nerve grafts are usually limited for patients because of the limited number of autologous nerve sources and the loss of neurosensory sensation in the donor area, whereas allogeneic or xenografts are even more limited by immune rejection. Tissue-engineered peripheral nerve scaffolds, with the morphology and structure of natural nerves and complex biological signals, hold the most promise as ideal peripheral nerve "replacements".
Aim: To prepare allogenic peripheral nerve scaffolds using a low-toxicity decellularization method, and use human umbilical cord mesenchymal stem cells (hUC-MSCs) as seed cells to cultivate scaffold-cell complexes for the repair of injured peripheral nerves.
The Influence of Anesthesia on Neuromonitoring During Scoliosis Surgery: A Systematic Review.
NeuroSci
December 2024
Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Article Synopsis
- Intraoperative neuromonitoring (IONM) is essential for ensuring patient safety during scoliosis surgery by monitoring spinal cord and nerve function through motor-evoked potentials (MEPs), with anesthesia type affecting the accuracy of these signals.
- A systematic review was carried out, analyzing studies from major medical databases, which evaluated the impact of various anesthetic techniques on neuromonitoring during scoliosis procedures, narrowing down from 998 articles to 45 for detailed analysis.
- The findings suggest that the Erector Spinae Plane Block (ESPB) offers significant advantages over traditional spinal and epidural anesthesia by improving neuromonitoring accuracy, reducing complications, and providing effective pain management, leading to better patient outcomes.
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