Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2024
Randomized Controlled TrialAn ultrasound-guided serratus anterior plane block with continuous local anaesthetic infusion and epidural analgesia for rib fracture pain.
We compared analgesia with an ultrasound (US)-guided serratus anterior plane block (SAPB) to thoracic epidural analgesia (EA) with continuous local anaesthetic infusion in patients with unilateral multiple traumatic rib fractures. EA often carries contraindications in patients with multiple rib fractures (MRFs), whereby having alternative effective methods to treat rib fracture pain remains important to patient care. Thus, we hypothesised that both regional anaesthetic techniques would provide effective pain relief. ⋯ SAPB with continuous local anaesthetic infusion is an effective alternative to treat rib fracture pain when EA is contraindicated. We found that SABP significantly reduces pain in patients with unilateral MRFs, although EA achieves better analgesia over the first 12 h following the block.
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Acta Anaesthesiol Scand · Mar 2024
Review Meta AnalysisMixing short- and long-acting local anaesthetics in peripheral nerve blocks: Protocol for a systematic review and meta-analysis.
This protocol describes a systematic review and meta-analysis to evaluate the clinical effects of mixing short- and long-acting local anaesthetics in peripheral nerve blocks. Clinicians often combine short- and long-acting local anaesthetics to achieve a briefer onset time. However, this may come with a prize, namely a shorter total duration of the block, which is of clinical importance. ⋯ We will conduct a meta-analysis of the extracted data, and the risk of bias for each study will be evaluated. We will perform a Trial Sequential Analysis, subgroup, and sensitivity analyses and assess the overall risk of publication bias. Finally, we will evaluate the review using the GRADE principles.
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Acta Anaesthesiol Scand · Mar 2024
ReviewChronic post-surgical pain following gastrointestinal surgery: Protocol for a scoping review.
Chronic post-surgical pain (CPSP) significantly impacts people's lives, affecting both socioeconomic aspects as well as their rehabilitation after surgery. Yet, CPSP remains an under-researched field. The prevalence varies depending on type of surgery, which highlights the importance of surgery-specific research. This scoping review aims to investigate CPSP following gastrointestinal surgery in order to map out incidences, risk factors, and impact on quality of life (QoL) as well as identify gaps in research. ⋯ The planned scoping review will map out the current evidence about CPSP in adults following gastrointestinal surgery. We will identify gaps in research that can support the development of further research into CPSP after gastrointestinal surgery.
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Acta Anaesthesiol Scand · Mar 2024
Multicenter Study Observational StudyMagnitude and time to peak oxygenation effect of prone positioning in ventilated adults with COVID-19 related acute hypoxemic respiratory failure.
Prone positioning may improve oxygenation in acute hypoxemic respiratory failure and was widely adopted in COVID-19 patients. However, the magnitude and timing of its peak oxygenation effect remain uncertain with the optimum dosage unknown. Therefore, we aimed to investigate the magnitude of the peak effect of prone positioning on the PaO2 :FiO2 ratio during prone and secondly, the time to peak oxygenation. ⋯ In ventilated adults with COVID-19 acute hypoxemic respiratory failure, peak PaO2 :FIO2 ratio effect occurred during the first prone positioning episode and after 9 h. Subsequent episodes also improved oxygenation but with diminished effect on PaO2 :FIO2 ratio. This information can help guide the number and duration of prone positioning episodes.