The serratus posterior superior intercostal plane block (SPSIPB) is a recently introduced fascial plane block providing hemithoracic analgesia at C3–T10 dermatomes. In adults, it has been shown to provide effective analgesia in cardiovascular surgeries and has the potential for postoperative analgesia in clavicular procedures. This case report highlights the perioperative analgesic efficacy of SPSIPB in two pediatric cases: a 7-year-old undergoing discrete subaortic stenosis surgery and a 9-year-old undergoing Sprengel deformity correction. To the best of our knowledge, these are the first reported pediatric applications of SPSIPB, both demonstrating effective analgesia without perioperative complications.

Laryngeal masks (LMA) are significant in airway management. The newly developed video LMA (SaCoVLM™) allows direct visualization. In our study, we sought to compare the success of intubation between the SaCoVLM™ and the Fastrack LMA using fiberoptic bronchoscopy guidance. Our primary objective was total intubation time, while our secondary objective was postoperative complications. Patients (101) intubated with the SaCoVLM™ were categorized as Group V, while those intubated with the Fastrach LMA were categorized as Group F. LMA placement time, intubation time, total intubation time, and postoperative complications within the first 24 h were followed. We found a shorter total intubation time with the SaCoVLM™. Moreover, patients in the Fastrack LMA experienced a higher incidence of sore throat and a greater frequency of blood-stained supraglottic airway devices (SADs). (p < 0.05). We found that the SaCoVLM™ is an effective alternative to the Fastrack LMA in terms of LMA placement success and intubation success. NCT06121895.

Objectives: Difficult and unsuccessful intubation is a leading cause of anesthesia-related morbidity and mortality. This study aimed to investigate the incidence and contributing factors of difficult and unsuccessful intubation in patients undergoing gynecologic oncology surgery, particularly those with significant comorbidities and obesity. Methods: The study included 653 patients over 18 years of age who underwent gynecologic oncology surgery with planned intubation under general anesthesia between January 1 and July 1, 2024. Data collected included demographic information, number of intubation attempts, personnel involved in intubation, auxiliary methods employed, intubation duration, complications, mouth opening, sternomental distance, thyromental distance, neck mobility, upper lip bite test results, presence of retrognathia or micrognathia, obstructive sleep apnea, and mobile dentures. Results: The incidence of difficult intubation in our cohort was 7.5%, with no cases of failed intubation. Significant factors associated with increased risk of difficult intubation included body mass index (P=0.008), obstructive sleep apnea (P<0.001), Mallampati score (P<0.001), and mouth opening <4 cm (P<0.001). Among patients with difficult intubation, statistically significant differences were observed for age (P=0.001), ASA score (P=0.002), presence of comorbid conditions(P=0.004), Cormack-Lehane score(P<0.001), sternomental distance <12 cm (P<0.001), thyromental distance <6 cm (P<0.001), limited neck mobility (P<0.001), upper lip bite test results (P<0.001), retrognathia/micrognathia (P<0.001), and presence of dentures (P<0.001). Conclusions: This study demonstrated that preoperative assessments of body mass index, obstructive sleep apnea, Mallampati score, and mouth opening are significant risk factors for difficult intubation. To reduce the risk of airway-related complications, patients undergoing gynecologic oncology surgery should undergo thorough and careful preoperative evaluation.

Varicose vein surgery is one of the most frequent indications for ambulatory vascular interventions. Although spinal anesthesia provides reliable surgical

Stereotactic Brain Biopsy with Awake Craniotomy: Our Awake Craniotomy Experience on a Complicated Case and Mini Review - Turkish Journal of Anaesthesiology and Reanimation

Objectives: The aim of this study was to compare the 4-in-1 block technique with femoral nerve block (FNB) and adductor canal block (ACB) in terms of perioperative pain and opioid consumption in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). Methods: The trial was retrospectively registered. In this randomized controlled trial, patients scheduled for ACLR under general anesthesia were randomly assigned to one of three groups: 4-in-1 block, FNB, or ACB. All blocks were performed under ultrasound guidance with 20 mL of 0.25% bupivacaine approximately 45 min before surgery. Intraoperative remifentanil use, postoperative 24-hour intravenous morphine equivalents (IME) consumption, and pain scores measured by the numerical rating scale (NRS) were recorded. Overall postoperative pain burden was additionally assessed using the 0–24-hour NRS area under the curve (AUC). An exploratory post-hoc non-inferiority analysis was performed. Results: A total of 60 patients were equally divided among the groups. Intraoperative remifentanil consumption, postoperative 24-hour IME consumption, and the 0–24-hour NRS AUC values did not differ significantly among the groups ( p = 0.842, p = 0.502, and p = 0.958, respectively). Compared with the ACB group, the 4-in-1 block group used, on average, 0.8 mg less postoperative 24-hour IME (90% confidence interval [CI], − 5.61–4.01). Compared with the FNB group, 24-hour IME use was 2.8 mg greater (90% CI, − 1.48–7.08). In both comparisons, the upper bounds of the two-sided 90% CIs did not exceed the exploratory post-hoc non-inferiority margin (Δ = 10 mg). Conclusion: In patients undergoing ACLR, the 4-in-1 block did not differ significantly from FNB or ACB in terms of analgesic outcomes. These exploratory findings require further investigation to clarify the role of the 4-in-1 block in perioperative pain management for ACLR. Trial registration: ClinicalTrials.gov identifier: NCT05643040. Registered 23 November 2022. Retrospectively registered.