Search Our Scientific Publications & Authors

JSES Int 2020 Jun 3;4(2):357-361. Epub 2020 Mar 3.

Department of Orthopedics, Penn State Hershey Medical Center, Hershey, PA, USA.

Background: Optimal modalities for pain control in shoulder arthroplasty are not yet established. Although regional nerve blockade has been a well-accepted modality, complications and rebound pain have led some surgeons to seek other pain control modalities. Local injection of anesthetics has recently gained popularity in joint arthroplasty. Read More

Reg Anesth Pain Med 2020 May 28. Epub 2020 May 28.

Anesthesiology and Pain Medicine, Women's College Hospital, Toronto, Ontario, Canada.

Background: Evidence regarding the role of cannabinoids in managing acute postoperative pain is conflicting. The purpose of this systematic review and meta-analysis was to determine the analgesic efficacy of perioperative cannabinoid compounds for acute pain management after surgery.

Methods: Original research articles evaluating the addition of cannabinoids to standard opioid-based systemic analgesia (Control) in the postoperative period were sought. Read More

Int J Gynecol Cancer 2020 May 25. Epub 2020 May 25.

Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, Pennsylvania, USA.

Objective: The aim of this study was to identify the rate of 30-day postoperative complications after the use of epidural in women undergoing hysterectomy for gynecologic malignancy. Secondary outcome was the impact of epidural on hospital length of stay.

Methods: A retrospective cohort study was conducted using the American College of Surgeons' National Surgical Quality Improvement Program database. Read More

J Am Geriatr Soc 2020 May 22. Epub 2020 May 22.

Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Background: Geriatric hip fracture patients are susceptible to the adverse effects of opioid-induced analgesia. Fascia iliaca blocks (FIBs) have emerged as an analgesic technique for this population. There are limited data on a preoperative FIB's effect on perioperative opioid intake. Read More

J Craniofac Surg 2020 May 4. Epub 2020 May 4.

Yeni Yüzyil University, Health Occupation High-School Audiometry.

Aim: The prominent ear is the most common congenital deformity of the external ear. Otoplasty is performed to correct the appearance of the prominent ear. This study was planned to compare the analgesic and anesthetic effects of local nerve blockade and local infiltration anesthesia in the otoplasties. Read More

Int J Spine Surg 2020 Apr 30;14(2):222-225. Epub 2020 Apr 30.

Department of Cell Biology and Anatomy, New York Medical College, Valhalla, New York.

Background: This is a brief technical report about a novel regional anesthesia technique in which local anesthetic was deposited around the thoracolumbar dorsal rami nerves via 4 multiorifice pain catheters to obtain analgesia for posterior spinal fusion surgery on scoliosis patients. Scoliosis is the most common deformity of the spine. Currently, most surgeons prefer a dual rod, segmental spinal fixation system that allows multiple anchor points for attachment to the deformed spine. Read More

Medicine (Baltimore) 2020 Apr;99(17):e19903

Department of Anesthesiology, Ningbo No.6 Hospital, Zhejiang Province, China.

Background: Periarticular infiltration (PAI) and adductor canal block (ACB) have become popular modes of pain management after total knee arthroplasty. The purpose of our study is to evaluate the efficacy of ACB in comparison with PAI for pain control in patients undergoing primary total knee arthroplasty.

Methods: This study is a prospective, 2-arm, parallel-group, open-label randomized controlled trial that is conducted at a single university hospital in China. Read More

Medicine (Baltimore) 2020 Apr;99(17):e19896

Department of Anesthesiology, The Affiliated Xuzhou City Hospital of Xuzhou Medical University.

Background: Delirium is a common postoperative complication in older patients undergoing thoracic surgery and presages poor outcomes. Postoperative pain is an important factor in the progression of delirium. The purpose of this study was to test whether continuous thoracic paravertebral block (PVB), a more effective approach for analgesia, could decrease the incidence of delirium in elderly patients undergoing esophagectomy. Read More

Saudi J Anaesth 2020 Apr-Jun;14(2):186-191. Epub 2020 Mar 5.

Department of Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.

Background: The erector spinae plane block is a newer technique of analgesia to the chest wall.

Objective: The study was carried out to establish the efficacy and safety of this block in patients undergoing total mastectomy and axillary clearance.

Design: Prospective randomized controlled study. Read More

Med Arch 2020 Feb;74(1):54-57

Pain Therapy Center, Division of Anesthesia, Analgesia and Intensive Care, Department of Emergency, Ospedali Riuniti di Ancona, Ancona, Italy.

Introduction: Postoperative pain management in the total knee replacement (TKR) represent a fundamental step for a positive outcome, allowing rapid mobilization, already on the first day. Further, continuous peripheral nerve block techniques have been reported to allow effective and safe control of acute postoperative pain, ensuring the implementation and completion of an accurate and intensive joint rehabilitation program.

Aim: The aim of this study was to assess early mobility and compliance of patients that underwent TKR surgery using the femoral block. Read More

BMC Anesthesiol 2020 Apr 20;20(1):91. Epub 2020 Apr 20.

Department of Anaesthesia, Lausanne University Hospital, Rue du Bugnon 46, BH 05.311, 1011, Lausanne, Switzerland.

Background: Innervation of the clavicle is complex and debated, with scarce data on the analgesic and clinical impact of regional anaesthesia after surgical repair of clavicle fracture.

Methods: In order to assess the analgesic efficiency of an interscalene brachial plexus block (ISB) for surgical repair of clavicle fracture, 50 consecutive patients scheduled for surgical fixation of middle/lateral clavicle fracture under general anaesthesia with ISB were prospectively enrolled. This cohort was compared to a historical control of 76 retrospective patients without regional block. Read More

Medicine (Baltimore) 2020 Apr;99(16):e19417

Orthopedic Medical Center of the Second Hospital of Jilin University, PR China.

Introduction: The impact of dexamethasone on pain management for knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexamethasone for knee arthroscopy.

Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through October 2018 for randomized controlled trials (RCTs) assessing the effect of dexamethasone on pain intensity for patients with dental implant. Read More

J Pain Res 2020 5;13:709-717. Epub 2020 Apr 5.

Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.

Purpose: Erector spinae plane block (ESPB) is a newly reported interfascial plane block in pain management, and it can block the nerves exactly in line with the area of the posterior lumbar surgery. The objective of this research was to determine the effectiveness of pre-operative ESPB in enhancing recovery of posterior lumbar surgery.

Patients And Methods: A total of 60 patients undergoing open posterior lumbar decompression surgery under general anesthesia were randomized into two groups. Read More

BMC Anesthesiol 2020 Apr 14;20(1):83. Epub 2020 Apr 14.

Department of Anesthesiology, First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.

Background: Ultrasound-guided Erector Spinae Plane Block (ESPB) has been increasingly applied in patients for postoperative analgesia. Its effectiveness remain uncertain. This meta-analysis aimed to determine the clinical efficacy of ultrasound-guided ESPB in adults undergoing general anesthesia (GA) surgeries. Read More

Medicine (Baltimore) 2020 Apr;99(15):e19721

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Introduction: Moderate to severe postoperative pain and associated opioid use may interfere with patients' well-being and course of recovery. Regional anesthetic techniques provide an opportunity for opioid sparing and improved patient outcomes. A new regional technique called the erector spinae plane (ESP) block has the potential to provide effective analgesia after shoulder arthroscopy with minimal risks and decreased opioid consumption. Read More

Anesth Analg 2020 Apr 10. Epub 2020 Apr 10.

From the Department of Anesthesiology and Pain Medicine, Seattle Children's, University of Washington, Seattle, Washington.

Background: Opioids have been a central component of routine adult and pediatric anesthesia for decades. However, the long-term effects of perioperative opioids are concerning. Recent studies show a 4. Read More

J Pain Res 2020 31;13:661-668. Epub 2020 Mar 31.

Surgical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

Background: Serratus anterior plane (SAP) block, a novel regional anesthetic procedure, involves the anterolateral chest wall. Opioid receptors have been found on peripheral nerve terminals, so morphine may have a local action.

Objective: This work aimed at exploring the analgesic efficacy of morphine added to bupivacaine in SAPB in patients for whom modified radical mastectomy was conducted and whether it is a mere local effect. Read More

Ann Palliat Med 2020 Mar;9(2):447-450

Department of Anesthesiology, Wuxi Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.

Background: To investigate the effectiveness and rationality of different administration modes of dexmedetomidine with 0.5% ropivacaine on intercostal nerve block.

Methods: In total, 150 patients aged from 20-45 years with a body mass index (BMI): 18. Read More

J Orthop Trauma 2020 Apr 1. Epub 2020 Apr 1.

Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Objectives: Perioperative fascia-iliaca regional anesthesia (FIRA) decreases pain in hip fracture patients. The purpose of this study is to determine which hip fracture types and surgical procedures benefit most.

Design: This is a prospective observational study compared to a retrospective historical control. Read More

J Pediatr Surg 2020 Mar 12. Epub 2020 Mar 12.

Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. Electronic address:

Purpose: The purpose of our study was to compare the effectiveness of transincisional (TI) versus laparoscopic-guided (LG) rectus sheath block (RSB) for pain control following pediatric single-incision laparoscopic cholecystectomy (SILC).

Methods: Forty-eight patients 10-21 years old presenting to a single institution for SILC from 2015 to 2018 were randomized to TI or LG RSB. Apart from RSB technique, perioperative care protocols were identical between groups. Read More

Curr Osteoporos Rep 2020 Jun;18(3):130-137

Hughston Clinic, Jacksonville, FL, USA.

Purpose Of Review: The purpose is to review current literature on pain management strategies from initial presentation to postoperative care on common fracture types.

Recent Findings: - Hip fractures benefit from use of multimodal pain control for early mobility and decreased narcotic requirement. - Distal radius fracture pain during reduction can be managed with hematoma block. Read More

Anticancer Res 2020 Apr;40(4):2231-2238

Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy.

Aim: Acute post-operative pain following modified radical mastectomy (MRM) in patients with breast cancer is challenging for anesthesiologists. This study aimed to prospectively compare the quality outcome of interfascial plane blocks performed with ultrasound guidance, and evaluate the consequences of sharing tasks with the breast surgeon.

Patients And Methods: The study involved 255 patients scheduled for unilateral MRM, who were divided into two groups: Pecs group: General anesthesia plus ultrasound-guided modified pectoral nerves blocks type I and II, including serratus and parasternal infiltration according to surgical requirements; and Control group: general anesthesia only. Read More

Pain Med 2020 Mar 31. Epub 2020 Mar 31.

Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Gainesville, Florida, USA.

Setting: Post-tonsillectomy pain in adults can be severe and is often poorly controlled. Pain can lead to decreased oral intake, bleeding, longer hospital stays, emergency department visits, dehydration, and weight loss. Due to persistent pain despite scheduled medications, other methods for pain control are needed. Read More

J Bone Joint Surg Am 2020 May;102(10):866-872

Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California.

Background: Fascia iliaca nerve blocks (FIBs) anesthetize the thigh and provide opioid-sparing analgesia for geriatric patients with hip fracture awaiting a surgical procedure. FIBs are recommended for preoperative pain management; yet, block administration is often delayed for hours after admission, and delays in pain management lead to worse outcomes. Our objective was to determine whether opioid consumption and pain following a hip fracture are affected by the time to block (TTB). Read More

Geriatr Orthop Surg Rehabil 2020 4;11:2151459320910844. Epub 2020 Mar 4.

Department of Orthopedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.

Background: Music has emerged as a well-received medical intervention. Patients may be uncomfortable during total joint replacement, which can result in high sedation requirements. These requirements place elderly patients at risk for delirium. Read More

J Clin Anesth 2020 Aug 13;63:109783. Epub 2020 Mar 13.

Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China. Electronic address:

Study Objective: Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS).

Design: Prospective, randomized, double-blinded, placebo-controlled trial. Read More

J Anaesthesiol Clin Pharmacol 2020 Jan-Mar;36(1):115-116. Epub 2020 Feb 18.

University of Alabama Birmingham Medical Center, Division of Multispecialty Anesthesia, Department of Anesthesiology and Perioperative Medicine, JT 923, 619 19 Street South, Birmingham, AL 35249-6810, United States of America.

Abdominal organ transplantation - and more specifically small bowel transplant - can be quite painful, generally requiring significant opioid administration with the attendant negative ramifications. We present contrasting experiences with a gentleman who underwent transplantation for Crohn's disease and his retransplantation with the addition of post-operative anterior Quadratus Lumborum (QL) block. After the index procedure, he had significant pain and discomfort. Read More

Hernia 2020 Mar 13. Epub 2020 Mar 13.

Department of General, Visceral and Cancer Surgery, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.

Purpose: Laparoscopic inguinal hernia repair (IHR) may lead to early postoperative pain. Therefore, opioid and non-opioid analgesic agents are often administered in the post-anesthesia care unit (PACU). To reduce the postoperative cumulative need of analgesic medication, as well as to accelerate the physical recovery time, the transversus abdominis plane (TAP) block has recently been studied. Read More

Wideochir Inne Tech Maloinwazyjne 2020 Mar 27;15(1):208-214. Epub 2019 May 27.

Clinical Department of Cardiac Surgery, District Hospital No. 2, University of Rzeszow, Rzeszow, Poland.

Introduction: One of the main challenges in cardiac surgery is effective postoperative analgesia. Erector spinae-plane block (ESP block) is a novel regional technique, introduced by Forero in 2016 for neuropathic chest pain, then used successfully for mastectomy.

Aim: To establish the efficacy of the ESP block in patients undergoing mitral and/or tricuspid valve repair through a right mini-thoracotomy. Read More

BMC Anesthesiol 2020 02 27;20(1):51. Epub 2020 Feb 27.

Division of Cardiovascular Surgery, St. Jadwiga Provincial Clinical Hospital, ul. Lwowska 60, 35-301, Rzeszów, Poland.

Background: Effective postoperative pain control remains a challenge for patients undergoing cardiac surgery. Novel regional blocks may improve pain management for such patients and can shorten their length of stay in the hospital. To compare postoperative pain intensity in patients undergoing cardiac surgery with either erector spinae plane (ESP) block or combined ESP and pectoralis nerve (PECS) blocks. Read More

PLoS One 2020 24;15(2):e0229320. Epub 2020 Feb 24.

Department of Critical Care Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.

Background: Immersive virtual reality (IVR) is a form of distraction therapy that has shown potential as an analgesia and sedation sparing agent. This study assessed the effect of IVR on the self-administered sedation requirements of patients undergoing joint replacement surgery under regional anesthesia in a single center.

Methods And Findings: This study was a single-center, randomized control trial at St Vincent's Hospital in Melbourne, Australia. Read More

Can Assoc Radiol J 2020 Feb 27;71(1):75-80. Epub 2020 Jan 27.

Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.

Purpose: Uterine artery embolization (UAE) is an effective treatment for the management of symptomatic uterine fibroids. We aim to evaluate the efficacy of superior hypogastric nerve block (SHNB) in reducing narcotic analgesia use for postprocedural pain after UAE.

Methods: A retrospective review of 88 consecutive patients with symptomatic fibroids who underwent UAE between August 2015 and August 2018 was performed. Read More

Niger J Clin Pract 2020 Feb;23(2):172-178

Department of Anaesthesiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.

Background: One of the drawbacks of subarachnoid block is the short duration of analgesia particularly when adjuvants are not added to local anesthetics agent used. However, dexmedetomidine an αadrenergic agent has been found to possess analgesic effect.

Aims: This study seeks to determine the analgesic efficacy of intrathecal 7. Read More

Paediatr Anaesth 2020 Apr 21;30(4):498-505. Epub 2020 Feb 21.

Pediatric Division, Department of Surgery, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Background: Ilioinguinal/iliohypogastric nerve block is commonly performed to control postherniotomy pain. The posterior quadratus lumborum block has been recently described as an effective analgesic technique for pediatric low abdominal surgery. No data were found regarding the use of posterior quadratus lumborum block in comparison with the traditional ilioinguinal/iliohypogastric nerve block in pediatric inguinal surgery. Read More

Local Reg Anesth 2019 29;12:67-70. Epub 2019 Aug 29.

Intensive Care Unit and Anestehsia, Università degli Studi di Parma, Parma, Italy.

Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative pain. In this context the continuous popliteal nerve block is described as an option for postoperative pain management for surgical procedures on the leg, and particularly on the ankle and foot. We applied continuous popliteal nerve block for different types of anesthesia and postoperative pain management via the same catheter. Read More

Korean J Anesthesiol 2020 Jan 31. Epub 2020 Jan 31.

Department of Anesthesiology, Shimane University, Izumo City, Shimane, Japan.

Background: Posterior transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have been developed for postoperative pain control after lower abdominal surgery. However, there is still a paucity of data regarding their effects. This prospective study observed their analgesic effects and the distribution of cutaneous sensory blockade in patients undergoing laparoscopic gynecologic surgery. Read More

Plast Reconstr Surg 2020 Feb;145(2):507-516

Philadelphia, Pa.; and Wright Patterson Air Force Base, Ohio From the Division of Plastic and Reconstructive Surgery, the Center for Healthcare Quality & Analytics, Department of Anesthesiology and Critical Care, the Department of Child & Adolescent Psychiatry & Behavioral Sciences, Children's Hospital of Philadelphia; Perelman School of Medicine at the University of Pennsylvania; and the 88th Surgical Operations Squadron, Plastic Surgery Element.

Background: Cleft repair requires multiple operations from infancy through adolescence, with repeated exposure to opioids and their associated risks. The authors implemented a quality improvement project to reduce perioperative opioid exposure in their cleft lip/palate population.

Methods: After identifying key drivers of perioperative opioid administration, quality improvement interventions were developed to address these key drivers and reduce postoperative opioid administration from 0. Read More

Anaesthesia 2020 04 26;75(4):499-508. Epub 2020 Jan 26.

Département d'Anesthésie Réanimation, Centre Hospitalier Universitaire de Toulouse Purpan, Hôpital Riquet, Université Toulouse 3-Paul Sabatier, Toulouse, France.

Interscalene brachial plexus block provides analgesia for shoulder surgery but is associated with hemidiaphragmatic paralysis. Before considering a combined suprascapular and axillary nerve block as an alternative to interscalene brachial plexus block, evaluation of the incidence of diaphragmatic dysfunction according to the approach to the suprascapular nerve is necessary. We randomly allocated 84 patients undergoing arthroscopic shoulder surgery to an anterior or a posterior approach to the suprascapular nerve block combined with an axillary nerve block using 10 ml ropivacaine 0. Read More

Br J Anaesth 2020 03 21;124(3):299-307. Epub 2020 Jan 21.

Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, Western University, London, ON, Canada.

Background: Pain after anterior cruciate ligament reconstruction (ACLR) with autologous hamstring graft can be attributed to both arthroscopic surgery and the graft donor site. This study investigated whether donor site pain control was superior with the addition of either peri-hamstring injection or anterior division obturator nerve block in comparison with adductor canal block (ACB) alone.

Methods: Patients scheduled to undergo knee arthroscopy with ACLR using a graft from the ipsilateral hamstring were randomised to one of three groups. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2020 Jan 22;55(1):54-58. Epub 2020 Jan 22.

Electrochemotherapy (ECT) is a symptom control method for inoperable or exulcerating cutaneous metastases or skin cancer. With the help of electroporation, an enhancement of the efficacy of the administered chemotherapeutic agent, bleomycin or cisplatin, is achieved, which leads to a local reduction of the metastases and thereby has a low impact on the systemic health.ECT can be performed under local, regional or general anaesthesia, whereby the form of anaesthesia depends on the number and extent of the metastases as well as the affected body site. Read More

J Clin Anesth 2020 Jun 20;62:109715. Epub 2020 Jan 20.

Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY 11794-8480, United States of America. Electronic address:

Study Objective: The Quadratus lumborum (QL) block was first reported as a postoperative analgesic technique for abdominoplasty, and since has been used for a variety of surgeries. In this systematic review and meta-analysis, we summarize the current literature on the postoperative analgesic effect of QL block.

Design: We systematically searched PubMed, CENTRAL, CINAHL, EMBASE, Clinical Trials Registry (U. Read More

BJOG 2020 05 14;127(6):738-745. Epub 2020 Feb 14.

Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France.

Objectives: To evaluate the impact of preoperative Music Therapy (MT) on pain in first-trimester termination of pregnancy (TOP) under local anaesthesia.

Design: Randomised controlled trial comparing women undergoing a first-trimester TOP under local anaesthesia with or without a preoperative MT session.

Setting: University Hospital of Angers from November 2016 to August 2017. Read More

Ann R Coll Surg Engl 2020 Apr 17;102(4):290-293. Epub 2020 Jan 17.

West Suffolk NHS Foundation Trust, UK.

Introduction: Local anaesthetic repair of paraumbilical hernia (PUH) is a commonly performed operation. The aim of this study was to investigate whether local anaesthesia (LA) repair of PUH was feasible in patients with a high body mass index (BMI) and whether BMI had an impact on patient reported pain scores.

Methods: Patients undergoing PUH repair under the care of single consultant in a district general hospital between March 2010 and January 2018 were recruited. Read More

Ulus Travma Acil Cerrahi Derg 2020 Jan;26(1):109-114

Department of Anesthesiology and Reanimation, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla-Turkey.

Background: Hip fracture is a common clinical problem which causes severe pain in geriatric patients. However, severe pain following fracture may bring on mental disorders and delirium. A neuroinflammatory response with IL-6 and IL-8 has been shown to be associated with the pathophysiology of delirium. Read More

Plast Reconstr Surg Glob Open 2019 Nov 20;7(11):e2525. Epub 2019 Nov 20.

Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.

Adequate control of acute postoperative pain is crucial in breast surgeries, as it is a significant factor in the development of persistent chronic pain. Inadequate postoperative pain control increases length of hospital stays and risk of severe complications. Erector spinae plane block (ESPB) is a novel regional block that has the ability to sufficiently block unilateral multidermatomal sensation from T1 to L3. Read More

Am Surg 2019 Dec;85(12):1363-1368

From the *Department of Surgery, and the †Department of Colorectal Surgery, Providence Hospital and Medical Centers, Southfield, Michigan.

Enhanced recovery pathways (ERPs), when combined with transversus abdominis plane (TAP) blocks, have been proven to reduce the length of stay (LOS) and improve quality outcomes. Nonopioid pain management is an essential component of this pathway, leading to a reduction in immobility, postoperative ileus, and an increase in patient satisfaction. TAP block variations have been studied in general and gynecologic surgery. Read More

Pain Ther 2020 Jun 3;9(1):241-248. Epub 2020 Jan 3.

Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India.

Introduction: Although controversial, pre-emptive analgesia has shown some promise in preventing altered pain perception and reducing pain amplification after surgery. Hence, it has the potential to be more effective than a similar analgesic regimen started after surgery with an appropriate combination of patient category and analgesic modality. Hence, the present study was undertaken to evaluate the effect of preventive epidural analgesia in reducing pain severity and duration after bilateral single-stage knee arthroplasty. Read More

Anticancer Res 2020 Jan;40(1):253-259

Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland

Background/aim: The aim of the study was to compare the MDA (malonidialdehyde) plasma concentrations versus CAT (catalase)/NT (nitrotyrosine) plasma concentrations, patient satisfaction and pain score at rest/pressure to the wound area in laparotomy patients with rectus sheath block (RSB) analgesia.

Patients And Methods: Initially, 56 patients were randomized to four groups; control group (n=12), single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) RSB analgesia groups. The plasma concentrations of CAT, NT and MDA markers were measured just before, immediately after and 24 h after operation. Read More

J Cardiothorac Vasc Anesth 2020 May 9;34(5):1172-1181. Epub 2019 Nov 9.

University of Exeter Medical School, Exeter, United Kingdom; Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.

Objectives: Does intraoperative optimization of both depth of anesthesia and regional cerebral tissue oxygenation (rScO) in elderly patients reduce postoperative cognitive decline (primary outcome) or delirium (secondary outcome)?

Design: Prospective randomized controlled single blind trial.

Setting: A single major urban teaching and university hospital and tertiary referral center.

Participants: Patients, 65 years of age and older, undergoing elective coronary artery bypass graft surgery on cardiopulmonary bypass. Read More

Trials 2019 Dec 27;20(1):782. Epub 2019 Dec 27.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.

Background: Advancements in virtual reality (VR) technology have resulted in its expansion into health care. Preliminary studies have found VR to be effective as an adjunct to anesthesia to reduce pain and anxiety for patients during upper gastrointestinal endoscopies, dental procedures and joint arthroplasties. Current standard care practice for upper extremity surgery includes a combination of regional anesthesia and intraoperative propofol sedation. Read More