Background:For reconstruction of the anterior cruciate ligament (ACL) with hamstring autograft, perioperative analgesia can be achieved with multimodal analgesia and intra-articular local anesthesia infiltration with or without additional regional blocks. Saphenous nerve block (SNB) via the adductor canal is commonly used in our practice, but its benefit has not been well established in the literature.Purpose:To assess the efficacy of SNB in ACL reconstruction with hamstring autograft.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:Consecutive patients undergoing arthroscopic ACL reconstruction with hamstring autograft were randomized into a control group (no SNB) and an intervention group (SNB). All patients received standardized anesthetic induction and maintenance agents with perioperative analgesia, per study protocol, with local anesthetic infiltration of the graft harvest site and intra-articular infiltration.Results:Sixty patients were randomized into the 2 groups (n = 30 each). There was no statistically significant difference in total opiate consumption between the groups (control, 34 mg; SNB, 31 mg; P = .40). There was no statistically significant difference in visual analog scale scores for pain at 0, 8, and 24 hours postsurgery, and no difference in overall satisfaction score. The control group had a significantly higher visual analog scale score at 4 hours postsurgery (3.0 vs 1.9, P = .04).Conclusion:SNB has a minimal effect on postsurgical care for ACL reconstruction with hamstring autograft in the presence of multimodal analgesia and local anesthetic infiltration.

African American gospel music seems without obvious parallel as a musical and social phenomenon of the twentieth century. It is a powerful musical and 'spiritual' expression that is to a larger extent defined by the musical style, vocal techniques and performance practices of one of its central figures: the gospel singer. Although these originally African American gospel vocal techniques and practices have now also significantly influenced the development of contemporary popular music and the broader gospel vocal style, the specific terminology used to describe them lacks precise definition, and also highlights the failure of conventional notation in successfully capturing or representing them.This article seeks then to firstly define and annotate some of the key descriptive terms commonly applied to African American gospel singing techniques in order that greater consistency and clarity can be achieved in relation to their usage within contemporary popular music research. Secondly, it will also introduce an analytical notational system, accompanied by a series of annotated musical transcriptions, that forms the basis of the author's taxonomy of musical gesture for African American gospel music, and which may provide a framework for comparative analytical research within the field of gospel-inspired contemporary popular music.

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Dental trauma occurs commonly in young patients, can be complex to treat and can have negative psychological and social impacts on patients' lives. This case report outlines a multidisciplinary team approach to restoration of a traumatized anterior tooth with delayed presentation, insufficient inter-occlusal space for restoration and history of multiple failed restorations. This case report demonstrates orthodontic and restorative techniques for the management of insufficient inter-occlusal space and the indirect restoration of a traumatized anterior tooth. CPD/Clinical Relevance: A multidisciplinary team approach can be used to reorganize a patients' occlusion to provide the inter-occlusal space required to provide restorations.

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