Journal of clinical anesthesia
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This narrative review discusses the anatomy, mechanism of action, techniques, pharmacology, indications, complications and substitutes for erector spinae plane (ESP) blocks. ⋯ In recent years, ESP blocks have become the topic of considerable clinical interest. Future trials are required to investigate their optimal technique, dose of local anesthetic and perineural adjuvants. Moreover, additional investigation should compare ESP blocks with robust multimodal analgesic regimens as well as truncal blocks such as thoracic epidural block, midpoint transverse process to pleura block, PECS block, quadratus lumborum block, and transversus abdominis plane block.
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To review all randomized controlled trials (RCTs) comparing the analgesic efficacy of adductor canal block (ACB), periarticular infiltration (PAI), and any other mode of these treatments in analgesia, such as PAI with liposomal bupivacaine (LB), continuous adductor canal block (cACB) or ACB + PAI, after total knee arthroplasty (TKA). ⋯ PROSPERO (CRD 42020168102).
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Whether dexmedetomidine effectively attenuates the increase in intraocular pressure (IOP) remains inconclusive. We aim to evaluate the effects of dexmedetomidine on IOP in adult patients undergoing surgery which requires general anesthesia and endotracheal intubation. ⋯ Dexmedetomidine effectively attenuates the increase in IOP levels, and should be considered especially for at-risk patients.
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Randomized Controlled Trial
Methylene blue reduces incidence of early postoperative cognitive disorders in elderly patients undergoing major non-cardiac surgery: An open-label randomized controlled clinical trial.
The purpose of the present study was to investigate whether methylene blue (MB) could reduce the incidences of postoperative delirium (POD) and early postoperative cognitive dysfunction (POCD) in elderly patients undergoing major non-cardiac surgery. ⋯ We conclude that intraoperative intravenous 2 mg/kg MB could significantly reduce the incidences of POD and early POCD in elderly surgical patients, while not remarkably increase incidence of perioperative adverse events, suggesting MB may be clinically effective and safe for prevention of early postoperative neurocognitive disorders.
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Randomized Controlled Trial Controlled Clinical Trial
The incidence of persistent postoperative opioid use among U.S. veterans: A national study to identify risk factors.
To calculate the incidence and identify the predictors of persistent postoperative opioid use at different postoperative days. ⋯ Many surgeries or invasive procedures are associated with an increased risk of persistent postoperative opioid use. The postoperative period is dynamic and the risk factors change with time.