European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Subpleural block is less effective than thoracic epidural analgesia for post-thoracotomy pain: a randomised controlled study.
Thoracic epidural and paravertebral blocks provide adequate analgesia for postoperative thoracotomy pain. Both procedures are usually performed percutaneously with considerable failure rates. A subpleural catheter placed in the space posterior to the parietal pleura and alongside the paravertebral area may provide superior postoperative pain relief. ⋯ Thoracic epidural analgesia is superior to subpleural analgesia in relieving post-thoracotomy pain.
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Airway management in children suffering from mucopolysaccharidosis 1 (Hurler syndrome) remains challenging despite advances in both treatment and airway management techniques. ⋯ The airway management of children with mucopolysaccharidosis 1 remains critical, despite advances in both treatment and airway management techniques. Problems did not seem to increase as children grew older. We assume that technical improvements such as standardised use of the laryngeal mask airway or attached tube channel videolaryngoscopes as well as a stem cell transplantation treatment of the disease helped the management of older children with mucopolysaccharidosis 1.
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The incidence of epidural haematoma after epidural anaesthesia is uncertain. ⋯ The incidence of spinal haematoma was 1: 6 628 in this general surgical population. When local anaesthetics are continuously applied, progressive motor block should increase the level of suspicion. When accompanied by pain or paraesthesia, progression to diagnosis by MRI is mandatory.