Current Clinical Management of Regional Analgesia and Anesthesia

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 755

Special Issue Editor


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Guest Editor
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80100 Naples, Italy
Interests: chronic pain; pain management; regional analgesia; general anesthesia; perioperative care

Special Issue Information

Dear Colleagues,

Regional analgesia and anesthesia are techniques that block pain signals from specific areas of the body by injecting local anesthetics close to the nerves or nerve plexuses to numb a specific area. This approach is crucial in perioperative pain management, as it targets specific nerve pathways to provide effective pain relief, reducing the need for systemic analgesics and minimizing side effects. This Special Issue, "Current Clinical Management of Regional Analgesia and Anesthesia", delves into a multifaceted exploration of regional techniques and their impact on perioperative care.

The aim of this Special Issue is to highlight the latest advancements and best practices in regional analgesia and anesthesia. It offers insights into current trends, challenges, and innovations in clinical management, providing valuable information for healthcare professionals in perioperative care. This Special Issue also considers tailored approaches for pediatric patients and the elderly, ensuring that different populations receive appropriate care.

Dr. Carmine Iacovazzo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

  • regional analgesia
  • anesthesia
  • sedation
  • intravenous
  • local anesthetics
  • pain management
  • perioperative care
  • adverse events

Published Papers (2 papers)

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Research

14 pages, 2816 KiB  
Article
Assessing Residual Gastric Fluid Volume after Administering Diluted Oral Contrast until One Hour Prior to Anesthesia in Children: An Observational Cohort Study
by Suryakumar Narayanasamy, Robert J. Fleck, Ali I. Kandil, Boma Afonya, Hana Mahmoud, Jiwon Lee, Lili Ding and Mohamed A. Mahmoud
J. Clin. Med. 2024, 13(12), 3584; https://doi.org/10.3390/jcm13123584 - 19 Jun 2024
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Abstract
Background: Gastric fluid volume has been used as a surrogate marker for pulmonary aspiration risk in studies evaluating fasting protocol safety. This study measured residual gastric fluid volume in children using a protocol in which diluted oral contrast medium was administered up until [...] Read more.
Background: Gastric fluid volume has been used as a surrogate marker for pulmonary aspiration risk in studies evaluating fasting protocol safety. This study measured residual gastric fluid volume in children using a protocol in which diluted oral contrast medium was administered up until one hour before anesthesia. Methods: This was a single-center prospective observational cohort trial of 70 children for elective abdominal/pelvic computed tomography (CT). Imaging was performed after diluted enteral contrast medium administration, beginning two hours before and ending at least one hour before induction. For each patient, gastric fluid volume was calculated using an image region of interest. The primary outcome measure was gastric fluid volume measured using the computed tomography image. Results: The median time from the end of contrast administration to imaging was 1.5 h (range: 1.1 to 2.2 h). Residual gastric volume, measured using CT was <0.4 mL/Kg in 33%; ≥0.4 mL/Kg in 67%; and ≥1.5 mL/Kg in 44% of patients. Residual gastric volumes measured using CT and aspiration were moderately correlated (Spearman’s correlation coefficient = 0.41, p = 0.0003). However, the median residual gastric volume measured using CT (1.17, IQR: 0.22 to 2.38 mL/Kg) was higher than that of aspiration (0.51, IQR: 0 to 1.58 mL/Kg, p = 0.0008 on differences in paired measures). Three cases of vomiting were reported. No evidence of pulmonary aspiration was identified. Conclusions: Children who receive large quantities of clear fluid up to one hour before anesthesia can have a significant gastric residual volume. Full article
(This article belongs to the Special Issue Current Clinical Management of Regional Analgesia and Anesthesia)
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15 pages, 373 KiB  
Article
Preoperative Echocardiographic Unknown Valvopathy Evaluation in Elderly Patients Undergoing Neuraxial Anesthesia during Major Orthopedic Surgery: A Mono-Centric Retrospective Study
by Antonio Coviello, Dario Cirillo, Maria Vargas, Andrea Uriel de Siena, Maria Silvia Barone, Francesco Esposito, Antonio Izzo, Pasquale Buonanno, Serena Volpe, Andrea Gabriele Stingone and Carmine Iacovazzo
J. Clin. Med. 2024, 13(12), 3511; https://doi.org/10.3390/jcm13123511 - 15 Jun 2024
Viewed by 421
Abstract
Background: The assessment of cardiac risk is challenging for elderly patients undergoing major orthopedic surgery with preoperative functional limitations. Currently, no specific cardiac risk scores are available for these critical patients. Echocardiography may be a reliable and safe instrument for assessing cardiac risks [...] Read more.
Background: The assessment of cardiac risk is challenging for elderly patients undergoing major orthopedic surgery with preoperative functional limitations. Currently, no specific cardiac risk scores are available for these critical patients. Echocardiography may be a reliable and safe instrument for assessing cardiac risks in this population. This study aims to evaluate the potential benefits of echocardiography in elderly orthopedic patients, its impact on anesthesiologic management, and postoperative Major Adverse Cardiac Events (MACEs). Methods: This is a retrospective, one-arm, monocentric study conducted at ‘’Federico II’’ Hospital—University of Naples—from January to December 2023, where 59 patients undergoing hip or knee revision surgery under neuraxial anesthesia were selected. The demographic data, the clinical history, and the results of preoperative Echocardiography screening (pEco-s) were collected. After extensive descriptive statistics, the χ2 test was used to compare the valvopathies and impaired Left Ventricular Function (iLVEF) prevalence before and after echocardiography screening and the incidence of postoperative MACE; a p-value <0.05 was considered statistically significant. Results: The mean age was 72.5 ± 6.9, and the prevalence of cardiac risk factors was about 90%. The cumulative prevalence of iLVEF and valvopathy was higher after the screening (p < 0.001). The pEco-s diagnosed 25 new valvopathies: three of them were moderate–severe. No patients had MACE. Conclusions: pEco-s evaluation could discover unknown heart valve pathology; more studies are needed to understand if pEco-s could affect the anesthetic management of patients with functional limitations, preventing the incidence of MACE, and assessing its cost-effectiveness. Full article
(This article belongs to the Special Issue Current Clinical Management of Regional Analgesia and Anesthesia)
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