Physicians should be alert about the possibility of subacute thyroiditis (SAT) being induced by COVID‐19 vaccination. SAT may present with anterior neck pain, extended fever or palpitation in recently vaccinated patients, which should not be easily dismissed as expected post‐vaccination flu‐like symptoms, thereby, facilitating in time diagnosis and treatment.

BackgroundVarious mechanisms have been suggested for analgesic effects of drugs used in infra-clavicular block and each has contributed to pain relief.ObjectivesThe aim of this study was to compare the degree of sympathetic block and measure tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-1 levels before and after infra-clavicular block with ropivacaine and bupivacaine in patients undergoing arterio venous fistula (AVF) surgery.MethodsForty-eight patients undergoing AVF surgery were randomly divided to two groups, undergoing infra-clavicular block with ropivacaine and bupivacaine. The bupivacaine group was blocked with 30 mL of 0.5% bupivacaine and in the ropivacaine group, the blockage was done with 30 mL of 0.5% ropivacaine. Infra-clavicular block was carried out by ultrasound in a vertical manner. Blood samples were taken before the block and one hour after the block to measure IL-1, IL-6, and TNF-alpha. Data were analyzed by covariance analysis and correlation t-test.ResultsT-correlation analysis showed that in both ropivacaine and bupivacaine groups, the TNF-alpha, IL-6, and IL-1 levels decreased after the block. Also, the increase in arterial diameter was significantly greater in ropivacaine group.ConclusionsThe present study showed that peripheral block with any single drug could reduce pre-inflammatory factors. On the other hand, ropivacaine significantly increased the diameter of the artery compared to the bupivacaine group.

Subacute thyroiditis (SAT) is an inflammatory thyroid disease of post-viral origin; linked with many viruses such as SARS-COVID-2. The objective of this work is to report a case of SAT associated with COVID-19 vaccination, in a healthy patient with no history of previous COVID-19 or upper respiratory tract infection.

Chordomas rare low grade slow-growing malignant tumors with an incidence rate of 1 in 100000 individuals.32% of chordomas occur in the clivus. Diagnosing Clival chordomas could be challenging due to their rare prevalence, insidious onset, and tendency to involve anywhere throughout the craniospinal column. Treating these tumors can also present as a challenge due to their proximity to vital structures and high recurrence rate. We present a case of massive recurrent Clival chordoma in a 27-year-old patient and discuss the anesthetic considerations in such cases.