In our study periarticular infiltration was clearly superior to PCA with morphine after THA, providing better pain relief and lower opioid consumption postoperatively. Infiltration seems to be equally effective to epidural analgesia without having the potential side effects of the latter.
This review article provides an overview of published data regarding the involvement of music in anesthesia practice. Music is an important topic for research in different fields of anesthesiology. The use of music preoperatively is aimed at reducing anxiety, stress, and fear. However, the effect of music on perception of pain intraoperatively is controversial, according to studies of both adults and children undergoing various surgical procedures under general and/or regional anesthesia. In postoperative pain management, postanesthesia care, and neonatal intensive care, music can be a complementary method for reducing pain, anxiety, and stress. Music is a mild anxiolytic, but it is relatively ineffective when a pain stimulus is severe. However, music is inexpensive, easily administered, and free of adverse effects, and as such, can serve as complementary method for treating perioperative stress and for acute and chronic pain management, even though music's effectiveness depends on each individual patient's disposition and severity of pain stimulus.
Cervical paravertebral anatomy can be depicted with ultrasound imaging techniques. This could be highly clinically significant for the implementation of regional anesthesia techniques.
Introduction: Isolated dissection of the superior mesenteric artery (SMA) is rare and remains the most common reason for aneurysmal degeneration of the vessel. The treatment is challenging and not standardised. The purpose of this report is to demonstrate that coiling of the false lumen is a good alternative for dissecting SMA aneurysms. Report: A 50 year old male presented with a 3.3 cm dissecting aneurysm of the SMA and epigastric pain of moderate severity. More than 50% of the ileal arteries arose from the collapsed true lumen. Via transfemoral access the true lumen was catheterised. An open cell balloon expandable stent was deployed at the proximal and a closed cell self expandable stent at the distal end of the dissection flap. Through the cells of the first stent a microcatheter was advanced into the false lumen and 33 coils were deployed into the aneurysm sac. A stent graft was deployed within the first stent leading to the total exclusion of the aneurysm. Follow up at three months was uneventful and the patency was assessed by contrast enhanced ultrasound. Discussion: Coiling of the false aneurysm is a good alternative for dissecting SMA aneurysms, where no other open surgical or endovascular options are applicable.
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