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Literature on anesthetic management of juvenile myasthenia gravis (JMG) for thymectomy is limited. Recently, use of inhalational agents and total intravenous anesthesia with propofol and remifentanyl has been reported. All these techniques individually or in combination have been tried to avoid the use of muscle relaxant. We report successful use of sevoflurane as sole anesthetic agent for intubation and in combination with thoracic epidural anesthesia for intraoperative anesthetic management in a 5-year-old child with JMG.
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http://dx.doi.org/10.4103/0970-9185.130088 | DOI Listing |
The highly variable clinical presentations of sciatica, combined with cognitive biases, often lead to misattribution of the underlying pathology responsible for patient symptoms. Such limitations can contribute to significant diagnostic delays. Prioritizing systematic evaluation and maintaining vigilance against biases are critical for ensuring timely diagnosis and improving patient outcomes.
View Article and Find Full Text PDFFront Neurol
August 2025
Department of Mini-invasive Spinal Surgery, The Third People's Hospital of Henan Province, Zhengzhou, Henan, China.
Background: This study aimed to develop and validate the first nomogram model for predicting postoperative complications in thoracic spinal stenosis (TSS) patients undergoing unilateral biportal endoscopy (UBE), integrating multidimensional risk factors to provide a quantitative basis for preoperative risk evaluation and individualized treatment planning.
Methods: Patients were divided into a retrospective training cohort ( = 375) and a prospective validation cohort ( = 100). Baseline clinical data [age, diabetes, preoperative Japanese Orthopaedic Association (JOA) score], radiographic parameters (Spinal cord/canal area (SC/ECA) ratio, intramedullary high signal, thoracic kyphosis (TK) angle), and surgical variables (intraoperative blood loss, number of lesion segments, dural adhesion, etc.
Rev Esp Anestesiol Reanim (Engl Ed)
September 2025
Mch Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, India.
Background: It is crucial to assess a patient's quality of recovery after major surgery. This study aims to compare the effect of neuraxial morphine and bilateral erector spinae plane block on quality of recovery in the first 48 postoperative hours in patients undergoing open upper abdominal surgeries.
Methods: This prospective, triple-arm, randomized study was performed to compare the effect of neuraxial morphine (intrathecal morphine, thoracic epidural) and erector spinae plane block on postoperative recovery.
World J Methodol
December 2025
Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal 462024, Madhya Pradesh, India.
Background: Chest physiotherapy and incentive spirometry, essential for pulmonary care, can exacerbate acute post-thoracotomy pain. Pain relief is, therefore, essential to facilitate early mobilization. This study evaluated the analgesic efficacy of unilateral continuous erector spinae block (ESB) compared to thoracic epidural analgesia (TEA) in terms of quality of pain relief and perioperative hemodynamic changes.
View Article and Find Full Text PDFPain Med Case Rep
August 2025
Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA.
Background: Patients with connective tissue disorders (CTDs), such as Ehlers-Danlos syndrome, can present unique challenges in the management of spinal pathology and procedural complications due to underlying tissue fragility and susceptibility to dural ruptures. Thus, there is a need for less invasive diagnostic and therapeutic care in this population.
Case Report: We present a case of a 48-year-old woman with joint hypermobility who developed acute-on-chronic back pain and radicular symptoms.