Expert review of medical devices
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Expert Rev Med Devices · Feb 2021
ReviewAcute postoperative pain management with percutaneous peripheral nerve stimulation: the SPRINT neuromodulation system.
Ultrasound-guided percutaneous peripheral nerve stimulation (PNS) may be used to treat acute postoperative pain for various types of surgeries. This modality avoids several limitations of traditional local anesthetic-based peripheral nerve blocks including avoidance of motor blockade and sensory deficits. ⋯ PNS is a novel modality in regional anesthesia that has much promise in reducing overall opioid use after surgery. Placement of PNS is very similar to that of catheter-based regional anesthesia techniques. Ultrasound is used to guide the percutaneously placed introducer needle in proximity to the target nerve. There are several benefits of PNS over catheter-based approaches, including: 1) avoidance of motor or sensory blockade; 2) no medication bag required to be carried; and 3) electric leads may be kept in situ safely for up to 60 days. While several proof-of-concept studies have been published highlighting its use in various types of surgeries, large high-quality randomized controlled trials are still needed.
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Expert Rev Med Devices · Feb 2021
Reflection efficiencies of AnaConDa-S and AnaConDa-100 for isoflurane under dry laboratory and simulated clinical conditions: a bench study using a test lung.
Background: Adequate sedation is important for the treatment of ICU patients. AnaConDa (Anesthetic-Conserving-Device; ACD; Sedana Medical, Sweden), connected between ventilator and the patient, retains isoflurane during expiration, and releases it back during inspiration. The reflection efficiency (RefEff) corresponds to the percentage of expired anesthetic molecules that are re-inspired. ⋯ For 1 Vol.% isoflurane at TV500, the infusion rate with ACD-50 was twofold higher compared to ACD-100 (4 versus 2 mL·h-1). Conclusion: Under DRY and concentrations <1.5 Vol.%, RefEff of both devices is around 90%. Under CLIN, ACD-100 performs better with RefEff between 80% and 90% (ACD-50:70-80%), decreasing with increased vapor volume exhaled in one breath.