Fluoroscopic-guided paramedian approach to subarachnoid block in patients with ankylosing spondylitis: A case series

A new indication of erector spinae plane block for perioperative analgesia is total hip replacement surgery – A case report

“…at the thoracic level for thoracic neuropathic pain. [1] It has subsequently been used for breast surgery,[234] thoracic surgery[5] when given at thoracic level and for abdominal surgery,[67] lumbar spine surgery,[8] and back pain when given at lumbar level. A recent role of this block has been seen in hip surgery and proximal femur surgery[9] when given at lower lumbar level.…”

Anesthetic challenges in a patient with severe thoracolumbar kyphoscoliosis

“…The causes of failed or patchy spinal block in kyphoscoliotic patients can be due to anatomical defect itself, lack of proper placement of the local anesthetic, drug incompatibility, drug density, and drug defects. [ 3 4 5 ] However, in our case, it failed due to the inability to detect sclerosis that prevented the spread of local anesthetic solution in the subarachnoid space. It was detected later on X-ray lumbar spine AP and lateral view [ Figure 1 ].…”

“…Gupta and Gupta conducted a case series of 10 patients where they used fluoroscopic-guided paramedian approach to subarachnoid block in patients with ankylosing spondylitis. [ 5 ] However, fluoroscopy is not a foolproof method to ensure that the spinal block would always be successful in such patients as the intraoperative fluoroscopy may sometimes not show the spinal canal stenosis or sclerosis. We, therefore, recommend that every patient of kyphoscoliosis's preoperative X-ray/magnetic resonance imaging of the diseased spine must be studied by the anesthesiologist to adequately plan the exact level of the spinal block.…”

Regional block: Walking away from central to peripheral nerves and planes for local anaesthetic drug deposition

“…This journal has published in the past various original articles and reports pertaining to these newer blocks and their comparisons with older blocks. [234567891011121314] This issue of the journal reports a randomised trial wherein COMBIPECS (combinations of Pecs 1 and Pecs 2) block has been studied for breast surgeries. [15]…”

“…Most of the studies related to fascial plane block are primarily related to the analgesic effect as the primary outcome measure. [2456789101112131415] The majority of the studies report that addition of these newer blocks decreases the requirement of analgesics (specifically opioid) during the perioperative period. The comparative study among individual blocks has reported variable results and the superiority of an individual block has not been determined conclusively.…”