Efficacy of the Thoracolumbar Interfascial Plane Block for Lumbar Laminoplasty: A Retrospective Study

Study DesignThis paper was a single center-based retrospective study with prospective data collection.PurposeCompared with other surgeries, limited options are available for perioperative pain management in spinal surgery. Therefore, we aimed to identify new pain management in this study.Overview of LiteratureThe thoracolumbar interfascial plane (TLIP) block has been reported to provide effective regional analgesia in the lumbar region. This study investigated the efficacy of the TLIP block for pain management in lumbar laminoplasty.MethodsWe investigated patients who underwent lumbar laminoplasty for the treatment of lumbar spinal canal stenosis from April to October 2015. Patients with secondary surgery or surgery involving more than four intervertebral spaces were excluded. The primary outcome measure was the pain scale score within 48 hours after the surgery. The secondary outcomes were the number of additional analgesic drugs used and the number of patients complaining of complications, such as nausea and vomiting, within 24 hours after the surgery.ResultsWe retrospectively assessed the data of 44 patients who underwent lumbar laminoplasty. Of these, 25 patients received only general anesthesia (G group), whereas 19 patients received the TLIP block along with general anesthesia (T group). Compared with the G group, the T group reported lower pain scores for pain at 1, 2, 4, and 24 hours postoperatively. Moreover, the number of patients who received the additional analgesic pentazocine was lower in the T group than in the G group. The two groups showed no significant differences in the incidence of complications.ConclusionsThe TLIP block provides effective analgesia for 24 hours postoperatively in patients undergoing lumbar laminoplasty

Successful clavicle fracture surgery performed under selective supraclavicular nerve block using the new subclavian approach

Abstract Objectives Cervical nerves block cannot be performed on some patients because of the risk of phrenic nerve paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular nerve block at the subclavian site. Case report We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular nerve and the fifth and sixth cervical nerves for the clavicle fracture surgery. Conclusions We can perform selective supraclavicular nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax

Endotrol tracheal tube and McGrath Mac are an effective combination for oral tracheal intubation

Background: Tracheal intubation using the 2nd-generation video laryngoscope sometimes cannot be performed easily because there is no functional endotracheal tube (ETT) guide. Therefore, a rigid stylet is often required during tracheal intubation. The Endotrol® tracheal tube (Endotrol) is a single use ETT that whole tube can be bent and slide easily into the trachea. We studied the intubation ease of a combination of an Endtrol and the McGrath® video laryngoscope (McGrath), which is one of the 2nd-generation video laryngoscopes. Methods: Sixty adult patients under general anesthesia were randomized into three groups: Group A: McGrath with Endotrol, B: McGrath with a rigid stylet attached ETT, and C: Direct laryngoscope with an ETT. The primary outcome measure was intubation time. Secondary outcomes were the number of insertion attempts required and the number of patients who complained of a sore throat after the procedure. The level of significance for each test was set at P < 0.05. Results: Intubation time (median [range] in seconds) was shorter in Group A (32 [27–54]) than Group B (37 [27–49]) and C (37 [27–50]) (P = 0.01 for both comparison). There was no significant difference among groups for the number of insertion attempts required. The number of patients with a sore throat was lower in Group A (0) than Group B (5) and C (6) (P = 0.02 and 0.01, respectively). Conclusion: A combination of an Endtrol and a McGrath is effective for shortening intubation time and avoiding sore throats