<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective observational study</span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sixty patients were included in the study. The numerical rating scale</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesia group than in the ESP group [212.0 (6.6) mg, vs. 107.3 (36.9 mg), (p <0.001)]. The time to first stand up after surgery was significantly longer in the general anesthesia group (p = 0.011).</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> ESP block appear to be an effective method to relieve pain after lumbar surgery.</span>展开更多
Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends ...Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends to the cervical level. Herein, we present a successful multilevel ESPB plus an interscalene block using liposomal bupivacaine in a 45-year-old female patient with metastatic sarcoma who presented for scapula and proximal humerus resection. The post-operative course was smooth, and the patient was discharged home on post-operative day 2 with minimal narcotic requirements.展开更多
Antibacterial activity of biosynthesized silver nanoparticles (AgNPs) was significant in therapeutic application of nanotechnology. These researchers studied an ecofriendly and rapid method for the first time to synth...Antibacterial activity of biosynthesized silver nanoparticles (AgNPs) was significant in therapeutic application of nanotechnology. These researchers studied an ecofriendly and rapid method for the first time to synthesize silver nanoparticles using Zizyphus spina christi L aqueous leaves extract (ZSE), and their antibacterial properties. The extract was found to have the potential to form silver nanoparticles at room temperature within few minutes. The green synthesized silver nanoparticles were characterized using different techniques. The UV-visible spectrum of the solution containing AgNPs showed a peak at 414 nm corresponding to the plasmon absorbance of silver nanoparticles. The transmission electron microscopy (TEM) showed that the formed particles were hexagonal in shape with appreciable Nano size ranging from 21.5 to 59.67 nm. Fourier Transform Infrared Spectroscopy analysis (FTIR) of biosynthesized AgNPs affirmed the role of ZSE as reducing and capping agent of Ag+ ions to AgNPs, and X-Ray Diffraction patterns (XRD) showed that they could be indexed as face-centered-cubic structure of silver. Antibacterial activity of AgNPs was determined by well diffusion and micro plate assay methods, showing maximum inhibition zones of 24 mm, 23 mm, 15 mm and 17 mm against Staphylococcus aureus, Acinetobacter sp., Pseudomonas aeruginosa and Escherichia coli respectively. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) results showed that AgNPs had MIC, MBC of 45, 57 μg/mL, 49, 61 μg/mL, 63, 90 μg/mL and 59, 82 μg/mL against S. aureus, Acinetobacter sp., P. aeruginosa and E. coli respectively. Furthermore, the green synthesized AgNPs were loaded on band-aids and screened for antibacterial activity. The AgNPs loaded on band-aids exhibited strong antibacterial effect against multi drug resistant bacteria. These nanoparticles could be used for treating wounds and preparing wound dressing. Such researches are crucial in the demonstration of therapeutic importance of silver nanoparticles in medical application.展开更多
We present a case of Local Anesthesia Systemic Toxicity (LAST) in a 7-month-old male after a caudal block placement. The patient was a healthy 8.3 kg male without any medical history, surgical history, significant bir...We present a case of Local Anesthesia Systemic Toxicity (LAST) in a 7-month-old male after a caudal block placement. The patient was a healthy 8.3 kg male without any medical history, surgical history, significant birth history or any history of family problems with anesthesia. After induction of general anesthesia, a size 1.5 laryngeal mask airway (LMA) was placed, and an intravenous line with 22 gauge catheter was placed. The patient was positioned in the right lateral decubitus position. The caudal space was located by palpation, and a 22 g angiocath was easily placed through the sacral hiatus. Neither blood nor CSF was aspirated through the catheter and 1 ml test dose containing 0.25% Bupivacaine + 1:200,000 epinephrine was administered. After a full minute of watching for any EKG changes, the remaining 8 ml of 0.25% Bupivacaine + 1:200,000 epinephrine was slowly injected into the caudal space with intermittent aspiration. Several minutes after the injection, there was a sudden prominent change in the EKG with QRS complex widening on the EKG accompanied by a drop in ETCO2. 20% Lipid emulsion was administered immediately and a normal EKG pattern returned with a concomitant increase in ETCO2. The planned procedure was performed, and the patient extubated uneventfully. After being monitored in the PACU for an extended period of time, he was discharged home. Follow-up was unremarkable.展开更多
Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years ...Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully performed SPR at L&R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L&R.展开更多
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective observational study</span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sixty patients were included in the study. The numerical rating scale</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesia group than in the ESP group [212.0 (6.6) mg, vs. 107.3 (36.9 mg), (p <0.001)]. The time to first stand up after surgery was significantly longer in the general anesthesia group (p = 0.011).</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> ESP block appear to be an effective method to relieve pain after lumbar surgery.</span>
文摘Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends to the cervical level. Herein, we present a successful multilevel ESPB plus an interscalene block using liposomal bupivacaine in a 45-year-old female patient with metastatic sarcoma who presented for scapula and proximal humerus resection. The post-operative course was smooth, and the patient was discharged home on post-operative day 2 with minimal narcotic requirements.
文摘Antibacterial activity of biosynthesized silver nanoparticles (AgNPs) was significant in therapeutic application of nanotechnology. These researchers studied an ecofriendly and rapid method for the first time to synthesize silver nanoparticles using Zizyphus spina christi L aqueous leaves extract (ZSE), and their antibacterial properties. The extract was found to have the potential to form silver nanoparticles at room temperature within few minutes. The green synthesized silver nanoparticles were characterized using different techniques. The UV-visible spectrum of the solution containing AgNPs showed a peak at 414 nm corresponding to the plasmon absorbance of silver nanoparticles. The transmission electron microscopy (TEM) showed that the formed particles were hexagonal in shape with appreciable Nano size ranging from 21.5 to 59.67 nm. Fourier Transform Infrared Spectroscopy analysis (FTIR) of biosynthesized AgNPs affirmed the role of ZSE as reducing and capping agent of Ag+ ions to AgNPs, and X-Ray Diffraction patterns (XRD) showed that they could be indexed as face-centered-cubic structure of silver. Antibacterial activity of AgNPs was determined by well diffusion and micro plate assay methods, showing maximum inhibition zones of 24 mm, 23 mm, 15 mm and 17 mm against Staphylococcus aureus, Acinetobacter sp., Pseudomonas aeruginosa and Escherichia coli respectively. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) results showed that AgNPs had MIC, MBC of 45, 57 μg/mL, 49, 61 μg/mL, 63, 90 μg/mL and 59, 82 μg/mL against S. aureus, Acinetobacter sp., P. aeruginosa and E. coli respectively. Furthermore, the green synthesized AgNPs were loaded on band-aids and screened for antibacterial activity. The AgNPs loaded on band-aids exhibited strong antibacterial effect against multi drug resistant bacteria. These nanoparticles could be used for treating wounds and preparing wound dressing. Such researches are crucial in the demonstration of therapeutic importance of silver nanoparticles in medical application.
文摘We present a case of Local Anesthesia Systemic Toxicity (LAST) in a 7-month-old male after a caudal block placement. The patient was a healthy 8.3 kg male without any medical history, surgical history, significant birth history or any history of family problems with anesthesia. After induction of general anesthesia, a size 1.5 laryngeal mask airway (LMA) was placed, and an intravenous line with 22 gauge catheter was placed. The patient was positioned in the right lateral decubitus position. The caudal space was located by palpation, and a 22 g angiocath was easily placed through the sacral hiatus. Neither blood nor CSF was aspirated through the catheter and 1 ml test dose containing 0.25% Bupivacaine + 1:200,000 epinephrine was administered. After a full minute of watching for any EKG changes, the remaining 8 ml of 0.25% Bupivacaine + 1:200,000 epinephrine was slowly injected into the caudal space with intermittent aspiration. Several minutes after the injection, there was a sudden prominent change in the EKG with QRS complex widening on the EKG accompanied by a drop in ETCO2. 20% Lipid emulsion was administered immediately and a normal EKG pattern returned with a concomitant increase in ETCO2. The planned procedure was performed, and the patient extubated uneventfully. After being monitored in the PACU for an extended period of time, he was discharged home. Follow-up was unremarkable.
文摘Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully performed SPR at L&R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L&R.
