Minerva anestesiologica
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Minerva anestesiologica · Jul 2021
Observational StudyDetermination of the initial minimum effective dose of 0.5% bupivacaine with 20mcg of fentanyl for an operative fixation of fractured neck of femur. A prospective, observational trial.
Fractured neck of femur (FNF) is a common cause of morbidity and mortality in elderly. Spinal catheter allows fractionation of local anesthetic dose which combined with intrathecal opioid leads to a dose reduction and better hemodynamic stability. The primary objective of this paper was to investigate the initial minimum local anesthetic dose (iMLAD) of 0.5% isobaric bupivacaine with 20 μg of fentanyl administered via spinal catheter in order to commence the operative fixation of FNF. ⋯ This study demonstrates that the placement of a spinal catheter allows for careful titration of local anesthetic, enabling a reduction of the initial intrathecal dose of 0.5% isobaric bupivacaine below 0.4 mL (2 mg) and leading to a significant reduction of a dose required for the whole surgery when combined with an intrathecal opioid.
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Minerva anestesiologica · Jul 2021
Randomized Controlled TrialPost mastectomy pain syndrome after preoperative stellate ganglion block: a randomized controlled trial.
This study investigated the effect of preoperative ultrasound (US) guided stellate ganglion block (SGB) with bupivacaine on the frequency of post mastectomy pain syndrome (PMPS). ⋯ Following mastectomy with axillary dissection, preoperative US guided SGB is associated with less PMPS proportion, postoperative pain and opioid consumption and better patient daily activity and functional capacity.