Efficacy of Anxiolytic and Preoperative Counseling on Preoperative Anxiety Reduction: A Randomized Comparison Study

Background: The incidence of preoperative anxiety is high. Anxiolytic agents have been used to reduce preoperative anxiety for many years. Recently the role of non-pharmacological interventions like preoperative information through interviews, counseling, and verbal reassurance for the reduction in preoperative anxiety has been established. But, the efficacy of these non-pharmacological interventions and the anxiolytic agent has not been compared previously. In this study, we compared the effectiveness of oral alprazolam and preoperative counseling by an anesthesiologist for the reduction of preoperative anxiety. Materials and Methods: A total of 110 patients were randomly divided into two groups. Group A received 0.5 mg oral Alprazolam tablets, the night before surgery. Group C received counseling from an anesthesiologist with a fixed protocol the night before surgery. Anxiety was assessed with a state-trait anxiety inventory (STAI) scale, and scores were assessed in the pre-anesthetic assessment room, at night before surgery before giving study interventions, and on the day of surgery before shifting to the operation room. Hemodynamic parameters and respiratory rate were monitored along with anxiety scores. Data were analyzed using an independent t-test, Chi-square test, and repeated variance analysis measures (ANOVA). Results: Anxiety scores and hemodynamic parameters were comparable between the groups at all times of measurement. Anxiety scores in the alprazolam group were less than counseling group on the day of surgery, but this difference was not statistically significant. Conclusion: Although treatment with Alprazolam resulted in lesser anxiety scores, overall, both the methods were ineffective in reducing preoperative anxiety

Erector spinae plane block versus paravertebral block in breast surgeries

Abstract This article (Correspondence) is in response to the recently published study by Elewa et al. in BMC Anesthesiology that compared the erector spinae plane block (ESPB) versus paravertebral block (PVB) regarding postoperative analgesic consumption following breast surgeries. I greatly appreciate the authors for publishing this study which is one among a very few studies available on this topic. I wish to present my reflections on this article as well as add a few more points on this topic

Erector spinae plane block in spine surgeries: Single-level versus bi-level, single-shot versus continuous catheter technique

Erector spinae plane block (ESPB) is one of the commonly preferred regional anesthesia techniques in the recent past for various procedures including spine surgeries. The main advantages of ESPB are the ease of performing the technique and the lesser chance of complications. Many studies have proven that ESPB plays an important role in reducing perioperative opioid consumption, postoperative nausea and vomiting, as well as the length of stay in the hospital. Thus it has been adopted as one of the measures for the enhanced recovery after surgery (ERAS) protocol. Nevertheless, the role of bi-level ESPB and a continuous catheter technique are the major research gaps and thus require further research in this population. The details of these two methods are discussed elaborately here

Clarifications on: Pectoralis Blocks Nomenclature and Clinical Applications of Regional Anesthesia Techniques for Breast and Thorax

This is in response to the recently published case series applying pectoralis blocks (Pecs blocks) for infective breast conditions by  Brewer et al. I wish to provide a few clarifications regarding the Pecs blocks and other blocks such as Pecs Zero block, Serratus anterior plane block, Erector spinae block that can be adopted in an emergency department setting.&nbsp