[Experimental] List of manuscripts available for review volunteers
3 manuscripts available for review volunteers
October 31, 2017

Background

The transversus abdominus plane (TAP) block provides analgesia for abdominal wall incisions and reduces post operative opioid consumption. However, the pharmacokinetics of local anesthestics in children receiving this block remain understudied. Bupivacaine has been the local anesthetic used to perform TAP blocks in most studies published to date. The aim of this study was to establish the population pharmacokinetics of bupivacaine following single dose TAP block administration in children and to investigate the influence of patient covariates on drug disposition.

Methods

Following Research Ethics Board approval and parental/patient consent, 20 ASA I-III children over 3 months of age undergoing elective surgery with a scheduled TAP block were recruited into this observational study. After general anesthesia was induced, children received an ultrasound-guided TAP block with 0.25% bupivacaine with epinephrine 1:200 000. Venous blood samples were drawn at predetermined times using a population pharmacokinetic (PK) protocol following the TAP block.

Results

20 children were included in the study. The mean serum bupivacaine level was 0.58 mcg/l occurring 30 minutes following administration of local anesthetic. There was wide inter-patient variability and age was a major covariate. There were no adverse events.

Conclusions

The main finding of this study is that serum bupivacaine levels were below the toxic level after single-injection TAP block in children undergoing surgical procedures. The major covariate was patient age.

October 27, 2017
Background. Studies on the method of treatment of condylar fractures (CFs) are still timely and important. Despite many publications published in this area there are many controversies about how to treat these fractures. The aim of this review was to present and discuss the current views on the treatment of condylar fractures (CFs). The authors address the following issues: the etiology, epidemiology and mechanisms of CFs; the strategies and methods for the treatment of CFs. Moreover, the choice of surgical approach for the open treatment of CFs as well as techniques and materials used for fixation of CF are discussed. Methods. The scientific database PubMed was used to search for relevant articles published between 2000 and 2016. The following search terms were used: “Mandibular condylar fractures”, “Mandibular condylar process”, ”Mandibular trauma”, “Mandibular condyle fracture treatment”. The analysis referred to both original and review papers (including meta-analyses) that concerned adult patients. The case reports and conference proceedings were excluded from the analysis. Results. There are still differences in opinions among researchers regarding the choice of appropriate treatment - closed or open. There is no consensus among open treatment supporters in the context of choosing the right surgical approach. Important question is which material to choose for osteosynthesis of condylar fracture. Discussion. The recent studies show satisfactory results in terms of stability of condylar osteosynthesis with the use of 3D plates. When seeking an optimal technique of condylar osteosynthesis, one should take into consideration not only the biomechanical aspects, but also the effects of implants on organism, in particular on cellular, humoral and vascular mechanisms responsible for the inflammatory response. In the future, further discussion is required on the choice of the type of material for fixation of condylar fracture and, in particular, on the possibility of using resorbable materials. With the development of virtual surgical planning techniques as well as the increasing use of individual implants, it is possible to use these methods in the future for surgical treatment of condylar fractures.
October 24, 2017

Background: Patellofemoral pain is often reported as a diffuse pain at the front of the knee during knee-loading activities. A patient’s description of pain location and distribution is commonly drawn on paper by clinicians, which is difficult to quantify, report and compare within and between patients. One way of overcoming these potential limitations is to have the patient draw their pain regions using digital platforms, such as personal computer tablets.

Objective: To assess the validity of using computer tablets to acquire a patient’s knee pain drawings as compared to paper based records in patients with patellofemoral pain.

Methods: Patients (N=35) completed knee pain drawings on identical images (size and color) of the knee as displayed on paper and a computer tablet. Pain area expressed as pixel density, was calculated as a percentage of the total drawable area for paper and digital records. Bland-Altman plots, Pearson’s correlation coefficients and one-sample tests were used in data analysis.

Results: No significant difference in pain area was found between the paper and digital records of mapping pain area (mean difference (95%CI; p) = 0.002% (-0.159 to 0.157; P=0.98)). A strong linear correlation (R2=0.870) was found for pain area and the limits of agreement show less than ±1% difference between paper and digital drawings.

Conclusion: Pain drawings as acquired using paper and computer tablet are equivalent in terms of total area of reported knee pain. The advantages of digital recording platforms, such as, quantification and reporting of pain area, could be realized in both research and clinical settings.

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