Efficacy of Continuous Lumbar Plexus Blockade in Managing Post-Operative Pain after Hip or Femur Orthopedic Surgeries: A Systematic Review and Meta-Analysis.

Background: Post-operative pain management is essential for optimizing recovery, patient comfort, and satisfaction. Peripheral nerve blockade, or lumbar plexus block (LPB), has been widely used for analgesia and regional anesthesia. This study explored the existing literature to determine the efficacy of continuous lumbar plexus blockade in managing post-operative pain following hip or femur surgery. Methods: Reviewers comprehensively searched electronic databases to identify peer-reviewed scholarly articles reporting the efficacy of lumbar plexus block in managing post-operative pain after orthopedic surgery. The potential articles were carefully selected and assessed for the risk of bias using the Cochrane Collaboration Risk of Bias assessment tool. Data were systematically extracted and analyzed. Results: The literature search yielded 206 articles, 20 of which were randomized controlled trials. Lumbar plexus block demonstrated superior pain relief compared to conventional pain management approaches like general anesthetics. In addition, LPB reduced patients' overall opioid consumption compared to controls, reduced adverse effects, and enhanced functional recovery, which underlines the broader positive impact of meticulous pain management. More patients could walk more than 40 feet after the second day post-operatively among the lumbar plexus group (14.7%) compared to the continuous femoral group (1.3%). Other parameters, including cortisol levels and hemodynamic stability, were evaluated, showing comparable outcomes. Conclusions: Lumbar plexus block is effective in pain management after orthopedic surgery, as shown by the lower pain scores and less opioid consumption. Additionally, patient satisfaction was relatively higher in LPB-treated patients compared to other approaches like general anesthesia.

Osteochondrolipoma of the foot treated by surgical excision: a case report and literature review.

BACKGROUND: Osteochondromas, classified as a new benign subtype of lipomas and characterised by chondroid and osseous differentiation, are rare lesions that have been infrequently reported in previous literature. The maxillofacial region was reported as the most frequent localization, with infrequent occurrence in the lower limb. This paper represents the first documented case report of osteochondrolipoma in the foot. CASE PRESENTATION: A 51-year-old male patient presented with a chief complaint of right foot pain at the plantar aspect, accompanied by the observation of swelling between the first and the second metatarsal shafts. His complaint of pain and swelling started 10 and 4 years prior, respectively. Since their onset, both symptoms have progressed in nature. Imaging revealved a large mass exhibiting a nonhomogenous composition of fibrous tissue and bony structures. Surgical intervention through total excision was indicated. CONCLUSION: Osteochodrolipoma is a benign lesion that can affect the foot leading to decreased functionality of the foot due to the pain and swelling. Surgical excision is the recommended approach for this lesion, providing both symptomatic relief and confirmation of the diagnosis through histopathological examination.

The Impact of the COVID-19 Pandemic on Coronary Interventional Cardiology Activity in King Abdulaziz Medical City: A Retrospective Study.

BACKGROUND: The COVID-19 pandemic has decreased the number of patients undergoing coronary interventional procedures. This study aimed to identify the impact of the COVID-19 pandemic on the volume of patients and the types of interventional cardiology procedures performed at King Abdulaziz Cardiac Center (KACC) in Riyadh, Saudi Arabia. METHODS: A retrospective chart review was undertaken with a sample size of 301 patients aged over 18 years, who underwent various cardiac interventions at King Abdulaziz Cardiac Center (KACC) between March 15, 2019, and February 29, 2020 (prior to the pandemic, group A), and between March 1, 2020, and March 15, 2021 (during the pandemic, group B). The BESTCare 2.0 system (ezCaretech, Seoul, South Korea) was used to collect data, Microsoft Office Excel (Microsoft® Corp., Redmond, WA) was utilized for data entry, and the Statistical Package for Social Sciences software (IBM SPSS Statistics, Armonk, NY) was employed for data analysis. RESULTS: There was a 21.4% decrease in the number of procedures performed during the pandemic. The largest age group within the population was ≥60 years, comprising 43.5% and 52.3% of groups A and B, respectively. Most patients had a body mass index (BMI) of >30, i.e., 43.5% of patients before the pandemic and 47.7% after the pandemic. In group A, 39.9% were smokers and 60.6% in group B. The prevalence of hypertension and obesity was higher in group B, i.e., 77.3% and 42.3%, respectively. The incidence of ST-elevation myocardial infarction (STEMI) was 39.9% in group A and 39.4% in group B. For non-ST-elevation myocardial infarction (NSTEMI), the comparable statistics were 56.5% and 49.2%, respectively. In groups A and B, readmission frequencies were 17.9% and 20%, respectively. CONCLUSION: The study indicates a minor decline in the number of percutaneous coronary interventions (PCIs) conducted in the interventional cardiology department of King Abdulaziz Cardiac Center (KACC) immediately following the COVID-19 outbreak, reflecting a steady activity in the center.