Comments on "Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up" by De Michele et al.

Dear Editor, we read the original study by De Michele et al. titled "Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up" with great interest.

Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Managing Pain Due to Multiple Rib Fractures: A Scoping Review.

Ultrasound (US) guided serratus anterior plane block (SAPB) is a fascial plane block that has been utilized for managing pain after thoracotomy, mastectomy, and fractured ribs. We conducted this qualitative review to investigate the analgesic efficacy of US-guided SAPB in patients who sustained multiple rib fractures (MRFs). We registered our review proposal in a prospective register of systematic reviews, PROSPERO, with identifier CRD42020177145.

Gluteal Contractions as a Gateway to Sacral Plexus.

Background Neurostimulation-guided sacral plexus blocks (SPBs) are primarily indicated for surgeries of the foot and ankle and secondarily for supplementing a lumbar plexus block for hip surgeries. Although ultrasound has largely replaced neurostimulation-guided SPB, it may not be available at all facilities. Hence, it is prudent to understand the intricacies of neurostimulation-guided SPB.

Examining the Importance of Hand Hygiene Policy and Patient Safety Culture on Improving Healthcare Workers' Adherence to Hand Hygiene Practice in Critical Care Settings in the Sultanate of Oman: A Scoping Review.

Several studies suggest that adherence to hand hygiene (HH) policy would be enhanced by improving the culture of safety in an organization. This could be achieved through continuous awareness programs about the dramatic effect of HH practice according to the HH policy on improving patient safety and quality care. Understanding the importance and purposes of HH policy by healthcare workers would allow them to prioritize HH policy in their planning.

Impact and Outcomes of Regional Anesthesia Techniques in Elderly Patients With Fracture of Proximal Femur: A Retrospective Study.

Background Although subarachnoid block (SAB) is the most popular regional anesthesia (RA) technique for fixation of femur fractures, continuous lumbar epidural (CLE) anesthesia, and lumbosacral plexus blocks (LSPB) are also employed in specific situations. The choice of RA technique depends on either the choice of the anesthesiologist or based on the underlying comorbidities. At our institute, we anesthetize elderly patients who come for fixation of femur fracture with multiple comorbidities using RA techniques as mentioned based on comorbidities and overall general condition.

Ultrasound-Guided Continuous Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Patients Undergoing Radical Nephrectomy: A Randomized Controlled Trial.

Introduction Ultrasound (US) guided transmuscular quadratus lumborum block (TMQLB) has been widely used as regional anaesthesia (RA) technique for managing postoperative pain after intraperitoneal and retroperitoneal procedures like nephrectomy, percutaneous nephrostomy, cholecystectomy, and also for hip surgeries. Although continuous epidural analgesia is considered the gold standard for most of these procedures, alternative techniques such as transversus abdominis plane (TAP) block and continuous rectus sheath block have also been used successfully. US-guided TMQLB seems to have more advantages than TAP block as it blocks the visceral afferents.

Anatomic barriers to paraspinal blocks: a cadaver case series.

The paraspinal space is intriguing in nature. There are several needle tip placements described in compact anatomical spaces. This has led to an incertitude regarding the appropriate anatomic locations for needle tip positions.

A retrospective study comparing analgesic efficacy of ultrasound-guided serratus anterior plane block versus intravenous fentanyl infusion in patients with multiple rib fractures.

Background And Aims: Inadequately managed pain due to multiple rib fractures (MRFs) can lead to atelectasis, pneumonia, prolonged ICU stay thereby leads to significant morbidity, morbidity and cost of treatment. Opioids, non-steroidal anti-inflammatory drugs and regional anaesthesia techniques like thoracic epidural or paravertebral blocks, intercostal nerve blocks are used to manage pain. Serratus anterior plane block (SAPB) is an ultrasound (US) guided interfascial plane block which has been used in managing pain due to MRFs.

Perioperative melatonin in COVID-19 patients: benefits beyond sedation and analgesia.

Cytokine storm in coronavirus disease 2019 (COVID-19) patients leads to acute lung injury, acute respiratory distress syndrome, multiorgan dysfunction, shock, and thrombosis thus contributing to significant morbidity and mortality. Several agents like steroids, ascorbic acid, vitamins (C, D, E), glutathione, N-acetylcysteine have been used and several studies are underway to identify its efficacy in addressing undesirable effects due to COVID-19 illness. Among several experimental modalities based on expert opinion and anecdotal data, melatonin is one molecule that appears promising.

Management of Malignant Ascites by Indwelling Tunnelled Catheters in Indian Setup: A Case Series.

Malignant Ascites (MA) poses significant symptom burden in patients with peritoneal malignancies at the end of life. Various treatment options are available and Indwelling Tunneled Catheters (ITC) have the advantage of increased patient comfort being soft on abdomen, less painful, easy to tap fluid, and less chances of infection etc. A total of 5 patients underwent insertion of ITC after proper counseling and assessment.

Regional anesthesia prevents cancer recurrence after oncosurgery! What is wrong with the hypothesis?

Several studies have investigated the hypothesis of the efficacy of regional anesthesia (RA) techniques in preventing cancer recurrence when used perioperatively during oncological surgeries. Although theoretically, the association appears beneficial, the patient outcomes after cancer surgeries with or without RA were comparable, that is, the use of RA did not improve patient survival or prevent cancer recurrence after surgery. Another problem with this data is its retrospective nature which makes its interpretation difficult.

Anatomic and radiological correlation of injectate spread from first thoracic costotransverse junction in cervical erector spinae plane.

Introduction: Cervical erector spinae plane block (ESPB) provides postoperative pain relief when administered at the level of first thoracic costotransverse junction (CTJ) for surgeries on the proximal shoulder and cervical spine. We propose to describe the spread of 20 ml radiocontrast - dye solution administered at this level from caudad to cephalad direction in a fresh frozen cadaveric model through imaging and cross-sections.

Methods: An observational study with four thoracic to cervical ESP blocks at the level of first thoracic CTJ level on two fresh cadavers (total 4 specimens) was conducted using 20 ml of radiocontrast- methylene blue combination (10 ml through the needle and 10 ml through the catheter).

Efficacy of xenon anesthesia in preventing postoperative cognitive dysfunction after cardiac and major non-cardiac surgeries in elderly patients: a topical review.

Elderly patients undergoing major cardiac and non-cardiac surgeries have a high propensity (up to 40-60%) of developing postoperative cognitive dysfunction, which are caused by patient's factors, type of surgery, intraoperative and postoperative factors. All these pose a challenge to the clinicians. The noble gas xenon does not undergo metabolism or any kind of biotransformation in the body owing to its inert nature.

Circumpsoas block ... an anterior myofascial plane block for lumbar plexus elements: case report.

In an attempt to improvise the analgesia in patients with femoral fractures, we aimed at depositing local anesthetic deep to anterior psoas fascia (APf) under ultrasound (US) guidance to block lumbar plexus elements which emerge lateral, anterior, and medial to the psoas major muscle. We termed this as circumpsoas block (CPB). Clinical and computed tomography contrast studies revealed that a continuous CPB infusion with a catheter provided a reliable block of the lumbar plexus elements.