In patients undergoing orthopedic surgery, supplementation of spinal anesthesia with combined intrathecal and epidural MgSO(4) significantly reduces patients' post-operative analgesic requirements.

These findings show that septic shock alters microvascular muscle function and regulation. Diminished local VO2 presumably reflects maldistribution and faulty autoregulation of local blood flow.

In patients without sepsis at ICU admission IPF% increases before sepsis becomes manifest. Measuring IPF% through an easily available technology can therefore provide an early cellular marker predicting the development of sepsis.

Paresthesia-free cervical HF10 SCS may be a safe and effective therapeutic option for chronic migraineurs refractory to conventional treatments.

Medication overuse headache (MOH) is now recognized to be a major factor in many cases of both chronic and refractory chronic migraine. MOH must be addressed prior to evaluating the effectiveness of new preventative and prophylactic treatment approaches. Innovative new drugs and electrical neuromodulation are promising CM treatments. Future studies must carefully screen patients and acquire data that can lead to personalized, tailored treatment strategies.

No abstract

Nowadays, epidural space identification is made by using subjective and manual techniques characterized by failure rates up to 7%. In this work, we propose a fiber optic sensor technology based needle guidance system, that is directly inspired by the most common technique currently used for epidurals; through real-time strain measurements, the fiber Bragg grating integrated inside the needle lumen is able to effectively perceive the typical force drop occurring when the needle enters the epidural space. An in vivo swine study demonstrates the validity of our approach, paving the way for the development of lab-in-aneedle systems.

Purpose Underwater divers face several potential neurological hazards when breathing compressed gas mixtures including nitrogen narcosis which can impact diver's safety. Various human studies have clearly demonstrated brain impairment due to nitrogen narcosis in divers at 4 ATA using critical flicker fusion frequency (CFFF) as a cortical performance indicator. However, recently some authors have proposed a probable adaptive phenomenon during repetitive exposure to high nitrogen pressure in rats, where they found a reversal effect on dopamine release. Methods Sixty experienced divers breathing Air, Trimix or Heliox, were studied during an open water dive to a depth of 6 ATA with a square profile testing CFFF measurement before (T 0 ), during the dive upon arriving at the bottom (6 ATA) (T 1 ), 20 min of bottom time (T 2 ), and at 5 m (1.5 ATA) (T 3 ). Results CFFF results showed a slight increase in alertness and arousal during the deep dive regardless of the gas mixture breathed. The percent change in CFFF values at T 1 and T 2 differed among the three groups being lower in the air group than in the other groups. All CFFF values returned to basal values 5 min before the final ascent at 5 m (T 3 ), but the Trimix measurements were still slightly better than those at T 0 . Conclusions Our results highlight that nitrogen and oxygen alone and in combination can produce neuronal excitability or depression in a dose-related response. Keywords Nitrogen narcosis • Divers' safety • Critical flicker fusion frequency • GABA receptors Abbreviations ATA Atmospheres of pressure absolute 1 ATA = 1.01325 bar, 760 mmHg, 10 m H 2 O CFFF Critical flicker fusion frequency DCS Decompression sickness EAN Enriched air nitrox GABA receptors Gamma aminobutyric acid receptors HELIOX Helium and oxygen HPNS High pressure nervous syndrome TRIMIX Mixture of nitrogen, helium and oxygen Communicated by Jean-René Lacour.