Annals of translational medicine
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To measure the direct effects of pre-operative magnetic resonance neurography (MRN), and analyze the procedure and clinical outcomes of the percutaneous endoscopic interlaminar discectomy, in order to demonstrate the feasibility and safety of the interlaminar approach. ⋯ The MRN indicates that the incidence of herniated disc impingement increases over the distance between the nerve root and the dural sac, thus making the interlaminar approach more suitable for the treatment of herniation. The procedures and clinical outcomes of the IL-PELD demonstrate the safety and advantages of the interlaminar approach.
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The intraoperative lung protective effect of mechanical ventilation of different positive end-expiratory pressure (PEEP) levels on patients undergoing abdominal laparoscopic surgery with the steep Trendelenburg position remains undefined. The purpose of the study was to explore the optimal PEEP. ⋯ A moderate PEEP level (8 cmH2O) with low tidal volume was sufficient to improve Cdyn and to decrease VD/VT without increasing QS/QT, which was suggested to be a good choice of intraoperative lung protective ventilation during abdominal laparoscopic surgery with Trendelenburg position.
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Thoracic paravertebral block (TPVB) technique for thoracotomy has seen increased application. The erector spinae plane block (ESPB) technique is simpler to perform than TPVB. However, whether it can be employed as a safe alternative analgesic technique has not been verified by a head-to-head clinical study. ⋯ Preoperative single-injection ESPB plus postoperative sufentanil PCA provided similar effects of pain relief for patients undergoing thoracotomy when comparing to TPVB. Yet, ESPB had the advantages of a lower adverse effect incidence.