Journal of clinical anesthesia
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Randomized Controlled Trial
Posteromedial quadratus lumborum block versus transversus abdominal plane block for postoperative analgesia following laparoscopic colorectal surgery: A randomized controlled trial.
Our hypothesis was that a pre-operative posteromedial quadratus lumborum (QL) block would reduce postoperative morphine consumption and provide superior analgesia in the setting of multimodal analgesia compared with a lateral transversus abdominis plane (TAP) block for laparoscopic colorectal surgery. ⋯ The pre-operative bilateral, ultrasound-guided posteromedial QL block reduces morphine consumption and improves analgesia in the setting of multimodal analgesia compared with the lateral TAP block after laparoscopic colorectal surgery.
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Randomized Controlled Trial
The effect of preoperative erector spinae plane vs. paravertebral blocks on patient-controlled oxycodone consumption after video-assisted thoracic surgery: A prospective randomized, blinded, non-inferiority study.
To investigate the effective analgesia for video-assisted thoracic surgery. ⋯ Preoperative Erector spinae plane blocks (ESPB), when in combination with round-the-clock NSAIDs, offered equivalent analgesia and quality of recovery after video assisted thoracic lung surgery compared with paravertebral blocks. Patients who received ESP blocks had similar consumption of oxycodone and length of hospital stay.
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To employ systems biology-based machine learning to identify biologic processes over-represented with genetic variants (gene enrichment) implicated in post-surgical pain. ⋯ High interindividual variability in pain responses immediately after surgery and risk for CPSP suggests genetic susceptibility. Lack of large homogenous sample sizes have led to underpowered genetic association studies. Systems biology can be leveraged to integrate genetic-level data with biologic processes to generate prioritized candidate gene lists and understand novel biological pathways involved in acute postoperative pain and CPSP. Such data would be key to informing future polygenic studies with targeted genome wide profiling. This study demonstrates the utility of functional annotation - based prioritization and enrichment approaches and identifies novel genes and unique/shared biological processes involved in acute and chronic postoperative pain. Results provide framework for future targeted genetic profiling of CPSP risk, to enable preventive and therapeutic approaches.