Local anaesthesia with conscious sedation in parotid gland tumour resection: a retrospective review.

Objectives: This study explored the suitability of local anaesthesia with conscious sedation for parotid gland tumour surgery.

Methods: Three hundred sixty-four medical records were reviewed to gather data on several key aspects for retrospective analysis. These included age, incision length, operation time, tumour size, NNIS score, ASA score, and pathology.

Free-hand Frameless Pinless Electromagnetic-Navigation (AXIEM™)-Guided Brain Lesion Biopsies: An Institution Based Experience from a Low-Middle-Income Country.

Objectives: To evaluate the precision and safety of a novel technique of free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions in a low-middle income country.

Methods: This retrospective study included 45 patients who underwent free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions using the Medtronic-Stealth S7 system over a 5-year period (January 2019 to December 2023) at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.

Results: A total of 45 patients were included in this study.

Investigation of Abdominoplasty Without General Anesthesia: A Scoping Review.

Abdominoplasty is a common aesthetic surgical procedure primarily performed under general anesthesia (GA). However, GA is aerosol-generating and involves extended immobilization associated with systemic complications like venous thromboembolisms (VTEs). There is increasing interest in performing abdominoplasties without GA because of potential lower complication rates and shorter postoperative recovery time.

Ketodex: A Game-Changer in Pediatric Sedation for Challenging Airway.

Managing sedation in pediatric patients with complex facial anomalies and airway challenges requires careful consideration of safety and efficacy. This case report presents the use of the Ketodex sedation protocol, combining ketamine (NMDA receptor antagonist) and dexmedetomidine (alpha-2-agonist), for a child with a large cervical/facial mass undergoing a diagnostic magnetic resonance imaging (MRI). Ketodex provides effective sedation with minimal need for manipulation of the airway and side effects, making it ideal for cases involving difficult airways.

Selective coronary arteriography via transradial access in young children.

Background: Transradial access (TRA) is not a common vascular access in children. We have been performing TRA actively to reduce puncture complications, and the purpose of this study was to investigate the safety and efficacy of TRA in young children.

Methods: The study included 29 patients aged 5-12 years who underwent diagnostic catheterization at Kurume University Hospital.

Parenting Styles and Sedation Efficacy in Pediatric Dental Care; A Study in Uncooperative Children Aged 4 to 6 Years: Structural Equation Modeling Approach.

Background: Behavioral problems in children contribute significantly to non-compliance and lack of cooperation with dentists.This study aimed to assess the impact of parenting styles on the success of conscious sedation with midazolam in uncooperative children aged 4 to 6 years.

Methods: This short-term longitudinal study included ninety-six children aged 4-6 years who were classified as uncooperative according to the Frankl Behavior Rating Scale (Frankl I, II), requiring pulp treatment and Stainless-Steel Crown (SSC) restoration.

Coil Embolization and Endoscopic Hematoma Removal for Ruptured Cerebral Aneurysm With Intracranial Hematoma Under Local Sedation: A Case Report.

Intracerebral hematomas (ICHs) can complicate ruptured cerebral aneurysms. The standard approach for these cases has traditionally involved craniotomy with clipping and hematoma evacuation. Recently, however, a combination of coil embolization and neuroendoscopic hematoma removal has shown promise.

The Value of Intraoperative Neurophysiological Monitoring During Patient Positioning in Spine Surgery: A Preventive Strategy.

Cervical spine surgery in patients with myelopathy poses a substantial anesthetic challenge, primarily due to the risk of secondary spinal cord injury (SCI). Traditionally, concerns have centered around cervical movements during intubation. However, limited evidence supports a direct link between intubation and SCI, so anesthesiologists must consider other factors, including patient positioning, spinal perfusion pressure, and direct surgical complications.

Effect of Intravenous Lidocaine Infusion on Propofol Dose and Perioperative Pain During Moderate Sedation-Analgesia for Hysteroscopy: A Randomized Controlled Trial.

Purpose: In China, the majority of hysteroscopic procedures require moderate sedation and analgesia. The efficacy of intravenous lidocaine in reducing the need for sedatives and alleviating perioperative pain during hysteroscopy remains equivocal. This study aims to determine whether the intravenous administration of lidocaine can reduce the required dose of propofol and enhance perioperative pain management.

Clinical experience and video description of minimally invasive surgery for benign prostatic obstruction using the Schelin Catheter®.

Although designed for in-office use, water vapor thermal therapy (Rezum™) remains a painful procedure, and oral±intravenous sedation is often required. Schelin Catheter® (ProstaLund AB, Lund, Sweden) is an innovative bladder catheter that delivers local anesthesia to the prostate in a sterile transurethral way. We aimed to evaluate the safety and feasibility of Rezum™ for male lower urinary tract symptoms due to benign prostatic obstruction (LUTS/BPO) with local anesthesia delivered with Schelin® catheter, and to report its first step-by-step video description.

Total Aortic Arch Repair With Double-Fenestrated Physician-Modified Endograft Under Local Anesthesia And Sedation: A Prospective Study.

The outcomes of local anesthesia and sedation (also referred to as monitored anesthesia care) in endovascular aortic arch repair are not well-studied or widely reported. This study aims to demonstrate the feasibility and safety of this approach using physician-modified endografts for total aortic arch repair and showing it is a promising alternative to general anesthesia. Only a few exclusion criteria necessitate performing the procedure under general anesthesia and no conversions to general anesthesia were required.

Clinical application of mobile CT combined with procedural sedation and analgesia in the preoperative localization of multiple pulmonary nodules.

Objective: To evaluate the safety and efficacy of mobile CT combined with procedural sedation and analgesia for the preoperative localization of multiple nodules.

Methods: The clinical data of 200 patients who underwent CT-guided localization before single-port thoracoscopic pulmonary lobe surgery at our hospital from July 2023 to September 2023 were retrospectively analyzed. The patients were divided into two groups according to the localization method: Group A consisted of 100 patients who were localized under local anesthesia, and Group B consisted of 100 patients who were localized under procedural sedation and analgesia combined with local anesthesia.

A randomized double-blinded study assessing the effect of different doses of transnasal dexmedetomidine on the median effective concentration of ropivacaine for a caudal block.

Background: Perineural administration of dexmedetomidine (PN-DEX) can enhance the efficacy of local anesthetics used in regional nerve blocks while decreasing the median effective concentration (EC50) of these anesthetics. Intranasal administration of dexmedetomidine (IN-DEX) is more accessible for sedation during regional anesthesia because of its non-invasive systemic administration and demonstrates synergism with local anesthetic. However, it remains unclear whether IN-DEX affects the EC50 of local anesthetics used in caudal blocks.

Right Drug in the Wrong Place: The Effects of Inadvertent Intrathecal Tranexamic Acid.

Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias.

Efficacy of Procaine, With and Without Epinephrine, Compared to Lidocaine in Local Anesthesia for Calves Before Thermocautery Disbudding.

Within the European Union, the use of lidocaine in food-producing animals is restricted due to concerns over human safety. This study compared the clinical effectiveness of procaine, with and without epinephrine, against lidocaine in pain alleviation during thermocautery disbudding in xylazine-sedated calves. The efficacy of local blocks was assessed through needle pricks, and the behavioral reactions to disbudding were scored.

Pain Management during Bromelain-Based Enzymatic Debridement (NexoBrid) in a USA Adult Burn Center.

Outside the United States, bromelain-based enzymatic debridement (BBED) has become an effective tool for the removal of burn eschar. A primary concern with BBED is that it is a painful procedure requiring appropriate analgesia. The purpose of this study was to describe our experience using NexoBrid (NXB), with a particular focus on pain management.

Inflatable penile prosthesis implantation in the outpatient setting is safe and feasible: a prospective, singe center study.

Inflatable penile prosthesis (IPP) implantations are commonly performed in hospital settings which accommodate an overnight stay and are increasingly being performed as day procedures in outpatient settings with same-day discharge. This study sought to investigate the safety and feasibility of day surgery insertion of an IPP. Surgical parameters and incidence of postoperative complications including infection, hospital admission, emergency room visitation, and additional analgesia were investigated.

The Application of Sleep Deprivation Combined With Chloral Hydrate on Pediatric Dermatological Surgery.

Background: In small dermatological surgeries for infant and child patients, it is required that the child be in a quiet state. However, general anesthesia not only requires the participation of professional anesthesiologists for surgery but also has a high cost and anesthesia risks. Parents have a low acceptance rate.

Comparison between ultrasound guided erector spinae plane block and paravertebral block on acute and chronic post mastectomy pain after modified radical mastectomy: randomized controlled trial.

Background: Inadequate acute postoperative pain management is linked to the effect on the stress response and development of chronic pain. A unique regional anaesthetic method that is becoming more important for postoperative pain management is erector spinea plane block (ESP). Since its initial description, physicians have questioned weather this novel easy method can take the place of paravertebral block (PVB).

Radical surgical excision of extensive perianal melanomas on standing horses: Twenty cases.

Objective: To report a radical surgical technique for perianal melanomas involving the anal margin in standing horses.

Study Design: Observational retrospective study.

Sample Population: Twenty client-owned horses presented for surgical excision of extensive (≥4 cm) perianal melanomas.

Association of Conscious Sedation With Dexmedetomidine and Outcome in Stroke Patients Undergoing Thrombectomy in the DEVT and RESCUE-BT Trials.

Background And Objectives: Although dexmedetomidine (DEX) is widely administered during endovascular treatment (EVT) to enhance procedural adherence of patients with acute ischemic stroke (AIS) with large vessel occlusion, there is limited research on the association of DEX and outcomes among these patients. Hence, this study aimed to explore the safety and outcomes of DEX during conscious sedation (CS) in a real-world setting among patients undergoing EVT.

Methods: This study was an individual patient-level pooled analysis of 2 multicenter randomized clinical trials RESCUE-BT and DEVT.