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Propensity score ‐matched outcomes after thoracic epidural or paravertebral analgesia for thoracotomy

Summary It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri‐operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0.88. For any postoperative complication, there were 80 out of 324 (25%) and 78 out of 324 (24%) complications, respectively, p = 0.85. There were 17 out of 324 (5%) re‐admissions to intensive care after thoracic epidural and 17 out of 324 (5%) after paravertebral block, p> 0.99, and the number of deaths before discharge were 6 out of 324 (2%) and 4 out of 324 (1%), respectively, p = 0.53. There was no significant difference in median (IQR [range]) hospital stay after thoracic epidural or paravertebral block, 6 (5–9 [2–94]) days vs. 6 (5–9 [2–122]), respectively, p = 0.83. Our study suggests that rates of complications as well as length of hospital stay after thoracic epidural analgesia and paravertebral blockade are similar. We were unable to compare analgesic efficacy due to incomplete data.
Source: Anaesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research

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Mohammed Aloddadi, Safar Alshahrani, Ibrahim AlnaamiJournal of Pediatric Neurosciences 2018 13(1):78-80The management of hydrocephalus represents a neurosurgical challenge. Ventriculoperitoneal (VP) shunts are usually the treatment of choice for hydrocephalus. However, when VP shunt is not an option, ventriculoatrial (VA) shunt becomes a second choice. VA shunts have special complications such as postoperative neck hematomas, shunt nephritis, and migration of the distal segment. There are two main techniques for the retrieval of migrated VA shunt: either by retrieval of the broken segment by thoracotomy, which is highly in...
Source: Journal of Pediatric Neurosciences - Category: Neuroscience Authors: Source Type: research
LEFT VENTRICULAR ASSIST DEVICES (LVADs) increasingly have been used in the management of acute and chronic cardiac failure.1 LVADs often are implanted through a left thoracotomy incision to preserve the sternotomy approach for future cardiac transplantation.2 Thoracic epidural analgesia (TEA) and thoracic paravertebral blockade (TPVB) are the current gold standards for managing acute post-thoracotomy pain3; however, block performance and catheter removal are contraindicated in the presence of systemic heparinization due to the risk of spinal hematoma.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
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Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research
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Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
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Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
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Source: Journal of the Egyptian National Cancer Institute - Category: Cancer & Oncology Source Type: research
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Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Since its initial description in September 2016 [1], the erector spinae plane (ESP) block has garnered widespread interest amongst regional anesthesiologists. A facial plane block where local anesthetic is injected between the erector spinae muscle (ESM) and the underlying transverse process (TP), this block has been used successfully for chronic pain and perioperative analgesia in adults [1,2]. Experiences with children, however, are limited thus far [3,4]. Until now, only 2 reported cases of continuous ESP block in children exist, both in patients undergoing a thoracotomy [4,5].
Source: Journal of Clinical Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research
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Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
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