Anesthesiology and Pain Medicine最新文献

{"title":"Safety and Efficacy of Ultrasound-Guided Combined Segmental Thoracic Spinal Epidural Anesthesia in Abdominal Surgeries and Laparoscopic Procedures: A Prospective Randomized Clinical Study","authors":"Alaa Ali M. Elzohry, A. S. Hegab, Osama Yehia A. Khalifa, Khadeja M. Elhossieny, F. A. Z. H. Abdel Hameed","doi":"10.5812/aapm-138825","DOIUrl":"https://doi.org/10.5812/aapm-138825","url":null,"abstract":"Background: Thoracic segmental spinal anesthesia (SA) may be a good alternative to general anesthesia (GA) for abdominal operations and laparoscopic procedures, especially in high-risk patients. Objectives: The aim of this study was to investigate the safety and efficacy of thoracic segmental SA vs GA during abdominal operations and laparoscopic procedures. Methods: This study was conducted at our university hospital and involved a total of 46 patients who underwent abdominal operations and laparoscopic procedures. The study period spanned from January 15, 2022, to October 15, 2022. Patients were divided into 2 groups: Group 1 (n = 23) received standard GA, and group 2 (n = 23) received thoracic segmental SA. A combination of 10 mg of hyperbaric bupivacaine 0.5% and 25 μg of fentanyl was injected through the spinal needle. The epidural catheter was then threaded through the Tuohy needle after withdrawal of the spinal needle to keep only 4 cm up in the epidural space. Demographic data, both intra and postoperative hemodynamic parameters, were monitored. Postoperatively, pain in both groups was treated with intravenous (IV) morphine by patient controlled analgesia (PCA), PCA settings were 1 mg morphine/mL, no background infusion, bolus dose 2 mL and lockout interval 15 min. Postoperative, both resting VAS and VAS during cough were measured for all patients at fixed intervals, and all patients were followed up for postoperative complications. Results: No significant variation was found in demographic data. Intra and postoperative mean arterial pressure (MAP) and heart rate (HR) measurements were higher in group 1 than in group 2 but without a statistically significant difference (P < 0.029). Early postoperative VAS values and discharge time from the postanesthesia care unit (PACU) were significantly reduced in group 2 than in group 1 (P < 0.001). The number of patients asked for analgesia and total opioid consumption were substantially reduced in group 2 than in group 1. Also, the time of the first analgesia request and patient satisfaction were substantially greater in group 2 than in group 1. Conclusions: Combined thoracic spinal/epidural block results in stable hemodynamics, longer postoperative analgesia with fewer side effects, and greater surgeon and patient satisfaction in patients undergoing abdominal operations and laparoscopic procedures.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"45 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial","authors":"Adel Ali Hassan, Amira Seleem Saleh, Maged Salah Mohamed, M. S. Khalil","doi":"10.5812/aapm-142719","DOIUrl":"https://doi.org/10.5812/aapm-142719","url":null,"abstract":"Background: Bupivacaine hydrochloride is widely used as the primary drug for spinal anesthesia. Objectives: This research aimed to evaluate the intrathecal administration of both isobaric and hyperbaric bupivacaine (HB) in lower abdominal surgery. Methods: A randomized, controlled, double-blind trial was conducted on 50 patients classified as American Society of Anesthesiologists (ASA) class I to II, scheduled for lower abdominal surgery under spinal anesthesia. The patients were allocated randomly into two groups of similar size. Group A (control group) received 20 mg HB 0.5% intrathecally. Group B (case group) received 10 mg HB 0.5% and 10 mg isobaric bupivacaine (IB) 0.5%. Results: There was a significant decline in heart rate and mean arterial pressure in Group A compared to Group B (P < 0.05). Group A had a significantly greater sensory level at 10 and 20 minutes than Group B (P = 0.008 and 0.006, respectively). Group A had an earlier duration in reaching Bromage 3 and the first need for analgesia, compared to group B (P = 0.001 and 0.003, respectively). Conclusions: In lower abdominal surgery, the intrathecal administration of HB with IB increased hemodynamic stability and duration of both sensory and motor blockade but with slower recovery from anesthesia compared to HB alone.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"52 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intravenous Injection of Magnesium Sulphate on Intraoperative End-Tidal CO2 Level and Postoperative Pain in Laparoscopic Cholecystectomy","authors":"Mahboobeh Akhondi, Ali Sarkoohi","doi":"10.5812/aapm-135189","DOIUrl":"https://doi.org/10.5812/aapm-135189","url":null,"abstract":"Background: Pain control and stabilizing hemodynamic indices are serious medical challenges, especially in anesthesia. Laparoscopic surgery is increasing in the world, and cholecystectomy surgery is no exception. Objectives: This study investigated the effect of intravenous (IV) magnesium sulfate injection on intraoperative end-tidal CO2 (ETCO2) levels and postoperative pain in laparoscopic cholecystectomy. Methods: This is a clinical trial. The sample size was calculated to be 64 people who were selected among the patients who were candidates for laparoscopic surgery by convenience sampling. They were randomly assigned to intervention and control groups. The intervention group received magnesium sulfate (50 mg/kg) and normal saline (100 mL) within 1 h. The control group only received normal saline (100 mL). Systolic and diastolic blood pressures, ETCO2 level, heart rate, arterial oxygen saturation, pain level, and narcotic analgesics in recovery were measured 2, 6, 12, and 24 h after surgery. The data were analyzed using 1-way analysis of variance (ANOVA) and repeated measures analysis. Results: The mean of systolic blood pressure and ETCO2 during recovery in the intervention group were less than the control group (P = 0.029 and P = 0.015). In the intervention group, analgesic consumption in recovery and 6 h after surgery was less than the control group (P < 0.001). The mean pain score in the intervention group in recovery and 2, 6 (P < 0.001), and 12 h (P = 0.038) after surgery was significantly lower than the control group. Conclusions: Magnesium sulfate can be a suitable and safe supplement to reduce pain after surgery and reduce the use of narcotics. The current conclusion should be investigated on a larger scale of patients, with extended monitoring for postoperative pain over a longer period of time.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"75 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139132102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intravenous Aminophylline on Hemodynamics and Recovery of Patients Undergoing Functional Endoscopic Sinus Surgery Under Dexmedetomidine Hypotensive Anesthesia: A Randomized Controlled Study.","authors":"Osama Mohammed Rehab, Doha Mohammed Bakr, Osama Abdelmoneam Algazzar, Islam Morsy","doi":"10.5812/aapm-141669","DOIUrl":"10.5812/aapm-141669","url":null,"abstract":"<p><strong>Background: </strong>The sympatholytic property of dexmedetomidine (DEX) makes it suitable as a hypotensive drug during functional endoscopic sinus surgery (FESS); however, delayed emergence from anesthesia and high postoperative sedation have been reported.</p><p><strong>Objectives: </strong>Delayed emergence from anesthesia and high postoperative sedation are associated with a prolonged length of stay in the operating room and the postanesthesia care unit (PACU), which increases health care costs. This study aimed to overcome the negative impact of DEX on recovery by using aminophylline.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled study was conducted on 52 patients planned for elective FESS under general anesthesia with DEX infusion for controlled hypotension during surgery. Patients were equally divided into 2 groups. The aminophylline group received 4 mg/kg aminophylline diluted in 50 mL saline 0.9% over 30 minutes after positioning in a 20-degree reverse Trendelenburg position. The control group received 50 mL saline 0.9% with a similar volume and period as the aminophylline group.</p><p><strong>Results: </strong>The extubation time was significantly shorter in the aminophylline group (6.5 (5.25 - 7.75) minutes) than in the control group (9 (7.25 - 10) minutes) (P-value < 0.001). The PACU discharge time was significantly shorter in the aminophylline group (15 (10 - 20) minutes) compared to the control group (20 (15 - 28.75) minutes) (P-value = 0.036). Intraoperative heart rate and mean arterial pressure were nonsignificantly different between the 2 groups. Ramsay sedation score measurements at 15 min, 30 min, and 60 min after extubation were significantly lower in the aminophylline than in the control group (P-value < 0.05). Complications were nonsignificantly different between the 2 groups.</p><p><strong>Conclusions: </strong>Intraoperative aminophylline infusion enhances the recovery of patients undergoing FESS under DEX hypotensive anesthesia without intraoperative hemodynamic alterations and decreases their postoperative sedation without significant postoperative side effects.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"13 6","pages":"e141669"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Caudal Epidural Method to Ultrasound-Guided S1 Transforamen Block in Patient's Lumbar Discectomy with Failed Back Syndrome Symptoms: A Double-Blind Clinical Trial.","authors":"Masoud Hashemi, Artadokht Khoshooei, Alireza Amanollahi, Sogol Asgari","doi":"10.5812/aapm-137325","DOIUrl":"10.5812/aapm-137325","url":null,"abstract":"<p><strong>Background: </strong>Post-lumbar surgery syndrome (PLSS) refers to persistent or recurrent pain following spinal surgery with an unknown cause. It is commonly associated with epidural fibrosis (EF). Some studies suggest that epidural steroid injection (ESI) can effectively alleviate pain in PLSS, particularly when targeting the S1 nerve root using S1 transforaminal epidural steroid injection (S1-TFESI). A key factor in a successful block is accurately visualizing the first dorsal sacral foramen, and the needle's destination is the dorsal S1 foramen. Although S1-TFESI is often performed under fluoroscopy through the transforaminal route, an alternative to reduce radiation exposure is ultrasound guidance. This study aimed to compare the efficacy of ultrasound-guided caudal epidural steroid injection (CESI) and S1-TFESI in PLSS patients.</p><p><strong>Methods: </strong>A randomized double-blinded clinical trial was conducted involving 52 PLSS patients who were randomly assigned to either the CESI group or the S1-TFESI group. The patients were positioned prone. A linear transducer with a curve at a low frequency (2 - 5 MHz) was used to visualize the area. An aseptically prepared puncture site was used to insert a 2- to 5-MHz curved ultrasound probe with an ultrasound gel to identify the articular processes of the lower lumbar vertebrae and the posterior sacral surface. The probe was then positioned longitudinally to the para-sacral area, about 2 cm lateral to the midline. The articular process represented the L5/S1 level at the farthest caudal side, and the S1 posterior sacral foramen was represented by the concavity at the posterior sacral surface that was somewhat caudal. The probe was angled caudally to provide enough room for the needle to enter the S1 foramen. The injection site for the needle tip was the S1 foramen. A combination of triamcinolone (40 mg, 1 mL), normal saline (2 mL), and ropivacaine (0.2%) was administered. For TFS1 ESI, 5 mL of the combination was used. For CESI, the sacral hiatus was palpated in the prone position, and a linear high-frequency transducer was placed transversely to obtain a transverse view of the sacral hiatus. A combination of triamcinolone 40 mg and ropivacaine (0.2%) totaling 10 mL was employed. The Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) were used to assess patients' preoperative and postoperative conditions, and adverse events were recorded. Follow-up was conducted one week and one month after the procedures.</p><p><strong>Results: </strong>In both groups, NRS and ODI scores decreased at different time points after treatment, compared to baseline (P < 0.001). The CESI group had lower median ODI scores after one week and one month, although this difference did not reach statistical significance (P = 0.334). Despite similar baseline NRS ratings, the CESI group had statistically significantly lower mean NRS scores at one week and one month (P < 0.001).</p><p><strong>Conclusi","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"13 6","pages":"e137325"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Fat-Free Mass and Ideal Body Weight Scalar for Anesthetic Induction Dose of Propofol in Patients with Morbid Obesity: A Double-Blind, Randomized Clinical Trial","authors":"Soudabeh Djalalimotlagh, Mahmoud Reza Mohaghegh, M. Ghodraty, A. Shafeinia, F. Rokhtabnak, Tina Alinia, Farnoosh Tavakoli","doi":"10.5812/aapm-140027","DOIUrl":"https://doi.org/10.5812/aapm-140027","url":null,"abstract":"Background: Obesity is a growing problem worldwide and can affect both the pharmacodynamics (PD) and pharmacokinetics (PK) of various drugs, including anesthetics, resulting in the under-or overdosing of certain drugs. There is no consensus on the ideal dosing regimen for obese populations. Objectives: In this study, 2 weight-based dosing of propofol used for induction of anesthesia were compared in terms of the onset of action time, adequacy of anesthesia, and effects on hemodynamic indices (eg, heart rate [HR] and blood pressure). Methods: In this randomized, double-blind clinical trial, 40 patients with morbid obesity (MO) scheduled for bariatric surgery with body mass index (BMI) > 35, age 18 - 59 years, American Society of Anesthesiologists physical status (ASA-PS) II and III were randomly divided into 2 groups, using block randomization method, to receive 2 mg/kg of propofol for induction of anesthesia based on either fat-free mass (FFM) group or ideal body weight (IBW) group. The primary outcome was the time duration to reach the bispectral index (BIS) ≤ 60. Time to the disappearance of eyelash reflex, signs of inadequate anesthesia (ie, BIS > 60, straining during intubation, or eye-opening), requirements for additional doses, and hemodynamic indices (including HR and mean arterial pressure [MAP]) were also compared. Results: The mean time to reach BIS ≤ 60 was 134.1 s in the FFM group and 148.7 s in the IBW group. This difference was not statistically significant (P = 0.334). The time of disappearance of eyelash reflex was also not significantly different between the study groups (P = 0.814). However, 2 patients in the FFM group and 8 patients in the IBW group showed signs of inadequate anesthesia and required additional doses. This difference was statistically significant (P = 0.032). Hemodynamic variables, before and 2 min after propofol induction dose administration were comparable between the study groups (P = 0.520, P = 0.327, P = 0.847, P = 0.516 for pre-intervention MAP, post-intervention MAP, pre-intervention HR, and post-intervention HR, respectively). Conclusions: Propofol dosing, based on FFM and IBW, for induction of anesthesia, provides comparable onset time of action and hemodynamic effects; however, in terms of the adequacy of anesthesia, the dosing based on FFM is more favorable compared to the dosing based on IBW.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"31 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Non-invasive Ventilation Failure and Associated Factors Among the COVID-19 Patients Admitted to Intensive Care Unit","authors":"H. A. Varpaei, Nurhan Bayraktar, Mostafa Mohammadi","doi":"10.5812/aapm-140847","DOIUrl":"https://doi.org/10.5812/aapm-140847","url":null,"abstract":"Background: Non-invasive ventilation (NIV) is a method of oxygenation supply that utilizes a face mask and eliminates the need for an endotracheal airway. Non-invasive ventilation failure is defined as the necessity for endotracheal intubation or death during the NIV trial. Objectives: This study aimed to identify the predictors and associated factors of NIV failure in coronavirus disease 2019 (COVID-19) patients admitted to an intensive care unit (ICU). Methods: This retrospective, longitudinal cohort study utilized electronic medical records of COVID-19 patients admitted to the ICU. A total of 150 patients were included in the study. Patient demographics, medical history, laboratory tests, partial pressure of carbon dioxide (PCO2), oxygen saturation (SpO2), heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR score), and the ratio of oxygen saturation (ROX) index (the SpO2/fraction of inspired oxygen [FIO2] to respiratory rate [SF] ratio) were recorded. Non-invasive ventilation failure was determined based on the need for endotracheal intubation or cardiac-respiratory arrest while on NIV. Statistical analysis was conducted using SPSS software (version 26). Results: Of the patients, 55.3% were male (mean age: 55.9 years), with an NIV failure rate of 67.3%, a mortality rate of 66.7%, and 3.3% of patients requiring tracheostomy after NIV failure. The ROX index consistently decreased over time, and an increase in the HACOR score and PCO2 after 6 hours of commencing NIV were the predictors of NIV failure. Additionally, higher levels of lactate dehydrogenase, lower SF ratios, and higher APACHE scores upon ICU admission were significantly associated with NIV failure. Notably, the erythrocyte sedimentation rate (ESR) as an inflammatory index, SF ratio upon ICU admission, HACOR score, ROX index, and PCO2 after 12 hours were significant predictors of in-hospital mortality in patients receiving NIV. Conclusions: The ROX index, HACOR scale, and PCO2 are significant predictors of both NIV failure and in-hospital mortality.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139009355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine vs Dexamethasone as an Adjuvant to Levobupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomies","authors":"Jyoti Sinha, A. Pokhriyal, Veena Asthana, Ruchira Nautiyal","doi":"10.5812/aapm-142059","DOIUrl":"https://doi.org/10.5812/aapm-142059","url":null,"abstract":"Background: In the postoperative period, open total abdominal hysterectomy (TAH) surgeries induce considerable pain. Multimodal strategies are being used to alleviate pain. Objectives: This study aimed to examine the efficacy and safety of dexamethasone and dexmedetomidine as an adjuvant to levobupivacaine in ultrasound-guided transversus abdominis plane (TAP) blocks for postoperative pain in TAH patients. Methods: A total of 72 patients with ASA grade I and grade II were randomly and equally assigned to two groups. After the completion of surgery with a subarachnoid block (SAB), patients in group 1 received a mixture of 20 mL of 0.25% levobupivacaine and 4 mg of dexamethasone on each side of the TAP block. Patients in group 2 received a mixture of 20 mL of 0.25% levobupivacaine and dexmedetomidine, with a total dose of 1 µg/kg body weight evenly distributed bilaterally in the TAP block. Patients were evaluated for pain using the Visual Analog Scale (VAS), total tramadol consumption as rescue analgesia, time to first rescue analgesia, any adverse effects, and patient satisfaction. Results: When comparing VAS scores for pain assessment, we observed that the mean VAS score was initially comparable between the two groups for the first hour. However, at 6, 9, and 12 h, VAS scores were significantly lower in group 2. The mean total tramadol consumption was higher in group 1 than in group 2 (213.33 ± 44.08 vs 161.11 ± 37.93 mg, P-value 0.027). The time to the first rescue analgesia after the TAP block in the postoperative period was significantly longer in group 2 (47.5 ± 62.76 vs 77.22 ± 56.14 min, P-value 0.002). No significant side effects were noted, and a greater proportion of patients in group 2 expressed satisfaction with their overall pain treatment. Conclusions: The addition of dexmedetomidine to levobupivacaine is superior to the addition of dexamethasone, as it prolongs the duration of the block in the dexmedetomidine group. However, the use of dexamethasone as an adjuvant is a good alternative option, particularly due to its lower cost and reduced incidence of adverse effects such as postoperative nausea and vomiting.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138982209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes zoster Reactivation After COVID-19 Vaccine with Focus on Postherpetic Neuralgia Prevention: A Case Series","authors":"Eleni Chrona, Maria Tsoumani, C. Batistaki","doi":"10.5812/aapm-131366","DOIUrl":"https://doi.org/10.5812/aapm-131366","url":null,"abstract":"Introduction: Herpes zoster (HZ), also known as shingles, is caused by the reactivation of the varicella-zoster virus (VZV). There have been several reports of HZ associated with COVID-19 vaccination, and the outcomes have varied. Case Presentation: In this report, we present 4 cases of patients who experienced HZ reactivation after receiving a COVID-19 vaccine. These individuals sought treatment at a pain management center due to postherpetic neuralgia (PHN). While HZ itself can be treated, post-herpetic neuralgia can persist for years, significantly impacting the patients’ quality of life. Therefore, early recognition of this adverse effect is crucial, and patients should receive specialized analgesic support promptly to prevent the development of chronic pain.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inserting the Condition of the Laryngeal Mask Airway in an Innovative Method vs the Classic Method","authors":"H. Shetabi, Ali Shahriari, O. Aghadavoudi","doi":"10.5812/aapm-140999","DOIUrl":"https://doi.org/10.5812/aapm-140999","url":null,"abstract":"Background: A laryngeal mask airway (LMA) is a simple and non-invasive device used to establish the airway and maintain ventilation and oxygenation during short-duration medical procedures. Objectives: This study aimed to compare the placement of an LMA using an innovative technique vs the classic method. Methods: This clinical trial was conducted at Faiz Hospital in Isfahan. Out of 110 candidates for elective eye surgery, 10 patients were excluded from the study as they did not meet the inclusion criteria. Ultimately, 100 patients were randomly allocated to 2 groups of 50 each. One group underwent LMA insertion using the classic method, while the other group underwent insertion using the face-to-face triple maneuver technique (FFTMT). Data, including laryngeal mask insertion conditions, hemodynamic responses, and clinical complications, were collected, entered into SPSS version 26, and analyzed. Results: There were no significant differences between the 2 groups in terms of laryngeal mask placement time (P = 0.061), number of attempts to place the LMA (P = 0.059), oropharyngeal leak pressure (OLP; P = 0.942), frequency of hoarseness (P > 0.99), or laryngospasm (P > 0.99). However, it is noteworthy that FFTMT appeared to provide easier placement of the LMA (P < 0.0001), required fewer attempts, and offered better quality of ventilation with a lower presence of blood on the cuff (P = 0.038). Conversely, the FFTMT group had a higher frequency of sore throat (P < 0.0001). Conclusions: The performance of LMA using FFTMT is comparable to the classic method. In procedures under sedation where the surgeon has access to the patient’s head and neck (such as cataract surgery), airway management with LMA using FFTMT (while maintaining the patient’s sterile covering) appears to be effective in case of an emergency.","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}