Rejected

Regional anaesthesia has been used to reduce acute post-operative pain as well as opioid-related side effects in breast cancer surgery. Erector spinae plane (ESP) block is a relatively new fascial plane block being tried in various surgical procedures. Our study is a double-blind randomised trial, designed to prove the efficacy of this block in breast surgeries.

To compare different modalities of renal replacement therapy in critically ill adults with acute kidney injury.

To study the clinical features of children with influenza A virus infection and neurological symptoms.

Associations between attention-deficit/hyperactivity disorder (ADHD) and chronic pain disorders, such as fibromyalgia, have been reported. However, associations between persistent chronic nonspecific low back pain (CNLBP) and ADHD have not yet been investigated.

Worldwide, over 200 million people are diagnosed with lower extremity arterial disease (LEAD). LEAD significantly increases the risk of death and amputation of the lower limb. A new classification system (WIfI) has been proposed to initially assess all patients with ischemic rest pain or wounds and also predicts 1-year amputation risk. Elabela is a bioactive peptide and a part of the apelinergic system, which has beneficial effects on body fluid homeostasis and cardiovascular health. We aimed to investigate serum Elabela levels in LEAD.

Several Australian systems-level initiatives have been implemented to reduce opioid overprescribing. The aim of this study was to explore general practitioner (GP) attitudes towards these interventions.

Transmuscular Quadratus Lumborum Block (TQLB) is a novel regional anaesthesia technique, however, its analgesic efficacy as a component of multimodal analgesia (MMA) in Total Laparoscopic Hysterectomy (TLH) is not well studied. The aim of the study was to evaluate the analgesic efficacy of TQLB as a component of MMA for postoperative pain in TLH.

The trigeminal nerve theory has been proposed as a pathophysiological mechanism of migraine; however, its association with the triggers of migraine remains unclear. Cervical disability such as neck pain and restricted cervical rotation, have been associated with not only cervicogenic headaches but also migraine. The presence of cervical disability could worsen of the migraine, and also the response to pharmacologic treatment may be reduced. The aim in this review is to highlight the involvement of cervical disability in migraine, considering contributing factors.

Patients with high-risk conditions for surgery may benefit from some form of regional block when neuroaxial regional blocks may be life threatening. Despite the increased use of ultrasound-guided peripheral regional blocks internationally, local infiltration and targeted nerve blocks aided by knowledge of anatomical landmarks remain helpful in these two patients presented. A 48-year old woman, presented with bleeding left breast mass, mild respiratory distress, and radiological features of lung metastases (Carcinoma of the breast stage 4). Her American Society of Anesthesiologist risk assessment (ASA) was grade 4. Anesthetic technique was mainly local infiltration and intercostal nerve block with 1% lignocaine (10 mg) and 2.5% bupivacaine (62.5 mg) and a 1 in 100,000 dilution of adrenaline in cardiac position with mild sedation with good analgesia and outcome. Another 24-year-old pregnant woman with dilated cardiomyopathy was being managed by a multidisciplinary team. Her cardiac state deteriorated as pregnancy progressed. Caesarean section was done successfully at 35 weeks gestation under local infiltration and rectus sheath block with local anesthetic agents, sedation, and oxygen masks in the cardiac position with good outcome. The good outcomes in these two patients showed the benefit of peripheral regional blocks in high risk patients. Early recognition of high-risk patients and appropriate anesthetic and clinical assessment with the formulation of right techniques can help salvage lives. This thought is more apt in equipment challenged environments like ours in Nigeria, when resources for ultrasound assisted peripheral nerve blocks are not always available.