Perineural liposomal bupivacaine for postoperative pain control in patients undergoing upper extremity orthopedic surgery: A prospective and randomized pilot study

Background: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain. Methods: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block. A sham block was performed in an attempt to blind enrollees in the control group. We administered the EuroQol 5D-5L questionnaire preoperatively and on postoperative days 1-3 and considered the results the primary outcome of our investigation. Block procedure times, postanesthesia care unit (PACU) length of stay, instances of nausea/vomiting, need for narcotic administration, and patient satisfaction were also assessed. Results: We observed no significant differences in postoperative EuroQol scores between the 2 groups and no significant differences in patient demographics, PACU length of stay, or side effects in the PACU. In some instances, the short-acting supraclavicular block resolved in the PACU, and these patients reported higher pain scores and required titration of analgesics prior to discharge. Conclusion: Larger prospective studies are needed to determine the safety and efficacy of liposomal bupivacaine in patients undergoing upper extremity surgery. Liposomal bupivacaine is currently only approved for local anesthetic infiltration use

The economic burden of rotavirus hospitalization among children < 5 years of age in selected hospitals in Bangladesh

Background: Rotavirus is a common cause of severe acute gastroenteritis among young children. Estimation of the economic burden would provide informed decision about investment on prevention strategies (e.g., vaccine and/or behavior change), which has been a potential policy discussion in Bangladesh for several years. Methods: We estimated the societal costs of children &lt;5 years for hospitalization from rotavirus gastroenteritis (RVGE) and incidences of catastrophic health expenditure. A total of 360 children with stool specimens positive for rotavirus were included in this study from 6 tertiary hospitals (3 public and 3 private). We interviewed the caregiver of the patient and hospital staff to collect cost from patient and health facility perspectives. We estimated the economic cost considering 2015 as the reference year. Results: The total societal per-patient costs to treat RVGE in the public hospital were 126 USD (95% CI: 116–136) and total household costs were 161 USD (95% CI: 145–177) in private facilities. Direct costs constituted 38.1% of total household costs. The out-of-pocket payments for RVGE hospitalization was 23% of monthly income and 76% of households faced catastrophic healthcare expenditures due to this expense. The estimated total annual household treatment cost for the country was 10 million USD. Conclusions: A substantial economic burden of RVGE in Bangladesh was observed in this study. Any prevention of RVGE through cost-effective vaccination or/and behavioural change would contribute to substantial economic benefits to Bangladesh

sj-docx-1-aop-10.1177_10600280221129348 – Supplemental material for Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Patients With Nephrotic Syndrome: A Retrospective Cohort Study

Supplemental material, sj-docx-1-aop-10.1177_10600280221129348 for Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Patients With Nephrotic Syndrome: A Retrospective Cohort Study by Aminat Tijani, Eric M. Coons, Britta Mizuki, Miranda Dermady, Katerina Stanilova, Ashley L. Casey, Muhannad Alqudsi, Mariella Gastanaduy, Ardem Elmayan, Adi Bamnolker and Juan Carlos Q. Velez in Annals of Pharmacotherapy</p

sj-docx-2-aop-10.1177_10600280221129348 – Supplemental material for Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Patients With Nephrotic Syndrome: A Retrospective Cohort Study

Supplemental material, sj-docx-2-aop-10.1177_10600280221129348 for Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Patients With Nephrotic Syndrome: A Retrospective Cohort Study by Aminat Tijani, Eric M. Coons, Britta Mizuki, Miranda Dermady, Katerina Stanilova, Ashley L. Casey, Muhannad Alqudsi, Mariella Gastanaduy, Ardem Elmayan, Adi Bamnolker and Juan Carlos Q. Velez in Annals of Pharmacotherapy</p