Purpose: Any elective surgery should be as atraumatic to the patient as possible to allow for a comfortable postoperative recovery. The present study was performed to evaluate the efficacy of preoperative regional blocks in reducing pain, discomfort, and analgesic use in patients scheduled to undergo bimaxillary surgery.
Patients And Methods: A prospective, double-blind, randomized controlled trial was conducted to include all patients aged 16 to 30 years requiring bimaxillary surgery. We excluded patients with syndromes and systemic conditions. The primary predictor variable was the maxillary and mandibular nerve blocks (extraoral lateral pterygoid method) administered preoperatively in the operating room using 0.25% bupivacaine hydrochloride. Standard anesthetic and postoperative protocols were followed. The primary outcome variable was postoperative pain. The secondary outcome variables were postoperative discomfort, analgesic consumption, duration of surgery, and blood loss. The unpaired t test and Mann-Whitney U test were used for statistical analyses, with P < .05 considered to indicate statistical significance.
Results: A total of 110 patients were included in the study (55 in the control group and 55 in the test group), of whom 61 were female and 49 were male. Postoperative pain, recorded using a visual analog scale was significantly lower (P < .001) in the test group compared with the control group. Secondary outcome variables such as postoperative discomfort and analgesic consumption were also significantly lower in the test group. A significant positive correlation was present between the duration of surgery and pain measured at 6, 12, 24, and 48 hours postoperatively in both groups.
Conclusions: From our results, it can be established that the administration of preoperative regional blocks using 0.25% bupivacaine immediately before bimaxillary surgery can effectively minimize patients' postoperative pain, discomfort, and consumption of analgesics.
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http://dx.doi.org/10.1016/j.joms.2019.10.014 | DOI Listing |
J Neuroinflammation
January 2025
Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, USA.
The thrombolytic protease tissue plasminogen activator (tPA) is expressed in the CNS, where it regulates diverse functions including neuronal plasticity, neuroinflammation, and blood-brain-barrier integrity. However, its role in different brain regions such as the substantia nigra (SN) is largely unexplored. In this study, we characterize tPA expression, activity, and localization in the SN using a combination of retrograde tracing and β-galactosidase tPA reporter mice.
View Article and Find Full Text PDFAesthetic Plast Surg
January 2025
Department of Burn and Plastic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, China.
Background: Facial trauma repair requires precise reconstruction while preserving aesthetic units. Traditional local anesthesia can distort tissue planes and compromise surgical precision.
Methods: This prospective study evaluated landmark-based nerve blocks versus local infiltration for complex facial laceration repair in emergency settings from January 2022 through February 2023.
J Emerg Med
August 2024
Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Healthcare System, 508 Fulton St, Durham, North Carolina. Electronic address:
Background: Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Background: Postoperative delirium (POD) is an acute brain dysfunction that mainly occurs in elderly patients after surgery. Postoperative pain is an important factor in the occurrence of POD, and effective pain management can reduce the risk of POD. Our study aims is to investigate the effect of ultrasound-guided femoral nerve block (FNB) on postoperative pain and the occurrence of POD after knee arthroplasty, and whether its mechanism is related to oxidative stress, inflammatory factors.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Department of Psychology, Center for Brain Science, Harvard University, Cambridge, MA 02138.
The hippocampus possesses anatomical differences along its long axis. Here, we explored the functional specialization of the human hippocampal long axis using network-anchored precision functional MRI in two independent datasets (N = 11 and N = 9) paired with behavioral analysis (N = 266 and N = 238). Functional connectivity analyses demonstrated that the anterior hippocampus was preferentially correlated with a cerebral network associated with remembering, while the posterior hippocampus selectively contained a region correlated with a distinct network associated with behavioral salience.
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