These results confirm the analgesic efficacy of IBPB for shoulder surgery. Nonetheless, the combination of intraarticular and subacromial infiltration, studied for the first time, appears to be a clinically valid alternative with no clinical meaningful adverse effects.
Levobupivacaine (0.5%) has better anaesthetic properties with respect to 0.75% ropivacaine and is well-suited for peribulbar block in cataract surgery.
The aim of this prospective study was to evaluate the efficacy of endoscopic epidurolysis in the treatment of degenerative chronic low back pain.Two hundred and thirty four patients affected by chronic low back pain, with VAS ≥ 5 and Oswestry Low Back Pain Disability Index (ODI) from 0 to 60% (0-20%, group A; 20-40%, group B; 40-60%, group C) were enrolled and treated prospectively with endoscopic epidurolysis by means of a flexible fiberoptic endoscope introduced into the caudal epidural space and by the intermittent instillation of saline solution added with 150 UI hyaluronidase. Targeted application of ozone (8 ml; 38 γ/ml) and 50 mg ciprofloxacin close to the abnormal areas was also performed. Short and long term efficacy (1 week, 3 months, 6, 12, 24, 36 and 48 months) was prospectively evaluated. VAS score <5 and ODI <40% were considered as a positive outcome.The treatment significantly reduced VAS score in all three groups of patients starting from the first week and throughout the entire follow-up period (P < 0.001). Disability Index (ODI) too showed encouraging results (P < 0.001) that was particularly evident at 3 months and maintained up to long-term follow-up intervals.Epiduroscopy by mechanical adhesiolysis and administration on targeted areas of ciprofloxacin and ozone seems to be, in this prospective study, an effective technique to provide a sensible and persisting pain relief and act of improving ODI in chronic low back pain.
Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.
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