The serratus posterior superior intercostal plane (SPSIP) block is a novel technique recently described for thoracic analgesia. This study presents two cases using this technique for postoperative pain after mastectomy with axillary lymph node dissection. The SPSIP block was administered to the patients in the preoperative period as part of multimodal analgesia, and postoperative pain was monitored using the numeric rating scale (NRS). In both patients, the NRS pain scores were below 3/10. SPSIP provided adequate postoperative analgesia in these cases without the need for any opioid agents. Thus, an SPSIP block can be a valuable treatment option for postoperative pain after breast surgery.

Both the pectoserratus plane block and the combined deep and superficial serratus anterior plane block (CSAPB) are recognized as effective regional anesthesia methods for pain control. This research aims to assess the ability of two different nerve blocks to provide analgesia. The study included 60 patients who underwent modified radical mastectomy (MRM). Participants were allocated into separate groups: Group P (Pectoserratus Plane Block) and Group S (CSAPB). The primary outcome was the tramadol consumption, while the secondary outcome was the assessment of pain levels. The median (Q1, Q3) postoperative 24-hour tramadol consumption was 60 (60,80) mg in Group P and 60 (40,60) mg in Group S. (p = 0.006) Additionally, higher NRS scores were observed in group P at 2 and 4 h. In this study, we found that the CSAPB and the pectoserratus plane block provided comparable analgesic efficacy in patients undergoing MRM. This approach may serve as an effective alternative to the pectoserratus plane block. NCT05961735.

Effective management of postoperative pain remains a significant challenge after breast surgery. Among the available strategies, regional nerve blocks play

Can Artificial Intelligence Be Successful as an Anaesthesiology and Reanimation Resident? - Turkish Journal of Anaesthesiology and Reanimation

Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) levels and ischemia status in the tissues. Coronary artery bypass grafting (CABG) surgery is a procedure associated with high oxidative stress. Dexmedetomidine, an alpha-2 agonist anaesthetic agent, has antioxidant effects. In this study, the effects of dexmedetomidine on oxidative stress in CABG surgery were investigated. Patients who underwent on-pump CABG surgery were divided into two groups: those receiving dexmedetomidine (Group D) and those not receiving dexmedetomidine (Group C). From anesthesia induction to the end of surgery, patients in Group D received intravenous infusions of 0.05–0.2 mcg/kg/min remifentanil and 0.2–0.7 mcg/kg/h dexmedetomidine. Patients in Group C received intravenous infusion of 0.05–0.2 mcg/kg/min remifentanil. Blood samples were collected from the patients 30 min before induction of anesthesia (T1), 30 min after removal of the aortic cross-clamp (T2), and at the end of the surgery (T3). Thiol-disulfide homeostasis (TDH) was assessed using a novel method. A novel automated method enables the determination of native thiols, total thiols and disulfides levels in plasma, allowing the calculation of their respective ratios. In patients receiving dexmedetomidine, lower postoperative levels of disulfide, disulfide/native thiol, and disulfide/total thiol, along with higher native thiol/total thiol, were observed compared to the control group. (p < 0.05) Postoperative native thiol and total thiol levels were similar for both groups. (p > 0.05) In our study, through dynamic thiol-disulfide measurements, we found that levels of oxidative stress (OS) were lower in patients who received dexmedetomidine. We believe that the positive effects of dexmedetomidine on OS could be beneficial in CABG surgery. Furthermore, we anticipate that with further studies conducted in larger patient cohorts, the clinical utilization of dexmedetomidine will become more widespread. NCT05895331 / 06.07.2023.