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Anasthesiol Intensivmed Notfallmed Schmerzther 2022 Jun 21;57(6):405-416. Epub 2022 Jun 21.

Non-intubated thoracic surgery is currently gaining popularity. In select patients and in experienced centres, non-intubated approaches may enable patients to safely undergo thoracic surgical procedures, who would otherwise be considered at high risk from general anaesthesia. While non-intubated techniques have been widely adopted for minor surgical procedures, its role in major thoracic surgery is a topic of controversial debate. Read More

Cureus 2022 May 16;14(5):e25044. Epub 2022 May 16.

Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, IND.

Introduction: Adding adjuvant drugs to intrathecal local anesthetics improves the quality and duration of the sensory blockade and prolongs postoperative analgesia. Intrathecal opioids are synergistic with local anesthetics, thereby intensifying the sensory block without increasing the sympathetic block. This study was designed to comparatively evaluate the two different dosages of nalbuphine as intrathecal adjuvants on subarachnoid block (SAB) characteristics of 0. Read More

Clin Exp Dent Res 2022 Jun 19. Epub 2022 Jun 19.

Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.

Objectives: The amount of propofol required for intravenous sedation (IVS) in patients on long-term oral benzodiazepine (BZD) therapy may be affected by drug interactions and central changes in sensitivity. However, there is no research on the effect of long-term oral BZD use on the amount of propofol required for IVS. We aimed to clarify the difference between the total propofol dose required for IVS in patients with or without long-term oral BZD therapy. Read More

BMC Urol 2022 Jun 15;22(1):85. Epub 2022 Jun 15.

Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, Korea.

Background: For patients with malignant ureteral obstruction or stricture who require long-term internal drainage, plastic double-J stents (DJ stents) represent the mainstay of therapeutic strategies. DJ stents should be replaced at least once every 6 months to avoid infection or obstruction. Although DJ stents are generally replaced under cystoscopy, successful fluoroscopy-guided retrograde replacement of DJ stents in the interventional suite has been described in the literature. Read More

Ear Nose Throat J 2022 Jun 14:1455613221108366. Epub 2022 Jun 14.

Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University.

Objective: To investigate the clinical effect of dexmedetomidine combined with dezocine in local anesthesia for endoscopic dacryocystorhinostomy (DCR).

Methods: Ninety patients undergoing elective endoscopic DCR were randomly divided into two groups, local anesthesia group (LA group n = 45) and general anesthesia group (GA group, n = 45). These subjects were all American Society of Anesthesiologists (ASA)-Physical Status I-II patients. Read More

J Neurointerv Surg 2022 Jun 13. Epub 2022 Jun 13.

Cerebrovascular Center, Neurologic Institute, Cleveland Clinic, Cleveland, Ohio, USA

There is an ongoing debate about the optimal anesthetic and hemodynamic management of acute stoke patients with large vessel occlusion undergoing endovascular mechanical thrombectomy. Several prospective and retrospective analyses, and randomized controlled trials, attempted to address the challenges of using different anesthetic modalities in acute stroke patients requiring mechanical thrombectomy. We review the advantages and disadvantages of monitored anesthesia care, local anesthesia, conscious sedation, and general anesthesia, along with the relevance of hemodynamic management and perioperative oxygenation status in these complex patients. Read More

Am J Emerg Med 2022 May 6;58:159-174. Epub 2022 May 6.

Department of Emergency Medicine, UHS Southern California Medical Education Consortium, Temecula, CA 92592, USA.

Introduction: Pericardial tamponade requires timely diagnosis and management. It carries a high mortality rate.

Objective: This review incorporates available evidence to clarify misconceptions regarding the clinical presentation, while provifing an in-depth expert guide on bedside echocardiography. Read More

JBJS Essent Surg Tech 2022 Jan-Mar;12(1). Epub 2022 Feb 28.

Parc de Salut Mar, Universitat Autonoma Barcelona, Barcelona, Spain.

Proximal medial gastrocnemius release (PMGR) is a technique that is performed to relieve tension in the Achilles-calcaneus-plantar system when a biomechanical overload is present. One of the main indications for this technique is recalcitrant plantar fasciitis. This procedure may also be useful in second-rocker metatarsalgia or midportion Achilles tendinitis. Read More

J Clin Med 2022 May 31;11(11). Epub 2022 May 31.

Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel-Hashomer 5262000, Israel.

Background: Conscious sedation (CS) has been used successfully to treat patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) and as such is considered the standard anesthesia method. The local anesthesia (LA) only approach may be feasible and safe thanks to improvements in operators' experience.

Objective: To evaluate differences between LA only versus CS approaches on short- and long-term outcomes among patients undergoing TAVI. Read More

Eur J Obstet Gynecol Reprod Biol 2022 Jul 30;274:171-174. Epub 2022 May 30.

Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA.

Objectives: Fetal anemia secondary to incompatibility between maternal-fetal blood types can result in hydrops and demise. Intrauterine transfusions have improved survival in experience centers. Our objective was to determine the practice patterns amongst fetal centers. Read More

Mol Pain 2022 Jun 3:17448069221107810. Epub 2022 Jun 3.

anesthesiology.

α2 adrenergic agonists are widely used in clinical anesthesia and ICU sedation owing to their effective sedative and analgesic effects. Lumbago and leg pain is the most common clinical pain disease. Studies have reported that lumbago and leg pain is associated with dysregulation of paravertebral muscles, especially psoas major muscles. Read More

Cancer Rep (Hoboken) 2022 Jun 2:e1643. Epub 2022 Jun 2.

Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan.

Background: Recurrence after primary treatment is an important obstacle to the curing of primary breast cancer. Less-immunosuppressive anesthetic techniques, such as local anesthesia with lidocaine, intravenous anesthesia (IVA) with propofol, and/or sedation with midazolam under spontaneous breathing may reduce breast cancer recurrence compared with standard general anesthesia techniques such as IVA and inhalation anesthesia with opioids under mechanical ventilation.

Aim: The aim of this study was to analyze the factors involved in breast cancer recurrence in patients who underwent breast-conserving surgery (BCS) under non-mechanically ventilated anesthesia. Read More

Arthrosc Tech 2022 May 25;11(5):e917-e921. Epub 2022 Apr 25.

BTI Biotechnology Institute ImasD, Vitoria, Spain.

Knee osteoarthritis is a low-degree inflammatory condition that involves the whole synovial joint tissues as an organ. Recently, a biological approach using plasma rich in growth factors (PRGF) to tackle not only the synovial joint with intraarticular injections of PRGF, but also the subchondral bone with intraosseous infiltrations has been implemented with promising results. However, this procedure requires sedation, which limits the implementation of the procedure to operating room. Read More

Zhonghua Yi Xue Za Zhi 2022 Jun;102(21):1564-1567

Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

The reality that most of ophthalmic surgeries are conducted under retrobulbar block or topic anesthesia performed by the ophthalmic surgeons themselves may affect the balance between quality and efficiency of ophthalmic anesthesia. The authors suggest that the key principle to perform ophthalmic anesthesia is to help the patients be well prepared preoperatively. In order to achieve this goal, we should make full use of the supraglottic airway device and awake sedation, improve ultrasound-guided regional block technique, strengthen cooperation with ophthalmic surgeons, thereby meeting the comfortable anesthesia requirements of ophthalmic surgery patients and adapting for the development trend of day surgery. Read More

Biomed Res Int 2022 16;2022:2807581. Epub 2022 May 16.

Department of Anesthesiology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-Dori, Nagoya, Aichi 464-8651, Japan.

Intravenous dexmedetomidine (DEX) and midazolam (MZ) are currently used to achieve sedation in dental surgery under local anaesthesia. However, the efficacy of low-dose fentanyl (FEN) in combination with DEX and MZ sedation remains unclear. Therefore, we implemented a prospective randomised controlled trial to investigate the intra- and postoperative analgesic effects, intraoperative respiratory and circulatory dynamics, and frequency of intra- and postoperative adverse events of continuous low-dose fentanyl administration with DEX and MZ sedation. Read More

Biomed Res Int 2022 14;2022:1681803. Epub 2022 May 14.

Department of Anesthesiology, Chongqing University Jiangjin Hospital, School of Medicine, Chongqing University, Chongqing, China.

Objective: To evaluate the anesthetic effect and safety of dexmedetomidine in cesarean section.

Methods: The Cochrane Library, EMBASE, and PubMed databases (established until September 2020) were searched by computer. Two authors independently screened and extracted literature related to the application of dexmedetomidine in the cesarean section according to inclusion and exclusion criteria. Read More

Local Reg Anesth 2022 9;15:23-29. Epub 2022 May 9.

Department of Anaesthesiology, IRCSS-INRCA, Ancona, Italy.

Purpose: Few studies have described segmental thoracic spinal anesthesia (STSA) as primary anesthesiologic method in breast and axillary surgery, documenting the association of intrathecal local anesthetics and opioids. This case series reports an opioid-free scheme of STSA in four elderly patients undergoing major breast and axillary oncological surgery.

Patients And Methods: STSA was performed in three female patients undergoing unilateral mastectomy ± axillary lymph node dissection (ALND) or sentinel lymph node biopsy for invasive ductal carcinoma and in one male patient undergoing ALND for melanoma metastases. Read More

Shanghai Kou Qiang Yi Xue 2022 Feb;31(1):109-112

Department of Anesthesiology, Shanghai Stomatological Hospital, Fudan University. Shanghai 200001, China. E-mail:

Purpose: To compare the effect of two comfort techniques of nitrous oxide/oxygen inhalation and dexmedetomidine combined with flurbiprofen axetil sedation and analgesia in impacted teeth extraction among patients with hypertension.

Methods: According to the inclusion and exclusion criteria, sixty patients undergoing impacted teeth extraction with hypertension were randomly divided into 2 groups: X group( nitrous oxide/oxygen inhalation, n=30) and Y group(dexmedetomidine combined with flurbiprofen axetil assisted sedation and analgesia, n=30). The following parameters at T0(preoperative), T1(local anesthesia), T2 (surgical operation), and T3 (5 minutes after surgery) were recorded: mean arterial pressure(MAP), heart rate (HR), Ramsay sedation score, VAS pain score. Read More

Front Surg 2022 2;9:836398. Epub 2022 May 2.

Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.

Background: Dexmedetomidine (DEX), a highly selective α2-adrenergic receptor agonist, is now widely used in procedural sedation and analgesia. This study was designed to observe and compare the efficacy and safety of DEX administered in two different modes.

Methods: In total, 100 patients were randomly divided into two groups to receive intravenous DEX 1 µg/kg over 15 min followed by 0. Read More

BMC Anesthesiol 2022 May 18;22(1):152. Epub 2022 May 18.

Department of Anesthesiology, First Affiliated Hospital of Gannan Medical University, Jiangxi, People's Republic of China.

Background: Local anesthesia has been recommended for percutaneous endoscopic lumbar discectomy (PELD) in recent years; however, the efficacy, including oxidative stress, inflammatory reactions and ventilation effects, when intravenous dexmedetomidine (DEX) is administered during PELD has not been described.

Methods: Sixty adult patients undergoing PELD were randomly allocated to either an intravenous DEX sedation group (Group A) or a normal saline group (Group B). Respiratory data, including minute ventilation (MV), tidal volume (TV), and respiratory rate (RR), were recorded using a respiratory volume monitor (RVM), and peripheral oxygen saturation (SpO) was monitored by pulse oximetry. Read More

BMC Surg 2022 May 14;22(1):182. Epub 2022 May 14.

Orelhinha Institute, 55 Oriente ST, Chácara da Barra, Campinas, São Paulo, 13090-740, Brazil.

Objectives: This study proposes a new surgical alternative for the most common deformity in the ears, the so-called "protruding/prominent ears", which is a condition that affects 5% of the Caucasian population (Goulart et al. in Rev Bras Cir Plast 26:602-607, 2011). This technique comes with the benefits of reduced surgical time, shallow learning curve, and a low revision rate. Read More

Neurobiol Dis 2022 Aug 10;170:105747. Epub 2022 May 10.

Department of Neurosurgery, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel. Electronic address:

Background: Deep brain stimulation (DBS) is commonly and safely performed for selective Parkinson's disease patients. Many centers perform DBS lead positioning exclusively under local anesthesia, to optimize brain microelectrode recordings (MER) and testing of stimulation-related therapeutic and side effects. These measures enable physiological identification of the DBS borders and subdomains based on electrophysiological properties like firing rates and patterns, intra-operative evaluation of therapeutic window, and improvement of lead placement accuracy. Read More

Sci Rep 2022 05 6;12(1):7427. Epub 2022 May 6.

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, China.

It is still an unsolved problem to achieve both immediate intraoperative feedback and satisfactory surgical experience in percutaneous endoscopic lumbar discectomy under local anesthesia for lumbar disk herniation (LDH) patients. Herein, we compared the analgesic and sedative effects of local anesthesia alone and local anesthesia with conscious sedation in LDH patients during percutaneous endoscopic lumbar discectomy. Ninety-two LDH patients were enrolled and divided into the following groups: control group (Con Group), dexmedetomidine group (Dex Group), oxycodone group (Oxy Group), and dexmedetomidine + oxycodone group (Dex + Oxy Group). Read More

J Plast Surg Hand Surg 2022 May 5:1-8. Epub 2022 May 5.

Department of Plastic Surgery, Copenhagen University, Herlev and Gentofte, Copenhagen, Denmark.

Introduction: This study of breast augmentations performed under local anesthesia with intercostal blocks and light sedation describes the outcomes and evaluates benefits and complications.

Method: From December 2005 until August 2019, 335 women consecutively underwent bilateral breast augmentation procedures. The anesthetic protocol consisted of an initial intravenous bolus of 1 mg midazolam and 0. Read More

Am J Surg 2022 Apr 26. Epub 2022 Apr 26.

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. Electronic address:

Background: We compared post-treatment pain, quality of recovery and complications between those who did not receive (Group I) and received (Group II) intravenous low-dose Midazolam (<0.05 mg/kg) and Pethidine (<0.5 mg/kg) during radiofrequency ablation (RFA) of benign thyroid nodules. Read More

Am J Emerg Med 2022 Jun 28;56:232-235. Epub 2022 Mar 28.

Department of Orthopaedic Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China. Electronic address:

Purpose: This study aims to compare the efficacy of ultrasound-guided interscalene block (US-ISB) with that of intravenous analgesia and sedation (IVAS) in reducing first shoulder dislocation.

Material And Methods: A prospective study was performed in 66 patients with first anterior shoulder dislocation in emergency department. The patients were divided into a US-ISB (n = 32) group and an IVAS (IVAS n = 34) group. Read More

J Clin Anesth 2022 09 20;80:110786. Epub 2022 Apr 20.

Department of Anesthesia, MacKay Memorial Hospital, No. 92, Sec. 2, Chung-Shan North Road, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 501, No. 17, Xu-Zhou Road, Taipei, Taiwan; MacKay Medical College, No. 46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, Taiwan. Electronic address:

Study Objective: To determine the efficacy and safety, in terms of maternal and neonatal outcomes, of adding intrathecal midazolam to spinal anesthesia for cesarean delivery in healthy pregnant women.

Design: A meta-analysis of randomized controlled trials was conducted. PubMed, Cochrane Library, Embase, and Web of Science were searched manually, and citation screening was completed on May 20, 2021. Read More

J Neurointerv Surg 2022 Apr 21. Epub 2022 Apr 21.

Stroke Trials Unit, Mental Health & Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, UK.

Background: There is a paucity of data on anesthesia-related outcomes for endovascular treatment (EVT) in the extended window (>6 hours from ischemic stroke onset). We compared functional and safety outcomes between local anesthesia (LA) without sedation, conscious sedation (CS) and general anesthesia (GA).

Methods: Patients who underwent EVT in the early (<6 hours) and extended time windows using LA, CS, or GA between October 2015 and March 2020 were included from a UK national stroke registry. Read More

J Hand Surg Asian Pac Vol 2022 Apr 19;27(2):219-225. Epub 2022 Apr 19.

Dalhousie University, Saint John, Canada.

The aim of this review article is to provide many important tips and tricks for surgeons to start Wide Awake Local Anaesthesia No Tourniquet (WALANT) hand surgery in their practice. The massive cost reduction of this disruptive new approach will enable them to increase access to hand surgery for their patients who cannot afford unnecessary sedation or unnecessary sterility of the expensive main operating room environment. Evidence-based sterility will permit surgeons to move a lot of their surgery out of the main operating room to minor procedure rooms without a significant increase in infection rates. Read More

J Spine Surg 2022 Mar;8(1):70-75

Division of Orthopedics, Department of Surgery, University of Montreal Health Center, Montreal, QC, Canada.

Vertebroplasty is a minimally invasive treatment option for osteolytic spinal lesions. It provides pain relief and stability with established good results. In this paper, we describe a new CT guided percutaneous vertebroplasty technique using a direct lateral approach between the carotid sheath and the vertebral artery, that can be safely performed under conscious sedation in an outpatient setting. Read More