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Spinal anesthesia (SA) is the preferred technique for cesarean section (CS), but variability in sensory block levels poses challenges. This variability becomes particularly prominent in pregnant women, and while the physiological changes of pregnancy are widely recognized contributors, local anesthetic (LA) properties and some technical factors are also responsible for these variations. Literature from 2015 to 2025 was reviewed on PubMed and Google Scholar to identify physiological, technical, and pharmacological factors responsible for spinal block characteristics in parturients. Pregnancy-related changes, e.g., reduced cerebrospinal fluid volume (CSF), technical factors (e.g., interspace misidentification), and drug baricity contribute to variability. A detailed understanding of the physiological changes of pregnancy, fine details of anesthetic technique, and pharmacological properties of medications used is important. Individualized techniques and adopting ultrasound guidance could enhance consistency. Further studies on CSF density and standardized protocols are warranted.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366537 | PMC |
http://dx.doi.org/10.7759/cureus.88429 | DOI Listing |
Ann Afr Med
September 2025
Department of Anaesthesiology, Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, India.
Background: Regional anesthesia techniques, such as unilateral spinal anesthesia and peripheral nerve blocks, are essential components of multimodal analgesia. Nonetheless, "rebound pain," an abrupt increase in nociceptive intensity following the cessation of the block, is inadequately defined and may compromise patient satisfaction and functional recovery.
Aims And Objectives: This study aimed to compare postoperative pain profiles, the incidence of rebound pain, and patient satisfaction following popliteal sciatic nerve block versus unilateral spinal anesthesia in elective foot surgeries.
Anaesthesia
September 2025
Department of Applied Health Sciences, School of Health Sciences, University of Birmingham, UK.
Introduction: Restoration of surgical capacity is essential to post-COVID-19 recovery. This study explored the use and safety of anaesthesia options for inguinal hernia surgery, a common tracer condition, to describe current global practice and highlight opportunities to build the capacity of health systems.
Methods: This is a secondary analysis of an international prospective cohort study of consecutive patients who underwent elective inguinal hernia surgery.
BJUI Compass
September 2025
Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia University of Foggia Foggia Italy.
Objective: To investigate the incidence, risk factors and clinical consequences of acute kidney injury (AKI) following mini-percutaneous nephrolithotomy (mini-PCNL), with particular focus on its association with postoperative infectious complications.
Materials And Methods: A retrospective analysis was conducted on 496 adult patients who underwent mini-PCNL (22 Ch) between February 2020 and April 2025. AKI was defined according to KDIGO criteria as either a ≥ 1.
J Pain Res
September 2025
Department of National Institute of Traditional Chinese Medicine Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Purpose: Intrathecal fentanyl improves intraoperative analgesia and reduces hypotension by enhancing subtherapeutic local anesthetic doses during cesarean sections. This study explores whether these advantages are affected by the negative circulatory effects of carbetocin after delivery.
Patients And Methods: This randomized double-blind, non-inferiority trial was conducted at a tertiary hospital in China.
BMC Anesthesiol
September 2025
Faculty of Medicine, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Tanta University, Tanta, El Gharbia, 31511, Egypt.
Background: Virtual reality (VR) has shown promise as a nonpharmacological alternative to pharmaceutical pain relievers and anxiety medications in clinical trials by decreasing pain and anxiety in orthopedic surgeries. The aim of the study was to evaluate the impact of VR on these outcomes in individuals undergoing total hip arthroplasty (THA).
Methods: This randomized, controlled, open-label research included 50 participants planned for THA with spinal anesthesia (SA).