Updated Clinical Review: Perioperative Use of Tranexamic Acid in Orthopedics and Other Surgeries.

Tranexamic acid is a well-known antifibrinolytic that has numerous clinical indications, and it is efficacious and safe in many perioperative scenarios including patients with some thrombotic risks. However, further studies that characterize clinical outcomes concerning dosing, timing, and routes in combination are needed in ultra high-risk populations.

Drug-induced aseptic meningitis after an interlaminar lumbar epidural steroid injection.

Background: This case report describes a rare instance of drug-induced aseptic meningitis after an interlaminar lumbar epidural steroid injection.

Case Presentation: A 74 year-old female patient presented to the ED post-procedure day three after an L4-L5 interlaminar lumbar epidural steroid injection with fever, nausea, and vomiting. The patient had previously undergone numerous lumbar epidurals without complications and used identical medications, which included 1% lidocaine, iohexol contrast, methylprednisolone (Depo-medrol), and normal saline.

Venous leg ulcers: potential algorithms of care.

Management of VLUs can be challenging, depending on wound complexity, and may require the use of several treatment modalities to achieve complete wound closure or significant wound area reduction. This review presents a systematic approach to management of VLUs based on previous literature and the authors' clinical experience, with consideration given to wound size, etiology, and responses to prior treatment. Techniques described include debridement (autolytic, enzymatic, sharp/surgical), compression therapy, physical therapy, medical adjuncts, and cellular- and tissue-based therapy.

Nitric oxide versus epoprostenol for refractory hypoxemia in Covid-19.

Objective: To compare the efficacy and outcomes with inhaled nitric oxide (iNO) and inhaled epoprostenol (iEPO) in patients with refractory hypoxemia due to COVID-19.

Design: Retrospective Cohort Study.

Setting: Single health system multicenter academic teaching hospitals.

Serratus Anterior Plane Block Versus Intercostal Block with Incision Infiltration in Robotic-Assisted Thoracoscopic Surgery: A Randomized Controlled Pilot Trial.

Objectives: Patients undergoing robotic video-assisted thoracoscopic surgery (rVATS) report significant postoperative pain. Both the serratus anterior plane block (SAPB) and the surgical intercostal block (IB) (performed by a surgeon from within the thorax), along with incision infiltration (II), are distinct modalities that target the lateral cutaneous branches of intercostal nerves and are acceptable analgesic modalities in an enhanced recovery after rVATS surgery.

Design: Prospective, double-blinded, randomized, controlled pilot trial with 65 patients to assess the difference in analgesia quality between the SAPB and IB+II in rVATS.