Anesthesiology and pain medicine
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The volume of pediatric Procedural Sedation and Analgesia (PSA) outside the operating room has been increasing. This high clinical demand leads non-anesthesiologists, especially pediatric intensivists, pediatricians, and emergency physicians, to take a role in performing procedural sedation. Our department has established the PSA service by pediatric intensivists since 2015. ⋯ Our data suggest that children who undergo procedural sedation outside the operating room conducted by pediatric intensivists are safe and effectively treated. Receiving more than three sedative medications is the independent risk factor associated with serious adverse events.
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There are many unknown questions and puzzle pieces that should describe the clinical course of COVID-19 and its complications, especially ARDS. We provide the initial immediate surge response to allow every patient in need of an ICU bed to receive one. ⋯ This treatment should now be performed regardless of the reason which lies behind the pathophysiology of this disease, which is yet unknown. In this report, we share our experience in the management of critically ill COVID-19 patients during the 2 months in our intensive care unit.
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Labor pain is a severe pain, and intrathecal opioid injection is one of the analgesia methods to reduce it. ⋯ Intrathecal fentanyl and sufentanil have a similar analgesic effect on labor. Fentanyl is associated with a faster onset of analgesia and more satisfaction, while sufentanil has longer analgesia.
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The labor pain is one of the factors encouraging pregnant women for cesarean section delivery. Recently, intradermal and subdermal injection of distilled water has shown to be effective in improving this pain. ⋯ The injection of distilled water by either intradermal or subdermal method was associated with a significant reduction in the pain score during labor, but there was no difference between these two methods in terms of decreasing labor pain. As sterile water injection is a safe, effective, and low-cost method, it is proposed to increase the knowledge of midwives and obstetricians about this method.
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Spinal cord stimulation (SCS) is an effective treatment option to relieve chronic intractable pain, and failed back surgery syndrome (FBSS) is a key indication. ⋯ This cost-consequences analysis suggests that R-SCS implants are more cost-beneficial than NR-SCS systems in well-selected patient candidates for this type of treatment.