Review
Anesthesiology
Andrea Fanelli, Eleonora Balzani, Stavros Memtsoudis, Faraj W. Abdallah, Edward R. Mariano
Summary: This study found that postoperative delirium can be reduced when regional analgesia techniques are used, but intraoperative regional anesthesia alone may not decrease postoperative delirium since there are other influencing factors.
MINERVA ANESTESIOLOGICA
(2022)
Article
Anesthesiology
David M. Schultz, Jonathan M. Hagedorn, Alaa Abd-Elsayed, Scott Stayner
Summary: This study aimed to provide evidence for the safety of posterior interlaminar cervical epidural steroid injections at and above C7-T1 levels. The results suggest that injections above C7-T1 do not increase complication rates, with no correlation found between the spinal level of injection and complication rates. Hundreds of injections were performed at levels above C5-6, with the most common level being C5-6 followed by C6-7.
Article
Multidisciplinary Sciences
Kyung-Don Hahm, Seok-Joon Jin, Seong-Sik Cho, Jihoon Park, Han Park, Doo-Hwan Kim, Seong-Soo Choi
Summary: The use of epidural PCA can lead to higher postoperative bleeding and a greater need for red blood cell transfusion compared to intravenous PCA in patients undergoing unilateral TKA. Therefore, caution should be exercised when considering epidural PCA for postoperative pain management in TKA.
SCIENTIFIC REPORTS
(2021)
Review
Cardiac & Cardiovascular Systems
Ke Zhou, Dongyu Li, Guang Song
Summary: This study is a meta-analysis on the use of different regional anesthetic techniques for patients after cardiac surgery. The results indicate that thoracic epidural analgesia (TEA) is the most effective technique, reducing pain scores and decreasing the need for rescue analgesia.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Shiori Yamazaki, Sachie Koike, Takashi Eguchi, Shunichiro Matsuoka, Tetsu Takeda, Kentaro Miura, Kazutoshi Hamanaka, Kimihiro Shimizu
Summary: This study investigated the necessity of thoracic epidural analgesia (TEA) during minimally invasive surgery (MIS) and the noninferiority of preemptive intercostal nerve block (ICNB) to TEA. The results showed that approximately one-third of patients undergoing MIS discontinued TEA early, and ICNB can be an alternative to TEA, providing equivalent pain relief.
ANNALS OF THORACIC SURGERY
(2022)
Article
Clinical Neurology
Stephen T. Magill, Minh P. Nguyen, Manish K. Aghi, Philip Theodosopoulos, Javier E. Villanueva-Meyer, Michael W. McDermott
Summary: A DWI signal > 1 cm is significantly associated with postoperative neurological deficits, both immediate and long-lasting. Greater estimated blood loss, older age, tumor location over the motor strip, and preoperative peri-tumoral edema increase the risk of having a postoperative DWI signal > 1 cm, reflective of perilesional ischemia. Most immediate postoperative deficits will improve over time.
JOURNAL OF NEUROSURGERY
(2021)
Article
Anesthesiology
Chris A. Rishel, Martin S. Angst, Eric C. Sun
Summary: The study found that changes in preoperative opioid utilization were not clinically significant for several postoperative outcomes, with patients who gradually decreased opioid utilization having lower postoperative opioid usage and patients who gradually increased usage having slightly lower usage.
Review
Agriculture, Dairy & Animal Science
Vincenzo Cicirelli, Matteo Burgio, Giovanni M. Lacalandra, Giulio G. Aiudi
Summary: This review focuses on the application of local and regional anaesthetic/analgesic techniques in canine ovariectomy. The use of multimodal analgesia has been proven effective in minimizing surgical responses and ensuring adequate intraoperative and postoperative pain relief. The routine use of multimodal analgesia is considered a useful alternative for pain management in canine ovariectomy.
Article
Health Care Sciences & Services
Juan P. Cata, Jian Hu, Lei Feng, Caroline Chung, Scott E. Woodman, Larissa A. Meyer
Summary: Millions of Americans infected with COVID-19 require oncologic surgery, and surgery may affect postoperative neuropsychiatric outcomes. This study aimed to investigate whether patients with a history of COVID-19 have an increased risk of developing postoperative delirium after major elective oncologic surgery. The results showed that a preoperative diagnosis of COVID-19 did not increase the risk of postoperative antipsychotic medication use or neurological complications. However, COVID-19 patients had a higher risk of respiratory and overall 30-day complications, indicating a need for further research on post-COVID-19 neurological events.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Medicine, General & Internal
Motaz Hamed, Harun Asoglu, Tim Lampmann, Lena Marie Winkelmann, Abdallah Salemdawod, Martin Mueller, Hartmut Vatter, Mohammed Banat, Lars Eichhorn
Summary: This study compared epidural analgesia (EA) with systemic analgesia (SA) for pain reduction and early postoperative complications after SDI. The SA group had significantly lower pain rating scores and lower cumulative opioid use compared to the EA group. There were no differences in infection, length of hospital stay, or surgery-related complications between the two groups.
Article
Anesthesiology
Carl Chauvin, Gregory Klar, Wilma M. Hopman, Leopoldo Muniz da Silva, Andrew G. Day, Rachel Phelan, Michael McMullen, Kai Chen, Rodrigo Moreira E. Lima, Glenio B. Mizubuti
Summary: The study showed that epidural waveform analysis (EWA) is useful in assessing the position of thoracic epidural catheters in the immediate postoperative period, with high sensitivity and specificity as well as robust inter-rater reliability. EWA may provide a useful adjunct for assessing epidural functionality in patients in whom sensory block to ice cannot be reliably assessed postoperatively.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Medicine, General & Internal
Eic Ju Lim, Won Uk Koh, Hyungtae Kim, Ha-Jung Kim, Hyun-Chul Shon, Ji Wan Kim
Summary: Postoperative delirium is common in elderly patients with hip fracture, and pain is a major risk factor for delirium. Regional nerve blocks (RNBs) are effective in controlling pain and reducing delirium incidence. A study involving 252 patients showed that RNB was associated with lower delirium rates and better pain control in elderly patients undergoing hip surgery.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Surgery
Ju Tang, Zhiguo Zheng, Qijun Ran, Feng Zhao, Yao Wang, Feng Hu, Chao Yang, Xiaoyong Tan
Summary: The aim of this study was to examine whether the addition of esketamine to morphine could improve postoperative analgesia after cesarean section. The results showed that patients who received 0.25 mg/kg esketamine plus 2 mg morphine through the epidural catheters had significantly lower pain scores at rest and with movement compared to the other groups, and they also required fewer rescue analgesics. Additionally, the addition of esketamine did not increase the incidence of adverse events.
FRONTIERS IN SURGERY
(2023)
Review
Chemistry, Medicinal
Panu Piirainen, Hannu Kokki, Merja Kokki
Summary: Epidural administration of oxycodone has advantageous pharmacokinetics and higher efficacy compared to intravenous administration, making it a potential option for epidural analgesia.
Article
Health Care Sciences & Services
Xianhui Kang, Yeke Zhu, Kun Lin, Liwei Xie, Heng Wen, Wujun Geng, Shengmei Zhu
Summary: This prospective research aimed to determine the incidence and risk factors of localized pain at the epidural insertion site following nonobstetric surgery with epidural anesthesia. The study found localized pain to be the most common complication, with risk factors including lumbar insertion, age less than 50, multiple block attempts, and postoperative patient-controlled epidural analgesia.
RISK MANAGEMENT AND HEALTHCARE POLICY
(2021)