Search Our Scientific Publications & Authors

Acta Anaesthesiol Scand 2019 Mar 18. Epub 2019 Mar 18.

Clinic for Anesthesiology, Reanimatology and Intensive Care Medicine, University Clinical Hospital Center Zagreb, Zagreb, Croatia.

Background: There are no data on the difference between the impact of ropivacaine and levobupivacaine on sympathetic nerve fibers during central neuraxial blocks. We hypothesized that there is no difference in the degree of sympathectomy between the two drugs during lumbar epidural analgesia for labor pain.

Methods: Sixty healthy parturients were randomized to the type of local anesthetic-opiod solution administered in the epidural space: 10 mL of 0. Read More

J Clin Med 2019 Mar 7;8(3). Epub 2019 Mar 7.

Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Korea.

Despite the high frequency of nerve blocks in the acute phase of herpes zoster, factors associated with intervention, such as response to epidural block, have not been analyzed as predictive factors of postherpetic neuralgia (PHN). To determine the predictive factors of progression to PHN in the presence of interventions, we analyzed the medical records of 145 patients who underwent transforaminal epidural injection (TFEI) in the acute phase of herpes zoster. A total volume of 5 mL (a mixture of 0. Read More

Paediatr Anaesth 2019 Mar 12. Epub 2019 Mar 12.

Jackson Rees, Department of Anesthesia. Alder Hey Children's NHS Foundation Trust, Liverpool, UK.

Systemic opioids have been the main stay for the management of perioperative pain in children undergoing cardiac surgery with sternotomy. The location, distribution and duration of pain in these children has not been studied as extensively as in adults. Currently there is no consensus to the dose of opioids required to provide optimum analgesia and attenuate the stress response whilst minimising their unwanted side effects. Read More

Plast Reconstr Surg Glob Open 2019 Jan 15;7(1):e2105. Epub 2019 Jan 15.

Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, Ontario, Canada.

Background: Epidural nerve blocks (EA) have been widely used in abdominal and thoracic surgery as an adjunct to general anesthesia (GA). The role for EA in microsurgical free flap breast reconstruction remains unclear with concerns regarding its impact on flap survival and operating room efficiency. The purpose of this study was to examine the effectiveness of epidural blocks in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. Read More

Cochrane Database Syst Rev 2019 Mar 1;3:CD006715. Epub 2019 Mar 1.

Department of Anesthesiology, Faculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.

Background: General anaesthesia combined with epidural analgesia may have a beneficial effect on clinical outcomes. However, use of epidural analgesia for cardiac surgery is controversial due to a theoretical increased risk of epidural haematoma associated with systemic heparinization. This review was published in 2013, and it was updated in 2019. Read More

Cochrane Database Syst Rev 2019 02 27;2:CD011436. Epub 2019 Feb 27.

Department of Anesthesiology, Faculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.

Background: The use of ultrasound guidance for regional anaesthesia has become popular over the past two decades. However, it is not recognized by all experts as an essential tool, perhaps because it is unclear whether ultrasound reduces the risk of severe neurological complications, and the cost of an ultrasound machine (USD 22,000) is substantially higher than the cost of other tools. This review was published in 2016 and updated in 2019. Read More

Medicine (Baltimore) 2019 Feb;98(8):e14316

Department of Anesthesiology and Pain Medicine, School of Medicine, Inha University, Incheon, Republic of Korea.

Rationale: Psoas compartment block (PCB) is typically performed using surface anatomical landmarks and neurostimulation for guidance. However, anatomical anomalies, such as scoliosis, make this technique unreliable, posing a challenge for the anesthesiologist when inducing regional anesthesia.

Patient Concerns: A 69-year-old woman with lumbar scoliosis scheduled for total hip arthroplasty underwent PCB with catheterization. Read More

Can J Anaesth 2019 Apr 6;66(4):380-387. Epub 2019 Feb 6.

Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.

Purpose: This study examined the concordance between epidural electrical stimulation test (EEST) and local anesthetic (LA) test dose to indicate correct thoracic epidural catheter position. The relationship between the test results and epidural postoperative analgesia was also assessed.

Methods: This prospective observational cohort study was done in patients receiving thoracic epidural analgesia for abdominal surgery. Read More

J Pediatr Surg 2018 Dec 28. Epub 2018 Dec 28.

Helen DeVos Children's Hospital/Spectrum Health/Michigan State University Department of Surgery, Grand Rapids, Michigan.

Purpose: Management of postoperative pain is a significant challenge following the Nuss procedure. Epidurals, PCAs, and newer analgesia modalities have been used elsewhere without demonstrating consistent improvement in the reported length of hospital stays (LOS). We reviewed a large single surgeon experience identifying three different methods of analgesia used over time to highlight marked improvement in patient LOS. Read More

Int Braz J Urol 2019 Jan-Feb;45(1):145-149

Department of Pediatric Urology, Children's Hospital Colorado, Denver, CO, United States.

Objective: In the majority of published series, children undergoing open pyeloplasty are admitted for at least one night. We hypothesized that it would be possible in the majority of infants to perform open pyeloplasty as an outpatient procedure.

Materials And Methods: All patients who underwent open pyeloplasty by a single surgeon between 2008 and 2016 were retrospectively reviewed. Read More

Anaesth Crit Care Pain Med 2018 Dec 23. Epub 2018 Dec 23.

Department of anaesthesiology and intensive care, Grenoble Alpes university hospital, 38043 Grenoble, France. Electronic address:

Background: Patients on either antiplatelet or anticoagulant therapy may need procedures performed under peripheral nerve blocks in preference to general anaesthesia techniques. The risk of bleeding associated with peripheral nerve blocks under these circumstances remains unknown. This systematic review evaluates the incidence of bleeding complications following peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication. Read More

BMC Anesthesiol 2018 Dec 19;18(1):191. Epub 2018 Dec 19.

Department of Anesthesiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211, Geneva 14, Switzerland.

Background: Multiorifice catheters have been shown to provide superior analgesia and significantly reduce local anesthetic consumption compared with end-hole catheters in epidural studies. This prospective, blinded, randomized study tested the hypothesis that, in continuous femoral nerve block (CFNB) under ultrasound guidance, multiorifice catheter would reduce local anesthetic consumption at 24 h compared with end-hole catheter.

Methods: Eighty adult patients (aged ≥18 years) scheduled to undergo primary total knee arthroplasty under a combination of CFNB, sciatic nerve block and general anesthesia were randomized to CFNB using either a 3-pair micro-hole (Contiplex, BRAUN®, 20G - 400 mm) or an end-hole (Silverstim VYGON®, 20G - 500 mm) catheter. Read More

J Ultrasound 2018 Dec 5. Epub 2018 Dec 5.

Department of Physical Medicine and Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Sanggye 7 dong 761-7, Nowon-gu, 139-707, Seoul, South Korea.

Purpose: Recent studies have compared the therapeutic efficacy and safety of the procedure using ultrasound and fluoroscopy. However, there are no published studies comparing the therapeutic efficacy and safety of fluoroscopy (FL)-guided cervical interlaminar epidural steroid injection (CIESI) with that of ultrasound (US)-guided selective nerve root block (SNRB). This study aimed to compare the mid-term effects and advantages of US-guided SNRB with FL-guided CIESI for radicular pain in the lower cervical spine through assessment of pain relief and functional improvement. Read More

Pain Res Manag 2018 17;2018:3562701. Epub 2018 Oct 17.

Ordu University, School of Medicine, Training and Research Hospital, Department of Anesthesia and Reanimation, Ordu, Turkey.

Introduction And Objective: TAP block has gained popularity to provide postoperative analgesia after abdominal surgery but its advantage over epidural analgesia is disputed. For lower abdominal surgeries, epidural analgesia has been the gold standard and time-tested technique for providing postoperative analgesia, but contraindications for the same would warrant need for other equally good analgesic techniques. The objective of this study is to compare the analgesic efficacy of both the techniques. Read More

Med Hypotheses 2018 Dec 14;121:70-73. Epub 2018 Sep 14.

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

The aim of this study is to develop an alternative way to locate the sacral hiatus for blind caudal block from the anthropometrical data measured on 3D pelvic CT. The intersection of the line connecting two sacral cornua and the midline is considered the ideal point (IP) for caudal block. The mean length from the coccyx tip to the IP was measured using 3D pelvic CT images in 30 men and 30 women and was 6. Read More

J Clin Anesth 2019 Mar 13;53:56-63. Epub 2018 Oct 13.

Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA; Quality Institute, and Neurology Institute Center for Outcomes Research (NICORe), USA.

Study Objective: Intravenous patient-controlled opioid analgesia (IVPCA), epidural analgesia and transversus abdominis plane (TAP) infiltrations are frequently used postoperative pain management modalities. The aim of this study was to conduct a cost-effectiveness analysis comparing the use of epidural, IVPCA, and TAP infiltrations with liposomal bupivacaine for analgesia in the first 72 h postoperatively in patients undergoing major lower abdominal surgery.

Design: Retrospective cost effectiveness analysis. Read More

Anaesthesist 2018 Nov 12;67(11):868-870. Epub 2018 Oct 12.

Department of Otorhinolaryngology, Kocaeli State Hospital, Kocaeli, Turkey.

Cranial nerve palsy is a rare neurological complication of epidural and subarachnoid blocks. Most of these complications are attributed to secondary intracranial hypotension due to cerebrospinal fluid leakage following dural puncture. Vocal fold paralysis (VFP) seems more likely to be overlooked and underreported due to delayed onset of symptoms and lack of attribution of dysphonia to spinal anesthesia. Read More

J Cell Biochem 2019 Mar 9;120(3):4342-4354. Epub 2018 Oct 9.

Second Department of Orthopedics, Affiliated Traditional Chinese Medical of Xinjiang Medical University, Urumqi, Xinjiang, China.

The aim of our current study is to compare efficiency of various interventions implemented for pain management after total hip arthroplasty (THA). PubMed and EMBASE were searched for randomized clinical trials (RCTs) reporting the pain scales for evaluate the efficacy of pain control after THA including at least one pair of direct control groups. Pain scale values and the associated 95% credible interval (CrI) were used to describe efficacy. Read More

Medicine (Baltimore) 2018 Oct;97(40):e12746

Rationale: The relief of selective hip pain may be difficult to attain. Therefore, a deep nerve block such as epidural anesthesia or lumbar plexus nerve block is required. However, deep nerve blocks may not be possible in patients with complications, including severe cardiovascular disease. Read More

Vet Anaesth Analg 2018 Nov 10;45(6):811-819. Epub 2018 Aug 10.

Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.

Objectives: To describe an ultrasound-guided thoracic paravertebral block and determine the distribution after injection of two volumes of methylene blue in dog cadavers.

Study Design: Prospective experimental cadaveric study.

Animals: Twelve dog cadavers weighing 11 ± 3 kg. Read More

J Ultrasound Med 2019 Mar 23;38(3):725-731. Epub 2018 Sep 23.

Department of Rehabilitation Medicine, Bundang Jesaeng Hospital, Seongnam-si, Korea.

Objectives: To compare the efficacy of a conventional fluoroscopy-guided epidural nerve block and an ultrasound (US)-guided intercostal nerve block in patients with thoracic herpes zoster (HZ).

Methods: This work was a comparative study of 38 patients with thoracic HZ pain and a chest wall herpetic eruption, aged 18 years or older, with pain intensity of 5 or greater on a numeric rating scale (NRS) for less than a 1-month duration. Patients were consecutively enrolled and assigned to 2 groups in which the intervention was either the US-guided intercostal nerve block or the fluoroscopy-guided epidural nerve block approach with the addition of a 5-mL mix of 2. Read More

Dis Colon Rectum 2018 Oct;61(10):1196-1204

Division of Colon and Rectal Surgery, St Joseph Mercy Hospital, Ann Arbor, Michigan.

Background: Multimodal pain management is an integral part of enhanced recovery pathways. The most effective pain management strategies have not been determined.

Objective: The purpose of this study was to compare liposomal bupivacaine transversus abdominis plane block with epidural analgesia in patients undergoing colorectal surgery. Read More

Trials 2018 Sep 5;19(1):475. Epub 2018 Sep 5.

Clinical Trials Research Centre, University of Liverpool, Liverpool, L12 2AP, UK.

Background: Sciatica is a common condition reported to affect over 3% of the UK population at any time and is often caused by a prolapsed intervertebral disc (PID). Although the duration and severity of symptoms can vary, pain persisting beyond 6 weeks is unlikely to recover spontaneously and may require investigation and treatment. Currently, there is no specific care pathway for sciatica in the National Health Service (NHS), and no direct comparison exists between surgical microdiscectomy and transforaminal epidural steroid injection (TFESI). Read More

BMC Anesthesiol 2018 Sep 5;18(1):123. Epub 2018 Sep 5.

Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 16# Jichang Road, Guangzhou, 510405, China.

Background: Continuous hiccups during surgery not only affect the surgical procedure, they can also cause adverse effects for the patient. Apart from active investigation of the cause of the hiccups, their timely termination is also necessary.

Case Presentation: We reported a case of a 70-year-old woman with continuous intraoperative hiccups that appeared during vaginal hysterectomy under low continuous epidural anesthesia. Read More

Reg Anesth Pain Med 2018 Oct;43(7):745-751

Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Background And Objectives: Fascial plane blocks are rapidly emerging to provide safe, feasible alternatives to epidural analgesia for thoracic and abdominal pain. We define a new option for chest wall and upper abdominal analgesia, termed the rhomboid intercostal and subserratus plane (RISS) block. The RISS tissue plane extends deep to the erector spinae muscle medially and deep to the serratus anterior muscle laterally. Read More

Saudi J Anaesth 2018 Jul-Sep;12(3):475-477

Department of Anaesthesia, University of British Columbia, Vancouver, Canada.

Obstructive sleep apnea (OSA) is prevalent and presents perioperative challenges. There are guidelines regarding perioperative care of OSA, but analgesia management of OSA patients is inconsistent or inadequate. This is a study of the United Kingdom anesthesiologists' postoperative analgesia preferences for OSA patients. Read More

Saudi J Anaesth 2018 Jul-Sep;12(3):426-432

Department of Anaesthesia, Ain Shams University, Cairo, Egypt.

Background: Psoas sciatic block (Pso/Sci) is a modern anesthetic technique for lower extremities surgery. The use of this technique can avoid the adverse effects of the general anesthesia or the central neuroaxial blockade, especially in patients with multiple comorbidities.

Purpose: The purpose of this study is to compare the efficacy of combined Pso/sci as a sole anesthetic technique with conventional combined spinal epidural (CSE) anesthesia for patients undergoing total knee arthroplasty. Read More

A A Pract 2018 Dec;11(12):340-343

Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. Read More

J Thorac Dis 2018 Jun;10(6):3539-3547

Department of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.

Background: The objective of the study is to retrospectively analyze the cough status after double lumen tube (DLT) and spontaneous respiration thoracic anesthesia, to compare the degree of influence of anesthesia and surgical factors, and to investigate whether spontaneous respiration anesthesia can reduce the incidence of cough.

Methods: Postoperative follow-ups were performed on 1,162 patients from July 2011 to December 2015 who meet the selected conditions, whose surgical approach is limited to VAST bullectomy, wedge resection, segmentectomy, or lobectomy. Patients' probability of cough in 1st day (T1), 2nd days (T2), 3rd days (T3), 1st month (T4), 3rd months (T5), 6th months (T6) and 12th months (T7) after thoracoscopic surgery were recorded, as well as the Leicester cough questionnaire (LCQ) survey results, visual cough score (VAS), and cough symptom scores. Read More

Reg Anesth Pain Med 2018 Nov;43(8):880-884

From the Department of Anesthesiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.

Background And Objectives: Postdural puncture headache (PDPH) is a severe and debilitating complication of unintentional dural puncture. The criterion-standard treatment for PDPH has been epidural blood patch (EBP), but it is an invasive intervention with the potential for severe complications, such as meningitis and paralysis. We believe this is the first ever 17-year retrospective chart review in which we compare the effectiveness of sphenopalatine ganglion block (SPGB) to EBP for PDPH treatment in postpartum patients. Read More

Med Sci Monit 2018 Jul 31;24:5320-5328. Epub 2018 Jul 31.

Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.

BACKGROUND Pain and surgical stress cause a pro-inflammatory response followed by downregulation of the immune response, which can increase the incidence of postoperative complications, such as infections or prolonged wound healing. T lymphocytes and natural killer (NK) cells have cytotoxic potential and are crucial components of cellular immunity, which is important for maintenance of immune balance. The aim of this study was to analyze the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after total knee replacement (TKR) to find the most effective analgesic technique for mitigating immune suppression. Read More

Int J Surg 2018 Sep 26;57:8-14. Epub 2018 Jul 26.

Department of Anaesthesiology, Second Hospital of Harbin Medical University, 246 Xuefu Road, Harbin 150001, Heilongjiang, China. Electronic address:

Background: Thoracoscopic lobectomy is less painful than normal thoracotomy, but pain management is still an issue in the postoperative period. Thoracic epidural analgesia (TEA) is considered as the gold standard for post-thoracotomy pain control, but is associated with numerous risks.

Methods: A total of 114 patients undergoing thoracoscopic lobectomy were randomly divided into three groups. Read More

Ann Card Anaesth 2018 Jul-Sep;21(3):333-338

Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.

Background: Good postoperative analgesia in cardiac surgical patients helps in early recovery and ambulation. An alternative to parenteral, paravertebral, and thoracic epidural analgesia can be pectoralis nerve (Pecs) block, which is novel, less invasive regional analgesic technique.

Aims: We hypothesized that Pecs block would provide superior postoperative analgesia for patients undergoing cardiac surgery through midline sternotomy compared to parenteral analgesia. Read More

BMC Musculoskelet Disord 2018 Jul 24;19(1):249. Epub 2018 Jul 24.

endogap, Joint Replacement Institute, Garmisch-Partenkirchen Medical Center, Auenstr. 6, 82467, Garmisch-Partenkirchen, Germany.

Background: The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary unicompartmental knee arthroplasty (UKA).

Methods: Between January 2016 until August 2016, 134 patients underwent primary UKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 38) or epidural catheter (group SP&EPI, n = 20) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 46) or spinal anesthesia (group SP&LIA, n = 30). Outcome parameters focused on the evaluation of pain (NRS scores), mobilization, muscle strength and range of motion up to 7 days postoperatively. Read More

BMC Musculoskelet Disord 2018 Jul 18;19(1):232. Epub 2018 Jul 18.

endogap, Joint Replacement Institute, Garmisch-Partenkirchen Medical Center, Auenstr. 6, 82467, Garmisch-Partenkirchen, Germany.

Background: Postoperative pain control and enhanced mobilization, muscle strength and range of motion following total knee arthroplasty (TKA) are pivotal requisites to optimize rehabilitation and early recovery. The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary total knee arthroplasty.

Methods: Between January 2016 until August 2016, 280 patients underwent primary TKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 81) or epidural catheter (group SP&EPI, n = 51) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 86) or spinal anesthesia (group SP&LIA, n = 61). Read More

Curr Opin Anaesthesiol 2018 Oct;31(5):601-607

Department of Anesthesiology and Perioperative Medicine, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.

Purpose Of Review: To provide an update on new strategies for pain management after rib fractures utilizing regional analgesia.

Recent Findings: Pain management for patients with rib fractures can be very challenging. Traditionally, intravenous patient-controlled analgesia (IVPCA) with opioids, epidural, and paravertebral blocks have been used. Read More

Tohoku J Exp Med 2018 07;245(3):179-185

Department of Anesthesiology, Tohoku University Hospital.

Thoracic epidural anesthesia (TEA) and paravertebral block (PVB) have been performed for perioperative regional anesthesia in the trunk. However, TEA and PVB are associated with a risk of serious complications, such as pneumothorax, hypotension, or nerve damage. Retrolaminar paravertebral block (RLB) was introduced as a new alternative to PVB. Read More

Medicine (Baltimore) 2018 Jul;97(28):e11492

Rationale: Evidence from cadaveric studies note that the sympathetic nerves from the second and third thoracic ganglia bypass the stellate ganglion in 20% of the population. We present a novel alternative technique for sympathetic blockade of upper extremity via thoracic epidural approach.

Patient Concerns: The patient-reported anxiety about "the placement of the needle in the front of the neck" and severe pain secondary to complex regional pain syndrome. Read More

Curr Opin Anaesthesiol 2018 Oct;31(5):608-613

Department of Anesthesia, Toronto Western Hospital, University of Toronto, Ontario, Canada.

Purpose Of Review: Recent research has shed further light on the place of ultrasound imaging in neuraxial blockade in routine clinical practice, its use in thoracic epidurals, and real-time ultrasound-guided techniques.

Recent Findings: Compared with the conventional technique of surface landmark palpation, preprocedural ultrasound imaging minimizes technical difficulty associated with lumbar neuraxial blockade in patients with poor-quality surface landmarks. Novice practitioners are able to learn to employ the technique effectively. Read More

J Nepal Health Res Counc 2018 Jul 4;16(2):248-250. Epub 2018 Jul 4.

Department of Anaesthesiology, Tribhuvan university Teaching hospital, Maharajgunj, Kathmandu, Nepal.

The postoperative pain management in the elderly is challenging due to comorbidities and change in physiology due to age itself. This limit the use of medication which include pain medication also. The fascia iliaca compartment block has been described in the literature for fracture of femur. Read More

Medicine (Baltimore) 2018 Jun;97(26):e11261

Department of Anesthesia, Lausanne University Hospital, Lausanne, Switzerland.

Background: The aim of the study was to compare the analgesic efficacy of epidural analgesia and transverse abdominis plane (TAP) block. TAP block has gained popularity to provide postoperative analgesia after abdominal surgery but its advantage over epidural analgesia is disputed.

Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Read More

Acta Anaesthesiol Scand 2018 Oct 25;62(9):1280-1289. Epub 2018 Jun 25.

Department of Anaesthesiology, Academic Medical Center, Amsterdam, The Netherlands.

Body temperature homeostasis is accurately regulated by complex feedback-driven neuronal mechanisms, which involve a multitude of thermoregulatory pathways. Thus, core temperature is constantly maintained within a narrow range. As one of the most effective regulatory systems skin temperature is dependent on skin blood flow. Read More

Anaesthesiol Intensive Ther 2018 22;50(3):215-220. Epub 2018 Jun 22.

Department of Anaesthesiology and Intensive Care, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland, St. Barbara's Memorial Hospital WSS no. 5 Trauma Centre, Sosnowiec, Poland.

Background: Horner's syndrome is comprised of a set of symptoms caused by a permanent or transient ipsilateral sympathetic trunk lesion or paralysis. It may occur after numerous pathologies in the cervical region, epidural, spinal anaesthesia, and interscalene, transscalene, supraclavicular, or infraclavicular brachial plexus block. The aim of this randomised, prospective clinical study was to evaluate the effect of the interscalene brachial plexus block (IBPB) technique on the occurrence rate of Horner's syndrome and identify contributing risk factors. Read More

Cochrane Database Syst Rev 2018 06 20;6:CD007105. Epub 2018 Jun 20.

Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Ave, Bronx, NY, USA, 10461.

Background: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017.

Objectives: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. Read More

Ann Thorac Cardiovasc Surg 2018 Aug 20;24(4):180-186. Epub 2018 Jun 20.

P.A. Herzen Moscow Cancer Research Institute, Moscow, Russia.

Purpose: Our study aimed to assess whether the type of regional anesthesia influenced the incidence of chronic postthoracotomy pain syndrome (CPTPS).

Methods: This was a prospective, randomized study that included 300 patients undergoing lung cancer resection using thoracotomy. They were randomized into three groups: paravertebral nerve block (PVB), thoracic epidural anesthesia (TEA), and intercostal nerve block (INB). Read More

Reg Anesth Pain Med 2018 Nov;43(8):864-868

Department of Anesthesiology, Pain, and Perioperative Medicine, Stanford University School of Medicine, Stanford, CA.

Background And Objectives: The retrolaminar block (RB) is used for truncal analgesia, but its mechanism of neural blockade remains obscure. We sought to learn the pattern of local anesthetic spread after thoracic RB using cadaveric models.

Methods: In 8 fresh cadavers, an ultrasound-guided T4 RB was performed with 20 mL of methylene blue 1% and bupivacaine 0. Read More

Scand J Pain 2010 Jan 1;1(1):12-23. Epub 2010 Jan 1.

Division of Anaesthesia and Intensive Care Medicine, Medical Faculty, Rikshospitalet, 0027 Oslo, Norway.

Background The "gold standard" for pain relief after thoracotomy has been thoracic epidural analgesia (TEA). The studies comparing TEA with paravertebral block (PVB) and recent reviews recommend PVB as a novel, safer method than TEA. Methods A systematic search of the Cochrane and PubMed databases for prospective, randomized trials (RCTs) comparing TEA and PVB for post-thoracotomy analgesia was done. Read More