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Percutaneous nephrolithotomy (PCNL) a minimally invasive method for the removal of renal calculi and is associated with significant pain in postoperative period. Conventionally, intravenous opioids, local anesthetic infiltration, and regional blocks (intercostal/paravertebral blocks) have been tried with less efficacy to control postoperative pain. The present study is conducted to assess the effectiveness of erector spinae plane block (ESPB) performed under fluoroscopy guidance for postoperative analgesia during PCNL.

After obtaining ethical clearance, the study was conducted on 61 American Society of Anaesthesiologists (ASA) I and II patients aged between 18-65 years admitted for PCNL. Group I (

= 30) did not receive ESPB while Group II (

= 31) received ESPB under fluoroscopy guidance and 20 ml of 0.375% ropivacaine was administered after PCNL. Patient-reported pain intensity using visual analogue scale (VAS) was considered as a primary outcome. The hemodynamic variables (heart rate, systolic, diastolic, and mean blood pressure) was considered as a secondary outcome. Statistical analysis was performed using Student's

-test and Mann-Whitney U test. Data analysis was performed using the Statistical Package for the Social Sciences version 23.0.

Postoperatively VAS score was significantly lower in Group II at 0, 1, 2, 3, 4, 6, 12, 18, and 24 hours after PCNL (

< 0.001). Dose of rescue analgesia significantly decreased in Group II compared to Group I.

ESPB performed under fluoroscopic guidance is a simple and effective technique and it provides significantly better postoperative pain relief.

ESPB performed under fluoroscopic guidance is a simple and effective technique and it provides significantly better postoperative pain relief.

Pain and depression are associated, but it is uncertain if effective pain relief during labor by labor analgesia reduces the incidence of postpartum depression (PPD). This randomized, controlled study assessed whether combined spinal-epidural (CSE) labor analgesia is associated with a decreased risk of PPD. Other reported risk factors for PPD were also assessed.

Parturients were randomly assigned to either CSE labor analgesia or normal vaginal delivery (

= 65 each). CSE parturients received 0.5 ml of 0.5% hyperbaric bupivacaine intrathecally and PCEA with continuous infusion of 0.1% levobupivacaine and 2 μg/ml fentanyl @5 ml/h along with patient-controlled boluses with a lockout interval of 15 min. Parturients of both the groups were assessed using Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms at day 3 and PPD at 6 weeks (primary outcome; defined as EPDS score ≥10 at 6 weeks postpartum). Secondary outcomes included pain scores, maternal satisfaction, and Apgar scores at 1 and 5 min. Parturients were also screened for several risk factors for PPD.

Incidence of PPD was 22.3%. The difference in incidence of PPD between the CSE group vs. control group was not significant (27.7% vs. 16.9%; Fisher's exact

= 0.103). Of all the risk factors analyzed in logistic regression model, perceived stress during pregnancy was the only significant predictor of the development of PPD (adjusted Odds Ratio 11.17, 95% Confidence interval 2.86-43.55;

= 0.001).

CSE analgesia in laboring parturients does not reduce PPD at 6 weeks. Instead, perceived high stress during pregnancy appears to be the most important factor.

CSE analgesia in laboring parturients does not reduce PPD at 6 weeks. Instead, perceived high stress during pregnancy appears to be the most important factor.

Thoracic paravertebral block (TPVB) has become the gold standard to provide postoperative analgesia in breast surgery. selleck inhibitor Recently, ultrasound-guided (USG) pectoralis (PECS) block and serratus anterior plane (SAP) block have been described as an alternative to TPVB. The objectives were to compare TPVB, PECS, and SAP block in terms of analgesic efficacy and the spread of local anesthetic by ultrasound imaging, correlating it with the sensory blockade.

Prospective randomized interventional study conducted in 45 ASA grades I-II patients scheduled for the elective breast surgery. Patients were randomly allocated into three groups, i.e., Gr.1 (USG -TPVB) (ropivacaine 0.375% 20 ml), Gr.2 (USG-PECS II) block (ropivacaine 0.375% 30 ml), and Gr.3 (USG-SAP) (ropivacaine 0.375% 30 ml). Spread of the local anesthetics was seen with ultrasound imaging. Onset of sensory blockade, postoperative fentanyl consumption, and pain scores was measured.

TPVB and SAP group had comparatively higher spread and sensory block compared to PECS group. Postoperative fentanyl requirement (mean ± SD) was 428.33 ± 243.1 μg, 644.67 ± 260.15 μg, and 415 ± 182.44 μg in the TPVB group, PECS II group, and SAP group, respectively. SAP group had significantly lesser requirement than PECS II group (

= 0.028) but similar requirement as in TPVB group (

= 1.0). Pain scores were not significantly different among the group in the postoperative period.

TPVB and SAP group result in a greater spread of the drug and provide equivalent analgesia and are superior to the PECS II block in providing analgesia for breast surgeries. SAP block is easier to perform than TPVB with lesser chances of complications and results in faster onset.

TPVB and SAP group result in a greater spread of the drug and provide equivalent analgesia and are superior to the PECS II block in providing analgesia for breast surgeries. SAP block is easier to perform than TPVB with lesser chances of complications and results in faster onset.

Ionizing radiation procedures are indispensable in medical clinical practice. Exposure to radiation at any dose could have serious adverse effects. Anesthesiologists working in interventional radiology suites are at a higher risk of radiation exposure than other personnel. The aim of this study was to assess the knowledge and attitude of anesthesiology trainees towards the radiation hazards and current safety practices.

This prospective cross-sectional survey was conducted at the department of anesthesiology at Aga Khan University. All anesthesiology trainees working in the department were given a 12-question paper-based survey after getting ethical review committee approval and informed consent. The questionnaire contained requests for personal demographic data and specific questions regarding radiation protection.

A total of 54 participants were included in this survey. Thirty-two (59.3%) were male, and 22 (40.7%) were female. The average year of experience working in anesthesia of the participants waelves properly. Radiation dose, hazards, and protection strategies must be included in the basic curriculum of medical colleges.

Short-term memory disorder following surgery and anesthesia is a common complication of anesthesia and a common complaint of the patients.

This study was designed to assess memory impairment in patients undergoing elective surgery, investigate the effect of general anesthesia (GA) on memory, and identify the factors contributing to it, as well as the specific effect of anesthesia on each of the memory domains.

This cross-sectional study was performed in a university hospital.

Patients with the American Society of Anesthesiologists (ASA) Class I, II, and III who were candidates for elective abdominal surgery were enrolled. Patients answered several questions based on the Wechsler Memory Scale-Revised V (WMS-R-V), a standardized questionnaire, minutes before entering the operating room (OR) and again after 24 h postoperation, and the differences were recorded.

Analysis was performed using T-independent and Chi-square tests with Pearson's coefficient and Fischer's exact test and Man-Whitney test. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software.

Four hundred patients (198 females and 202 males) with a mean age of 50.75 years were enrolled in our study. Our study results showed that short-term memory after GA was significantly decreased compared with preanesthesia (

< 0.05). There was no significant relationship between memory disorder following GA and gender (

= 0.18) or comorbidities (

= 0.138). However, older age was found to be a contributing factor to memory loss following GA (

< 0.001). The highest and lowest effect of GA were found on the number repeat (45.2%) and personal information (16.2%) domain of the memory.

GA significantly reduces the patient's short-term memory after the surgery.

GA significantly reduces the patient's short-term memory after the surgery.

The identification of risk factors for the development of perioperative complications is one of the most important problems of pediatric anesthesiology.

To identify risk factors for the development of perioperative complications in children undergoing ambulatory surgical interventions on ENT organs.

Total of 141 patients were examined at the age from 7 to 17 years. Depending on the presence of complications all patients were divided into three groups «No complications» (

= 64), «One complication» (

= 55) and «Two or more complications» (

= 22). The study was carried out in the following areas Preoperative clinical status, intraoperative and postoperative complications. The severity of nasal breathing disorders was determined rhinomanometrically. 31 children underwent somnography. In the study of heart rate variability was evaluated. Intraoperative complications included Cardiac arrhythmias, arterial hypertension and desaturation less than 90%. Postoperative complications included Cardiorespiratoryperations on ENT organs in children are associated with the initial autonomic status and the predominance of the parasympathetic nervous system as well as with clinical markers.

In literature, there is plenty of material regarding regional anesthesia techniques and block safety, but lacks about block success prevision. The perfusion index (PI) is an oximetry reliability indicator, available on many monitors as non-invasive parameter, indicating the ratio of arterial blood flow (pulsatile flow) to venous, capillary, and tissue blood flow (non-pulsatile blood flow). We hypothesized that that analysis of PI variations after performing regional anesthesia could have a role in predicting a successful nerve block.

Twenty-four consecutive patients regularly scheduled for limb surgery in regional anesthesia were included in our observation. PI measurements were recorded before regional anesthesia, and 1, 2, 3, 5, and 10 min after needle withdrawal. Along with PI, also sensation to cold (ice test), tactile sensation, and motor function were recorded before regional anesthesia, and 1, 2, 3, 5, and 10 min after needle withdrawal on the limb where the block were performed.

Ten sciatic nerve blocks, 6 spinal anesthesia, 8 brachial plexus block were performed and resulted successful. In all cases, PI values tripled at 5 min after the block execution and increased linearly, reaching at 10 min an average PI value 3.8 times higher for the interscalene group, 4 times for the spinal group, and 8 for the sciatic group.

A tripled PI within 5 min from performing regional anesthesia showed to be a reliable indicator of nerve block success, but a bigger trial involving more patients and different anesthetic concentrations may be necessary to confirm this assumption.

A tripled PI within 5 min from performing regional anesthesia showed to be a reliable indicator of nerve block success, but a bigger trial involving more patients and different anesthetic concentrations may be necessary to confirm this assumption.