Anesthesiology and pain medicine
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Review
Interventional Therapies for Chronic Low Back Pain: A Focused Review (Efficacy and Outcomes).
Lower back pain is considered to be one of the most common complaints that brings a patient to a pain specialist. Several modalities in interventional pain management are known to be helpful to a patient with chronic low back pain. Proper diagnosis is required for appropriate intervention to provide optimal benefits. From simple trigger point injections for muscular pain to a highly complex intervention such as a spinal cord stimulator are very effective if chosen properly. The aim of this article is to provide the reader with a comprehensive reading for treatment of lower back pain using interventional modalities. ⋯ Lower back pain is a major healthcare issue and this review article will help educate the pain practitioners about the current evidence based treatment options.
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The current randomized double-blind clinical trial aimed to compare the incidence of post-operative cough with intravenous vs. topical lidocaine in children with mild upper respiratory infection (URI) anesthetized with laryngeal mask airway (LMA) in the university-affiliated medical center. ⋯ The pediatric patients undergoing general anesthesia with LMA with intravenous lidocaine experienced fewer incidence of postoperative cough compared to the ones in the topical lidocaine group.
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Although local anesthesia is a suitable method for upper limb surgeries, there is debate regarding the effects of appropriate dosing. ⋯ The volume of the injected anesthetic accelerated the onset of sensory and motor block without affecting the rate of success in our patients.
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Opium is an addictive agent and one of the most common narcotics With great challenges of intraoperative hemodynamic instabilities. ⋯ Premedication with clonidine to decrease intraoperative blood loss can be more effective in patients with opium addiction than the ones without addiction.
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Intrathecal adjutants can be used for regional anesthesia (RA) in cesarean section to improve its quality in terms of time and complications. Some previous studies focused on the effects of adding sufentanil and/or midazolam to bupivacaine and compared each with using bupivacaine alone. However, there has been no study to assess the effects of using sufentanil and midazolam in combination with bupivacaine. ⋯ The findings showed that adding sufentanil or midazolam to bupivacaine shortens the onset of spinal anesthesia and increases the time duration of anesthesia; however it does not change the motor block recovery time. Adding sufentanil delays the first request for narcotic analgesics while adding midazolam leads to a decrease in nausea and hypotension. Adding sufentanil or midazolam does not have any deleterious effect on infants' Apgar scores. However, increases shivering in patients.