Journal of clinical anesthesia
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Randomized Controlled Trial
The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial.
Laparoscopic cholecystectomy (LC) causes moderate-to-severe postoperative pain. Postoperative pain is one of the leading contributors to respiratory dysfunction following surgery. This study investigated the effect of erector spinae plane (ESP) block on postoperative analgesia and respiratory function in patients undergoing LC. ⋯ Bilateral ESP blocks provides adequate analgesia, allowing for a lower opioid requirement and significant respiratory function improvement after LC; therefore, we concluded that ESP block could be added to the multimodal analgesia protocol in LC.
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Case Reports
Using the iPACK block to reduce chronic pain in a patient with knee osteoarthritis: A case report.
Infiltration between the popliteal artery and capsule of the knee (iPACK) block is an emerging modality to control perioperative knee joint pain. This case report describes the successful control of chronic knee joint pain using iPACK block in a patient with knee osteoarthritis. We suggest that iPACK block could be applied in the fields of both pain medicine and perioperative analgesia. In addition, by placing the needle closely to the popliteal plexus, iPACK block could serve as an intervention for pain related to procedures such as radiofrequency ablation.
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Meta Analysis
Effect of prone versus supine position in COVID-19 patients: A systematic review and meta-analysis.
To review the effects of prone position and supine position on oxygenation parameters in patients with Coronavirus Disease 2019 (COVID-19). ⋯ Our meta-analysis demonstrated that prone position improved PaO₂/FiO₂ ratio with better SpO₂ than supine position in COVID-19 patients. Given the limited number of studies with small sample size and substantial heterogeneity of measured outcomes, further studies are warranted to standardize the regime of prone position to improve the certainty of evidence. PROSPERO Registration: CRD42021234050.
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Observational Study
The association of bispectral index values and metrics of cerebral perfusion during cardiopulmonary bypass.
Low bispectral index (BIS) values have been associated with adverse postoperative outcomes. However, trials of optimizing BIS by titrating anesthetic administration have reported conflicting results. One potential explanation is that cerebral perfusion may also affect BIS, but the extent of this relationship is not clear. Therefore, we examined whether BIS would be associated with cerebral perfusion during cardiopulmonary bypass, when anesthetic concentration was constant. ⋯ There was an association of BIS and metrics of cerebral perfusion during a period of constant anesthetic administration, but the absolute magnitude of change in BIS as MAP decreased below the LLA was small.