To illustrate the potential value of pharmacogenetic testing to identify patients at risk for nonsteroidal anti-inflammatory drug-induced gastropathy.Case report.We report a case encountered in an outpatient setting pain management.We present patient treated with celecoxib who developed severe gastropathy.Suspecting relation between this adverse event and altered drug metabolism, was performed assess role cytochrome P450 (CP450) enzyme profile.Pharmacogenetic revealed allelic variant P450,...

This study was designed to compare the characteristics of nonobese and overweight/obese subjects with nonalcoholic fatty liver disease (NAFLD) in an urban South Indian population.The group comprises 541 drawn from Chennai Urban Rural Epidemiology Study (CURES), which carried out on a representative sample city southern India. NAFLD diagnosed by ultrasonography. Subjects were classified as (body mass index ≤22.9 kg/m(2)) ≥23 based World Health Organization Asia Pacific guidelines. Coronary...

BACKGROUND: The traditional loss-of-resistance (LOR) technique for thoracic epidural catheter placement can be associated with a high primary failure rate. In this study, we compared the LOR and dynamic pressure-sensing (DPS) technology success rate secondary outcomes pertinent to identifying space. METHODS: This pragmatic, randomized, patient- assessor-blinded superiority trial enrolled patients ages 18 75 years, scheduled major or abdominal surgeries at tertiary care teaching hospital....

A woman in her 40s with an ischaemic right lower limb, who was on extracorporeal membrane oxygenation (ECMO) following cardiopulmonary failure secondary to bilateral alveolar haemorrhage, scheduled for through-knee amputation. She under mechanical ventilation and continuous intravenous medications. Considering significant comorbidities, peripheral nerve blocks were chosen anaesthesia. Ultrasound-guided traditional blockade techniques of the femoral sciatic nerves not possible because...

Adductor canal block is a widely used regional anesthesia technique for total knee arthroplasty that helps in reducing post-surgical pain and opioid use. Anatomically, the adductor extends from apex of femoral triangle proximally to hiatus distally roofed by sartorius vasto-adductor fascia. All these serve as potential path spread local anesthetic when it injected inside during block. Subsartorial space unique interest lies between fascia, carrying subsartorial plexus can provide additional...

A thoracic epidural is commonly used for analgesia following trauma or surgery. Traditionally, epidurals are performed using the loss of resistance technique. However, false-positive and catheter placement outside space possible. In such scenarios when clinical equivalents, as hemodynamic changes sensory to blockade, fail well, assessment position can be accomplished ultrasound. Ultrasound scanning identify spread injectate past laminas confirm its positioning. addition, multiple approaches...

Acute pain service was consulted for acute management in a 40-year-old male who had sustained multiple bilateral rib fractures following fall injury. In addition to the fractures, patient also experienced injuries his lungs and spinal column, both of which required surgeries. Considering significant nature due multimodal approach that included pharmacological non-pharmacological strategies utilized. A thoracic epidural performed by provide immediate onset analgesia, especially during stay...

The objective of this study was to demonstrate efficacy, benefit, and potential use topiramate in treating obese patients with chronic low back pain. This is a case report from an outpatient academic pain multidisciplinary clinical center. patient 30-year-old morbidly (body mass index [BMI]: 61.4 kg/m2) female suffering With known association between obesity pain, possible role both simultaneously, the started on therapeutic trial topiramate. Over period 12-week therapy, experienced...

Background: Handheld ultrasound devices have become popular among clinicians due to their affordability and compatibility with tablets smartphones. Several handheld the capability construct three-dimensional (3D) images using a traditional two-dimensional (2D) transducer. Objectives: The current study aimed 3D of common peripheral nerve fascial plane blocks device 2D probe. Methods: A total 10 patients who were scheduled receive ultrasound-guided for outpatient surgery classified as American...

Neuraxial anesthesia is a standard of care during parturition. Since bleeding diathesis contraindication to neuraxial techniques, data about its safe administration in thrombocytopenic milieu limited and evolving. Thrombocytopenia associated with preeclampsia or eclampsia hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome leads significant maternal neonatal morbidity. We present case uneventful spinal for urgent cesarean section an eclamptic patient precipitous drop from...

Background Regional analgesic techniques such as paravertebral blocks (PVBs) have been popularized for analgesia following video-assisted thoracoscopic surgery (VATS). In this single center retrospective propensity matched cohort of subjects, we investigate the impact on and non-analgesic outcomes. Methods Institutional database was queried to identify all patients undergoing VATS between January 2013 July 2019 these were divided into those who received in combination with general anesthesia...

Arthroscopic knee anterior cruciate ligament (ACL) reconstruction is commonly performed as an outpatient surgery, where adequate pain control and early ambulation play key roles in recovery discharge. Peripheral nerve blocks aid this purpose. Blockade of the genicular nerves, articular branches knee, has recently become popular for surgery. We report on four patients who underwent ACL with ultrasound-guided (GNBs) under general anesthesia. The were reliably without any complications,...

Sepsis is a life-threatening organ dysfunction with non-specific clinical features that can mimic other conditions hyper metabolic state such as malignant hyperthermia. Perioperatively anesthesia providers come across scenarios, which are extremely challenging the need for urgent intervention. To illustrate early intervention and consultation added assistance to approach rule out hyperthermia possible causes during scenario. A 63-year-old male underwent an uneventful elective flexible...

A sepse é uma disfunção orgânica fatal com características clínicas inespecíficas que podem imitar outras condições quadro hipermetabólico, como a hipertermia maligna. Os cenários são extremamente desafiadores para anestesia perioperatória e requerem intervenção urgente. Ilustrar necessidade de consulta precoces assistência adicional na abordagem exclusão maligna possíveis causas durante tal cenário. Paciente do sexo masculino, 63 anos, submetido à cistoscopia eletiva cistoscópio flexível...