Ultrasound guided erector spinae block for postoperative analgesia in pediatric nephrectomy surgeries
Erector spinae block (ESB) is a newly identified regional anesthesia technique, which became popular between the clinicians for its ease and relatively safer administration [1]. There were quite many cases reporting its use for many different indications in adults. By far its use in pediatric cases was just defined for thoracic surgery [2,3]. We would like to share our experience about the use of ESB for postoperative analgesia in two pediatric cases undergoing nephrectomy for Wilms tumor. Written informed consent of all patients' parents was provided for using data of the children in this report. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 20, 2017 Category: Anesthesiology Authors: Can Aksu, Yavuz G ürkan Tags: Correspondence Source Type: research
Delayed diagnosis of contralateral tension pneumothorax during robotic lung wedge resection
Robotic thoracic surgery is on the rise as a minimally invasive alternative to open thoracic procedures. One lung isolation and ventilation is an essential component of these procedures and comes with its own set of cardiopulmonary changes. Contralateral tension pneumothorax can occur during one lung ventilation and requires prompt diagnosis and intervention to prevent cardiovascular collapse. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 19, 2017 Category: Anesthesiology Authors: Tsung-Pai James Huang, Ahmed Ahmed, Desmond D'Souza, Hamdy Awad Tags: Correspondence Source Type: research
Pain management in spine surgery
We read with great interest the study by Duttchen et al. [1] that compared the intraoperative ketorolac dose of 15mg versus the 30mg on early postoperative pain and opioid consumption in patients undergoing lumbar decompression spine surgery. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 19, 2017 Category: Anesthesiology Authors: Ozlem Korkmaz Dilmen, Hulya Bilgin Tags: Correspondence Source Type: research
Delayed diagnosis of contralateral tension pneumothorax during robotic lung wedge resection
Robotic thoracic surgery is on the rise as a minimally invasive alternative to open thoracic procedures. One lung isolation and ventilation is an essential component of these procedures and comes with its own set of cardiopulmonary changes. Contralateral tension pneumothorax can occur during one lung ventilation and requires prompt diagnosis and intervention to prevent cardiovascular collapse. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 19, 2017 Category: Anesthesiology Authors: Tsung-Pai James Huang, Ahmed Ahmed, Desmond D'Souza, Hamdy Awad Tags: Correspondence Source Type: research
Pain management in spine surgery
We read with great interest the study by Duttchen et al. [1] that compared the intraoperative ketorolac dose of 15mg versus the 30mg on early postoperative pain and opioid consumption in patients undergoing lumbar decompression spine surgery. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 19, 2017 Category: Anesthesiology Authors: Ozlem Korkmaz Dilmen, Hulya Bilgin Tags: Correspondence Source Type: research
Spread of local anesthetic solution in the erector spinae plane block
The erector spinae plane (ESP) block, with local anesthetic injected deep to the erector spinae muscle, has been reported to be able to block the dorsal and ventral rami of the thoracic spinal nerves [1,2]. Furthermore, the ESP block has been recently reported to be able to block the sympathetic nerve fibers [3]. However, the mechanism of sympathetic block is unknown. We investigated the spread of local anesthetic solution in the ESP block. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 16, 2017 Category: Anesthesiology Authors: Hironobu Ueshima, Otake Hiroshi Tags: Correspondence Source Type: research
Ultrasound guided left interscalene block for the treatment of refractory electrical storm
Electrical storm (ES) is a life-threatening medical emergency and is often associated with a poor outcome [1]. The condition is defined as 3 or more sustained episodes of ventricular tachycardia, ventricular fibrillation, or appropriate shocks from an implantable-cardioverter-defibrillator (ICD) within 24h [1]. Sympathetic blocks have been beneficial in stopping or decreasing ES and consequently improving 1-week mortality [2]. Temporary sympathetic blockade can be accomplished by blocking the cervical sympathetic ganglion, in the periphery at the adrenergic receptor, or in the thoracic central neuraxis [2,3]. (Source: Jour...
Source: Journal of Clinical Anesthesia - December 15, 2017 Category: Anesthesiology Authors: Robyn S. Weisman, Dayaris Morffi, Alexis P. Rodriguez, Ralf E. Gebhard Tags: Correspondence Source Type: research
Are paravertebral nerve blocks an answer to pain after iliac crest bone marrow biopsy?
While bone marrow biopsy and aspiration (BMBA) is recognized to be painful, current analgesic options are insufficient with widely variable efficacy. Local anesthesia does not reduce pain associated with bone marrow aspiration, and while opioids are often used to reduce suction-associated pain, many patients still report severe pain during the procedure [1]. The efficacy of premedication with oral narcotics and benzodiazepines is inconsistent, and some studies have found it to have no advantage over local anesthesia alone [2]. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 15, 2017 Category: Anesthesiology Authors: Abby M. Pribish, Arun Kalava Tags: Correspondence Source Type: research
Ultrasound guided left interscalene block for the treatment of refractory electrical storm
Electrical storm (ES) is a life-threatening medical emergency and is often associated with a poor outcome [1]. The condition is defined as 3 or more sustained episodes of ventricular tachycardia, ventricular fibrillation, or appropriate shocks from an implantable-cardioverter-defibrillator (ICD) within 24h [1]. Sympathetic blocks have been beneficial in stopping or decreasing ES and consequently improving 1-week mortality [2]. Temporary sympathetic blockade can be accomplished by blocking the cervical sympathetic ganglion, in the periphery at the adrenergic receptor, or in the thoracic central neuraxis [2,3]. (Source: Jour...
Source: Journal of Clinical Anesthesia - December 15, 2017 Category: Anesthesiology Authors: Robyn S. Weisman, Dayaris Morffi, Alexis P. Rodriguez, Ralf E. Gebhard Tags: Correspondence Source Type: research
Are paravertebral nerve blocks an answer to pain after iliac crest bone marrow biopsy?
While bone marrow biopsy and aspiration (BMBA) is recognized to be painful, current analgesic options are insufficient with widely variable efficacy. Local anesthesia does not reduce pain associated with bone marrow aspiration, and while opioids are often used to reduce suction-associated pain, many patients still report severe pain during the procedure [1]. The efficacy of premedication with oral narcotics and benzodiazepines is inconsistent, and some studies have found it to have no advantage over local anesthesia alone [2]. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 15, 2017 Category: Anesthesiology Authors: Abby M. Pribish, Arun Kalava Tags: Correspondence Source Type: research
Pleural and pericardial effusions in patient on tyrosine kinase inhibitor
A 73-year-old female with atrial fibrillation, hypertension, hypothyroidism, gout, gastroesophageal reflux disease, and remote breast cancer presented with abdominal pain and was found to have concurrent gastric (gastrointestinal stromal tumor (GIST)) and asymptomatic anterior mediastinal (thymoma) masses. Adjuvant treatment with imatinib, a tyrosine-kinase inhibitor (TKI), was initiated one month after the gastric GIST resection. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 14, 2017 Category: Anesthesiology Authors: Christopher L. Pysyk, Tim Asmis, Sebastien Gilbert Tags: Correspondence Source Type: research
Ultrasound to facilitate thoracic paravertebral catheter in severe scoliosis
Insertion of a thoracic epidural catheter for perioperative pain management of thoracic and upper abdominal major surgeries is an excellent technique utilized in both pediatric and adult populations, however many anesthetists consider severe scoliosis to be a technically challenging barrier precluding placement of a thoracic epidural. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - December 13, 2017 Category: Anesthesiology Authors: Muhammad H. Ibrahim, Mark E. Thompson Tags: Correspondence Source Type: research
