A&A practice
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Randomized Controlled Trial
Hip Fracture Intervention Study for Prevention of Hypotension Trial: a Pilot Randomized Controlled Trial.
Hypotension during anesthesia for surgery for hip fracture is common and associated with myocardial injury, stroke, acute kidney injury, and delirium. We hypothesized that maintaining intraoperative blood pressure close to patients' preoperative values would reduce these complications compared to usual care. ⋯ A randomized controlled trial of tight intraoperative blood pressure control compared to usual care to reduce major postoperative complications after fractured neck of femur surgery is possible. However, the data would suggest a large sample size would be required for a definitive trial.
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Intercostal neuralgia can be debilitating and extremely difficult to treat despite multi-modal therapies. The literature describing the role of neuromodulation in patients with intercostal neuralgia is scarce. In this medically challenging case report, we describe a 56-year-old male with a near complete resolution of intractable chronic intercostal neuralgia, secondary to traumatic rib fractures and multiple surgical interventions, with a single lead thoracic spinal cord stimulator (SCS) implant. Neuromodulation therapies should be considered as a viable option for this patient population.