Interfascial plane block of anterior and lateral cutaneous branches of intercostal nerves, known as pecto-intercostal fascial plane block (PIFB) and serratus--intercostal plane block (SIFB), is an anesthetic procedure for ribcage anesthesia not previously reported in the setting of critical care. A similar anesthetic technique has proven adequate pain control during and after abdominal and brea...

Perioperative stress and anesthesia are risk factors for exacerbation of Multiple Sclerosis (MS) attacks. Infection, emotional labiality and hyperpyrexia are also known to increase the risk of postoperative MS attacks. Appropriate preoperative evaluation, administration of a good premedication, control of fever, selection of the anesthetic agents and effective postoperative pain control can pre...

To the Editor:—We read with interest the case report published by Koff et al. and the editorial by Hebl. How can Dr. Hebl discuss the role that the use of an ultrasound may have played in this case? Ultrasound allows us to visualize the nerves and the spread of local anesthetic. From the authors’ description, it is clear that except for the use of 0.5% bupivacaine, the technique used to perform...

With recent advancements in clinical science, an increasing number of patients with congenital heart defects are surviving into adulthood and presenting for noncardiac surgeries. We describe one such example of a 26-year-old patient with corrected hypoplastic left heart syndrome presenting for knee arthroscopy and performed under general anesthesia with preoperative ultrasound guided saphenous ...

The wide range of patient responses to surgical pain, opioids, and anesthetic agents has puzzled anesthesiologists for many years. Much of the variation has been attributed to differences in patient size, technique, or prior drug use. However, recent genetic testing has revealed exciting clues into the basis for these variances, allowing us to start to predict which patients may have difficulti...

The use of truncal nerve blocks has been described since 2001. Since then, there have been many studies trying to understand the ideal clinical scenarios for its use. Since 2001, the transversus abdominis plane block has evolved in many ways including from landmark based technique to ultrasound guided and more recently, into the quadratus lumborum (QL) block. Its anatomical placement, concentra...