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J Matern Fetal Neonatal Med 2021 May 9:1-4. Epub 2021 May 9.

Department of Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.

Background: Accidental dislodgement of central venous catheters is a frequent complication in NICU and it often requires catheter replacement. Subcutaneously anchored sutureless devices (SAS) have been recently introduced in clinical practice for securement of different types of central catheters, but they have never been used in neonates. We evaluated safety and efficacy of SAS in neonates. Read More

Radiol Res Pract 2021 17;2021:6657137. Epub 2021 Apr 17.

Department of Radiology, Korle Bu Teaching Hospital, Accra, Ghana.

Background: Pain, anxiety, and distress are common in radiological investigations including hysterosalpingogram (HSG). Studies suggest that sedation allows patients to better tolerate diagnostic imaging and image-guided procedures by relieving anxiety, discomfort, and pain. This study aimed at assessing the safety and effectiveness of ketamine use in HSG and the proportion of true positive bilateral tubal blockage during HSG using the Jimah Procedure. Read More

J Am Coll Cardiol 2021 May;77(17):2204-2215

University Clinic Schleswig-Holstein and University Heart Center Lübeck, Lübeck, Germany.

Background: The randomized SOLVE-TAVI (compariSon of secOnd-generation seLf-expandable vs. balloon-expandable Valves and gEneral vs. local anesthesia in Transcatheter Aortic Valve Implantation) trial compared newer-generation self-expanding valves (SEV) and balloon-expandable valves (BEV) as well as local anesthesia with conscious sedation (CS) and general anesthesia (GA) in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Read More

J Clin Med 2021 Apr 7;10(8). Epub 2021 Apr 7.

Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) has become a routine treatment of advanced Parkinson's disease (PD). DBS surgery is commonly performed under local anesthesia (LA) to obtain reliable microelectrode recordings. However, procedural sedation and/or analgesia (PSA) is often desirable to improve patient comfort. Read More

Abdom Radiol (NY) 2021 Apr 29. Epub 2021 Apr 29.

Department of Radiology, University of Trieste, Trieste, Italy.

Purpose: To retrospectively investigate long-term outcomes of renal cryoablation from a multicenter database.

Methods: 338 patients with 363 renal tumors underwent cryoablation in 4 centers in North-Eastern Italy. 340/363 tumors (93. Read More

Dermatol Surg 2021 May;47(5):e184-e187

White House Center for Liposuction, Zurich, Switzerland.

Background: Liposuction has become one of the most popular aesthetic procedures today. Among the different anesthesia methods, tumescent local anesthesia (TLA) has been shown to be the safest. Liposuction is typically performed as an outpatient procedure under minimal oral sedation and without the need for any intravenous (IV) fluid administration. Read More

Laryngoscope 2021 Apr 21. Epub 2021 Apr 21.

Department of Otorhinolaryngology-Head and Neck Surgery, Rouen University Hospital, Rouen, France.

Objectives/hypothesis: Patients' eligibility for bilateral selective laryngeal reinnervation surgery is evaluated by suspension microlaryngoscopy (SML) examination with laryngeal electromyography (LEMG). Maintaining spontaneous ventilation, with remifentanil sedation/analgesia without endotracheal tube, to allow the patient to phonate with the surgeon during awake, LEMG is a major challenge for the anesthesiologist and the otorhinololaryngologist. The objective of this study was to evaluate the safety and efficacy of a novel anesthesia protocol to manage airway access during awake tubeless SML. Read More

Sudan J Paediatr 2021 ;21(1):6-12

Neurosciences Center of Excellence, Al Jalila Children's Specialty Hospital, Dubai, UAE.

Cerebral palsy (CP) is a non-progressive motor dysfunction leading to multiple morbidities, including spasticity, which can be managed with botulinum toxin injection (BTI). This literature review aims to examine published studies on the efficacy and safety of different interventions used to reduce pain and anxiety associated with BTI in children with CP. A literature review of all published evidence in English language, or with an English translation between 1999 and 2019, using PubMed, EBSCO host, and Medline databases was carried out. Read More

J Cardiothorac Surg 2021 Apr 20;16(1):95. Epub 2021 Apr 20.

Department of Pathology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey.

Background: The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions.

Methods: The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay. Read More

Facial Plast Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, Texas.

The location, severity, and associated injuries of the head and neck trauma dictate the type and treatment location needed for that particular patient. An in-depth knowledge of local and regional block options is vital to the proper management of facial wounds at the bedside, decreasing need for general anesthesia, anesthesia-related complication, length of hospital stay, and overall hospital costs. This article will discuss local and regional block options for the upper-face, midface, and lower face including dentition; complications of local and regional blocks and how to prevent them; and recent advances in local anesthesia. Read More

BMC Womens Health 2021 Apr 16;21(1):154. Epub 2021 Apr 16.

Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.

Background: Sacrospinous ligament fixation (SSLF) is a widely used vaginal procedure for correction of apical vaginal prolapse. The objective of this study was to evaluate subjective and objective outcomes of SSLF performed in a fast-track setting.

Methods: This was a prospective cohort study of sacrospinous ligament fixation performed using local anesthesia and light sedation in a fast-track setting at Aarhus University Hospital between April 2016 and December 2017. Read More

Anesth Analg 2021 05;132(5):1254-1264

From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

General anesthesia is characterized by loss of consciousness, amnesia, analgesia, and immobility. Important molecular targets of general anesthetics have been identified, but the neural circuits underlying the discrete end points of general anesthesia remain incompletely understood. General anesthesia and natural sleep share the common feature of reversible unconsciousness, and recent developments in neuroscience have enabled elegant studies that investigate the brain nuclei and neural circuits underlying this important end point. Read More

J Am Vet Med Assoc 2021 May;258(9):1007-1010

Case Description: A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis.

Clinical Findings: Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra. Read More

Cardiol J 2021 Apr 12. Epub 2021 Apr 12.

Department of Anesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland.

J Cardiothorac Vasc Anesth 2021 Mar 6. Epub 2021 Mar 6.

Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Jiangxi, China. Electronic address:

Objectives: Patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement usually experience substantial perioperative pain. The aim of the present study was to investigate the effect of transversus thoracic muscle plane block combined with serratus anterior plane block in patients undergoing S-ICD placement.

Design: Double-blind, randomized controlled study. Read More

Hand (N Y) 2021 Apr 9:15589447211003180. Epub 2021 Apr 9.

University of Connecticut, Farmington, USA.

Background: This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet.

Methods: Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Read More

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):31-33. Epub 2021 Apr 8.

Cardiothoracic Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.

Introduction/Study Goals: Thoracic sympathectomy is considered to be the most effective treatment for hyperhidrosis, a procedure traditionally performed under general anesthesia. Nowadays it's a minimally invasive procedure, which makes it possible to perform under sedation with local anesthesia. The goal in this study was to assess the efficacy and safety of this anesthetic technique in video-assisted thoracic sympathectomy. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25455

Department of Anesthesiology.

Rationale: An impacted foreign body (FB) in the larynx of an adult is a rare but potentially life-threatening occurrence. Patients with Down's syndrome (DS) are vulnerable to airway FB. However, the anesthesia for FB removal can be challenging. Read More

J Zoo Wildl Med 2021 Apr;52(1):401-405

Department of Clinical Sciences and Orthopedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO 80523, USA.

An approximately 41-yr-old female Asian elephant ( experiencing forelimb stiffness and decreased range of motion was diagnosed with bilateral carpal osteoarthritis (OA). Standing sedation combined with local anesthesia was used to deliver ultrasound-guided carpal articular injections of an autologous conditioned serum product, interleukin receptor antagonist protein, combined with hyaluronic acid. Within 2 mo of completing therapy, improved range and speed of motion were evident. Read More

Hand Surg Rehabil 2021 Apr 3. Epub 2021 Apr 3.

Baltalimanı Bone Diseases Training and Research Hospital, Hand Surgery Clinic, Baltalimanı Hisar Street, 34470, Sarıyer, Istanbul, Turkey. Electronic address:

The aim of our study was to compare the clinical results and costs of wide-awake local anesthesia no tourniquet (WALANT), intravenous regional anesthesia (IVRA), and infraclavicular brachial plexus block (IC-BPB). The patients were divided into WALANT, IVRA, IC-BPB groups, each with 50 patients. Demographic information, induction time, use of sedation, number of patients who were converted to general anesthesia, time in postanesthesia care unit (PACU), amount of bleeding during surgery, presence of tourniquet pain, hand motor function during surgery, time to onset of postanesthesia pain, discharge time, complications, and anesthesia costs were compared. Read More

Physiol Rep 2021 Apr;9(7):e14810

Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.

Background: Local ischemic preconditioning (IPC) and remote ischemic conditioning (RIC) induced by brief periods of ischemia and reperfusion protect against ischemia-reperfusion injury.

Methods: We studied the sensitivity to IR-injury and the influence of strain, age, supplier, and anesthesia upon the efficacy of IPC and RIC in 7- and 16-weeks-old Sprague-Dawley and Wistar rats from three different suppliers. The influence of sedation with a hypnorm and midazolam mixture (rodent mixture) and pentobarbiturate was compared. Read More

World J Urol 2021 Apr 3. Epub 2021 Apr 3.

Department of Urology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.

Purpose: To evaluate the feasibility, safety, and efficacy of ultrasound-guided transperineal laser ablation (TPLA) as a new minimally invasive surgical therapy (MIST) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).

Materials And Methods: Under local anesthesia and conscious sedation up to two laser fibers for each prostatic lobe were inserted under US-guidance by a percutaneous approach. TPLA was performed using a continuous wave diode laser (SoracteLite-EchoLaserX4) able to generate a light-induced thermal heating and subsequent coagulative necrosis of the prostatic tissue. Read More

Animals (Basel) 2021 Mar 15;11(3). Epub 2021 Mar 15.

Institute of Animal Welfare Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria.

Disbudding of calves is a common, painful intervention. Due to cytotoxic and anesthetic properties, the injection of clove oil or its component isoeugenol may be less detrimental to animal welfare. We investigated mechanical nociceptive threshold (MNT), possible tissue alterations and horn growth for up to 12 weeks after injection of 1. Read More

J Neurointerv Surg 2021 Mar 23. Epub 2021 Mar 23.

Interventional Neuroradiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Background: The optimal anesthetic modality for endovascular treatment (EVT) in acute ischemic stroke (AIS) is undetermined. Comparisons of general anesthesia (GA) with composite non-GA cohorts of conscious sedation (CS) and local anesthesia (LA) without sedation have provided conflicting results. There has been emerging interest in assessing whether LA alone may be associated with improved outcomes. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Mar 16. Epub 2021 Mar 16.

Service ORL et chirurgie cervicofaciale du CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France; Faculté de médecine de l'université de Tours, boulevard Tonnellé, 37000 Tours, France.

Objectives: The main study endpoint was tolerance of stapedotomy under local anesthesia with sedation and under general anesthesia using stress and quality of life assessment questionnaires. Secondary endpoints comprised operative time and functional results.

Material And Method: In a consecutive series of stapedotomy patients operated on over a 12-month period, quality of life and perioperative stress were analysed by 3 questionnaires: the Glasgow Benefit Inventory, Cohen's perceived stress scale and the Post-traumatic stress disorder checklist scale. Read More

Pediatr Transplant 2021 Mar 11:e13997. Epub 2021 Mar 11.

Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan.

Background: Complications associated with ultrasonographically guided percutaneous transhepatic liver biopsy (PTLB) after liver transplantation (LT) have been rarely reported, and there is no consensus about its safety. We retrospectively reviewed the safety and outcomes of PTLB after pediatric LT.

Methods: Between January 2008 and December 2019, 8/1122 (0. Read More

Int Urogynecol J 2021 Mar 11. Epub 2021 Mar 11.

Urogynecology Unit, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.

Introduction And Hypothesis: In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation.

Methods: The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. Read More

Lung India 2021 Mar-Apr;38(2):149-153

Department of Pharmacology, Narayana Hrudayalaya Foundations, Bengaluru, Karnataka, India.

Objective: The role of medical thoracoscopy in the treatment of pleural infections is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the management of carefully selected subset of patients with complicated parapneumonic effusions (PPEs).

Materials And Methods: We analyzed retrospective data of 164 thoracoscopic procedures performed at our center on patients with complicated PPE in the past 10 years. Read More

J Dairy Sci 2021 May 6;104(5):5881-5897. Epub 2021 Mar 6.

Department of Population Medicine, University of Guelph, Guelph, Ontario, N1G 2W1 Canada.

The use of local anesthesia and a nonsteroidal anti-inflammatory drug (NSAID) can reduce indicators of pain and inflammation and encourage self-rewarding behavior in calves following disbudding. Although the use of sedation may be recommended as a best practice for disbudding, there is little research in this area. The objective of this study was to evaluate the effects of xylazine sedation in conjunction with a local anesthetic and an NSAID in calves undergoing cautery disbudding. Read More

Heart Rhythm 2021 Mar 5. Epub 2021 Mar 5.

Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas. Electronic address:

Background: Subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective alternative to transvenous implantable cardioverter-defibrillator. General anesthesia (GA) is considered the standard sedation approach because of the pain caused by the manipulation of subcutaneous tissue with S-ICD implantation. However, GA carries several limitations, including additional risk of adverse events, prolonged in-room times, and increased costs. Read More