Regardless of the Puncture Angle, a Tuohy Needle with Sand-Blasted Steel at the Tip of the Bevel Is a Valid Needle on the Ultrasonic Images

Background: A high ability to visualize the needle on the ultrasonic images is necessary to perform the ultrasound-guided nerve block safely. The Rafa Tuohy needleR (Vygon, Paris, France, Rafa) is a non-stimulating Tuohy needle with sand-blasted steel at the tip of the bevel. We examined the degree to which the Rafa enhanced the visibility of ultrasonic images compared with the non-coated Tuohy needle. Methods: We punctured the Blue Phantom. The dimensions of both the Rafa and the non-coated Tuohy needles were 18 G × 80 mm. The puncture angle is 30 degrees and 45 degrees from the Blue Phantom. We measured the intensity of the tip of the bevel at a depth of 0.5, 1.0, 1.5 and 2.0 cm for the puncture angle of 30 degrees, and 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 cm for the puncture angle of 45 degrees. Six anesthesiologists with more than seven years of experience performed three punctures using each needle. Results: As an outcome, we concluded that at a puncture angle of both 30 degrees and 45 degrees, the intensity of the non-coated Tuohy needle decreased with the depth. On the other hand, at an angle of 30 degrees, the intensity of the Rafa needle did not decrease, and at an angle of 45 degrees the intensity only decreased very slightly as the depth increased. Conclusions: The Tuohy needle with sand-blasted steel at the tip of the bevel provided greater visualization than the non-coated Tuohy needle on the ultrasound images.

Erratum to “PECS Block Provides Effective Postoperative Pain Management for Breast Cancer Surgery—A Retrospective Study”, [International Journal of Clinical Medicine, 2017, 8, 198-203]

The original online version of this article (Ichikawa Yuki, Ueshima Hironobu, Hiroshi Otake, Akira Kitamura (2017) PECS Block Provides Effective Postoperative Pain Management for Breast Cancer Surgery—A Retrospective Study. International Journal of Clinical Medicine, 8, 198-203. https://doi.org/10.4236/ijcm.2017.83019) unfortunately contains some mistakes. The author wishes to correct the errors in pain management tools, method, and figures.

Erratum to “Regardless of the Puncture Angle, a Tuohy Needle with Sand-Blasted Steel at the Tip of the Bevel Is a Valid Needle on the Ultrasonic Images”, [Open Journal of Anesthesiology, 2016, 6, 101-104]

The original online version of this article (Ichikawa Yuki, Ueshima Hironobu, Hiroshi Otake, Akira Kitamura (2016) Regardless of the Puncture Angle, a Tuohy Needle with Sand-Blasted Steel at the Tip of the Bevel Is a Valid Needle on the Ultrasonic Images, 2016, 6, 101-104, https://file.scirp.org/Html/1-1920418_68780.htm) unfortunately contains some mistakes. The authors wish to correct the errors in co-authors, Table 1, and Table 2.

Focused Review: Efficacy of the Rector Spinae Plane Block

Since the original publication on the erector spinae plane (ESP) block in 2016, the technique of the ESP block has evolved significantly in the last few years. This review highlights recent developments in the technique for administering the ESP block and proposes directions for future research. Continuous efforts are being aimed at improving understanding regarding the administration of the ESP block. Current reports suggest that the ESP block provides effective analgesia in thoracic and abdominal sites in patients of all ages. However, no cohort studies or randomized controlled trials were performed in 2016 and 2017. The ESP block is an effective analgesic tool in a wide range of sites. However. We are uncertain how effective the ESP block is compared to other types of regional anesthesia. Therefore, more research on ESP blocks is required.

PECS Block Provides Effective Postoperative Pain Management for Breast Cancer Surgery—A Retrospective Study

We investigated the efficacy of ultrasound-guided pectoral nerves (PECS) block for modified radical mastectomy surgery retrospectively. Methods: We measured that pain scores and the use of additional analgesic drugs were recorded in the postoperative care unit within 24 hours after the operation. Postoperative complications (i.e., nausea and vomiting) were noted. Results: Patients who received the PECS block under general anesthesia (PECS group) reported lower visual analog scale pain scores at 0, 1, 2, 4, 6, 12, 24 hours after the operation than patients who did not receive PECS block under general anesthesia (control group). Moreover, the use of additional analgesic drugs during the first 24 hours after surgery was lower in the PECS group than in the control group. While in the postoperative care unit, the PECS group had less nausea and vomiting than the control group. Conclusion: The PECS block provides effective postoperative analgesia within the first 24 hours after breast cancer surgery.

New Tympanic Membrane Temperature Shows Good Correlation with the Esophageal Temperature <br/>—Accuracy of a Noncontact Continuous Tympanic Thermometer

Background: An ear-fitting thermometer probe “NIPRO CE THERMO?” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accuracy of the new CE thermo. In this time, the accuracy of the CE thermo was investigated. Methods: The correlation between the tympanic membrane temperature, measured using the new CE thermo, and the esophageal temperature of 30 patients (right ear: 16 patients, left ear: 14 patients) was measured in the prospective observational study. Results: A good correlation (r = 0.721) and no measurement error (within 1?C in mean ± 2SD) between the two temperatures were observed using Bland-Altman analysis. The correlation and measurement error for each ear yielded the same results. Conclusion: The tympanic membrane temperature, measured using the new CE thermo, showed good correlation with the esophageal temperature and could be used as a central temperature in the perioperative period.

Analgesic Efficacy of the Erector Spinae Plane (ESP) Block for Pneumothorax Surgery: A Retrospective Study

Background: Poor perioperative pain management during pneumothorax surgery leads to respiratory complications in the post-operative period. The erector spinae plane (ESP) block technique has been shown to be able to block the thoracic spinal nerves. Therefore, the ESP block may provide effective analgesic during thoracic surgery. We have retrospectively investigated the effectiveness of the ESP block for postoperative pain management in pneumothorax surgery. Patients and Methods: Patients who underwent pneumothorax surgery in 2017 were selected for the study. The primary outcome was assessed using the numeric pain rating (NRS) scales until the morning of the second post-operative day. The secondary outcomes were the cumulative amount of additional intravenous fentanyl administration until the morning of the second post-operative day. Results: This retrospective study included 29 patients who underwent pneumothorax surgery. Of these patients, 13 patients received only general anaesthesia (control group), while the other 16 patients received the ESP block in addition to general anaesthesia (study group). Compared to the control group, the study group did not show lower NRS scores at 1, 2, 4, 6, 12, and 24 hours post-surgery (P = 0.09, 0.17, 0.06, 0.36, 0.47, and 0.71). As for the cumulative amount of additional fentanyl, there were also no significant differences between the both groups. Conclusions: The ESP block could not provide effective analgesia for the 24 hours post-surgery period in patients undergoing pneumothorax surgery.

Pectoral Nerves (PECS) Block Is Effective for Motor Function Recovery in the Early Postoperative Period after Breast Cancer Surgery

Background: Pectoral nerves (PECS) block has been reported to be effective for a perioperative analgesia for breast cancer surgery. In addition, we may consider that the PECS block is also effective for motor function in postoperative period. Therefore, we investigated the effect of PECS block for motor function in postoperative period. Methods: This study selected the patients performed the breast cancer surgery between April and September, 2015. The study surveyed the difficulty of movement of the upper limbs at postoperative day 5 (D5) and postoperative month 6 (M6) by performing telephone survey. We counted the number of patients who complained of the difficulty of movement of the upper limbs. All results were compared using the chi- squared test. P < 0.05 was considered statistically significant. Results: 93 patients received only general anesthesia (G group). 85 patients received PECS block with general anesthesia (P group). The number of the P group at D5 was 2 patients. On the other hand, the number of the G group was 15 patients (P = 0.042). In the same way, the number of the P group M6 was no patient. On the other hand, the number of the G group was 10 patients (P = 0.043). Conclusion: A PECS block is effective for motor function recovery in the early postoperative period after breast cancer surgery.