1,720,969 research outputs found
Enhancing Pharmacological and Interventional Analgesia in Orthopedic Patients
No full textabstract not availabl
Enhancing Pharmacological and Interventional Analgesia in Orthopedic Patients
No full textabstract not availabl
From emergency department to operating room: interventional analgesia techniques for hip fractures
No full textPurpose of review To provide an update on pain management options with regional anesthesia for patients with hip fractures at the emergency department (ED). Recent findings Patients who sustain a hip fracture are typically admitted and diagnosed in the ED before being transferred to the operating room for surgery. Studies have clearly demonstrated the ability of the fascia iliaca compartment blocks (FICBs) and femoral nerve blocks (FNBs) to reduce pain and the risk of an acute confusional state. Their administration at an early stage of the patient's trajectory in the ED is beneficial. Recent anatomical studies contributed new knowledge of nociception in the hip joint, which allowed the development of more specific infiltration analgesia techniques without muscle weakness (e.g., pericapsular hip blocks). Further research on the timing of nerve blocks and an evaluation of new motor sparing techniques is indicated. FICB and FNB are established and recommended techniques in pain management for hip fracture patients. Their use early on in the ED may improve patient comfort and outcome. Pericapsular nerve hip blocks could provide a relevant alternative in future pain management in this group of patients
The effect of anesthesia on hemodynamics and outcome of patients undergoing thrombectomy after acute ischemic stroke: a retrospective analysis
No full textBackground Anesthesia during thrombectomy remains a matter of debate. We retrospectively investigated the influence of intraprocedural blood pressure and type of anaesthetic agent on 3-month functional outcome and mortality in stroke patients undergoing mechanical thrombectomy under general anesthesia in a single center study.Methods All patients suffering from stroke who presented between January 2019 and July 2021 at Ziekenhuis Oost-Limburg Genk, Belgium and who received thrombectomy were included. Patient's characteristics and outcome data had been collected for benchmarking. Detailed perioperative data were exported from the electronic anesthesia records and clinically validated. Patients were stratified by peri-operative presence of hypotension (MAP = 65 mmHg).Results All 98 patients received mechanical thrombectomy under general anesthesia. Thirty-six percent (n = 35) was hypotensive peri-operatively at any time point. Proportion of sevoflurane use was higher in non-hypotensive patients compared to hypotensive patients (73% (n = 45) vs. 51% (n = 18), p = 0.04). Peri-operative use of vasopressors was higher in the hypotensive group compared to non-hypotensive (88% (n = 30) vs. 63% (n = 39), p = 0.008). Proportion of patients with good functional outcome at 3 months (mRS 0-2) was higher in non-hypotensive patients compared to hypotensive patients 44% (n = 27) vs. 24% (n = 8), p < 0.05. 90-day mortality was lower in non-hypotensive patients compared to hypotensive patients 21% (n = 13) vs. 43% (n = 15), (p = 0.02).Conclusion Patients who are hypotensive at any given time during thrombectomy under general anesthesia may have worse neurological outcome compared to non-hypotensive patients. The best anaesthetic management for mechanical thrombectomy needs to be clarified prospectively in large multicenter studies.We would like to thank all health care workers who helped with this study. Dr. Pieter Jan Van Asbroeck, Dr. Ruben Haesendonck, Dr. Cédric Van Dijck are greatly thanked for their assistance. The Stroke Consortium includes following collaborators who were directly involved in patient care of the study: Stockx Luc, MD3 , Ernon, Ludovic, MD4 ,Van Boxstael, Sam, MD1, Vanelderen, Pascal, MD, PhD1,5
Motor-Sparing Nerve Blocks Can Improve the Results of Digit Tendon Surgery: A Case Report
No full textA 56-year-old woman presented with flexion dysfunction of the fifth digit 6 weeks after surgical repair of a flexor digitorum profundus laceration. She was scheduled for surgical adhesiolysis and restoration of the functionality of the finger. Intraoperative monitoring of the range of motion by active flexion was deemed important to prevent incomplete release of the tendon and residual dysfunction. Distal median and ulnar nerve blocks were used for anesthesia with the patient's ability to flex the finger. This case suggests that motor-sparing peripheral nerve blocks can improve functional outcome in certain hand surgeries
Spinal anesthesia in patients with aortic stenosis: a research report
No full textThe authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Acknowledgements
The authors would like to acknowledge the help of Ben Goethuys for the computerized data collection as well as the support of drs. Katarzyna Korwin-Kochanowska, Ruben Schreurs, Robbert Buck and Bram Byloos and block nurses at Ziekenhuis Oost-Limburg, Genk, Belgium. We would also like to thank Darren Jacobs for his assistanc
Pericapsular nerve group block: a 3D CT scan imaging study to determine the spread of injectate
Full text linkpeer reviewed[en] BACKGROUND: Current understanding of the mechanism of action of the pericapsular nerve group (PENG) block is primarily based on cadaver studies. We performed an imaging study in patients undergoing hip surgery to enhance the understanding of the analgesic mechanisms following a PENG block.
MATERIALS AND METHODS: 10 patients scheduled for hip surgery received an ultrasound-guided PENG block with 18 mL of 0.5% ropivacaine mixed with 2 mL of a contrast agent. After completion of the block, a high-resolution CT scan was performed to obtain a three-dimensional reconstruction of the injectate's dispersion.
RESULTS: The CT imaging revealed that injectate was mainly confined to the epimysium of the iliacus and the psoas muscle, with a minor spread to the hip capsule. Contrast dye was detected within the iliacus and/or the psoas muscle in all patients. No observed spread to either the subpectineal plane or the obturator foramen was detected.
CONCLUSION: Our study suggests that the analgesic effect of the PENG block may be related to the block of the branches of the femoral nerve traveling within the iliopsoas muscle without a spread pattern commensurate with the block of the obturator nerve.
TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT06062134)
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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