JA clinical reports
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JA clinical reports · Aug 2020
Anesthetic management using a combination of anterior quadratus lumborum block and erector spinae plane block for robot-assisted partial nephrectomy: two case reports.
There has been increasing attention regarding quadratus lumborum block (QLB) and erector spinae plane block (ESPB) as effective truncal blocks. There have been reports of combined QLB and ESPB usage in hip surgery resulting in a symbiotic increase in effectiveness. However, there have been no reports regarding robot-assisted partial nephrectomy (RAPN), which requires multiple port holes ranging from near the xiphoid process to below the umbilicus. We hypothesized that the combined use of QLB and ESPB was an option for anesthesia and analgesia during RAPN. ⋯ The combination of QLB and ESPB could be an option for the postoperative analgesia in RAPN.
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JA clinical reports · Aug 2020
Ultrasound-assisted intrathecal injection of nusinersen in a patient with severe vertebral deformity: a case report.
Spinal muscular atrophy (SMA) is a mostly autosomal recessive genetic disease characterized by progressive muscle weakness from anterior horn degeneration. Nusinersen has recently been approved as a disease-modifying drug for SMA that needs to be administered intrathecally. Its injection is often associated with extreme difficulty since patients with SMA have severe vertebral deformity and may be with vertebral instrumentation. ⋯ This the first report in which ultrasound-assisted technique has been used for the injection of nusinersen through a lumbar puncture in patients with severe spinal deformity. Use of preprocedural ultrasound imaging is highly recommended for treatments that repeatedly require intrathecal access.