Postdural puncture headache (PDPH) is a common complication of neuraxial anesthesia. The gold standard treatment for PDPH is an epidural blood patch (EBP). However, the risks of EBP, and patient willingness to undergo another attempted neuraxial procedure, can prevent patients from receiving this treatment. The erector spinae plane (ESP) block has been used in the treatment of acute postoperative and chronic pain secondary to many indications at many vertebral levels, and a prior case series describes two patients in which ESP block relieved tension headache. In our case report, we describe a novel use of the ESP block at the fourth thoracic vertebral level to relieve PDPH in a super morbidly obese patient with two prior inadvertent dural punctures.
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http://dx.doi.org/10.7759/cureus.6237 | DOI Listing |
Agri
January 2025
Department of Anesthesiology and Reanimation, Bursa Uludağ University Faculty of Medicine, Bursa, Türkiye.
Objectives: In this study, we aimed to compare the efficacy of two regional anesthesia methods, transversus abdominis plane (TAP) block and erector spinae plane (ESP) block, for intraoperative and postoperative pain relief in patients undergoing laparoscopic nephrectomy.
Methods: Fifty patients aged 18-80 years with American Society of Anesthesiologists (ASA) classification I-II scheduled for elective laparoscopic nephrectomy were included after ethical approval and informed consent. Patients were randomly assigned to either Group TAP (receiving TAP block) or Group ESP (receiving ESP block).
Rev Esp Enferm Dig
January 2025
Hepatology. Gastroenterology Unit, Hospital Universitario Central de Asturias.
A 16-year-old boy was diagnosed from multiple sclerosis (MS) after suffering from paresthesia in upper limbs and VI cranial nerve paresis. Corticosteroids and fingolimod were started. After 13 months a worsening of liver biochemical tests (LBT) was noticed: ALP 787 U/L, GGT 737 U/L, AST 195, ALT 321, Bi 0.
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December 2024
Emergency Medicine, Hospital Episcopal San Lucas, Ponce, PRI.
Sciatica, often characterized by low back pain (LBP) radiating to the leg, is a challenging condition to manage, especially when conventional therapies fail. We present the case of a 27-year-old man who suffered from persistent low back pain with left-sided radicular symptoms. Despite treatment with numerous oral medications, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, and muscle relaxants, his symptoms persisted and intensified.
View Article and Find Full Text PDFRev Esp Cardiol (Engl Ed)
January 2025
Unidad de Arritmias, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Unidad de Arritmias, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
J Emerg Med
January 2025
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.
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