Not just a matter of weight: A case report of ECMO treatment in a severely obese patient.

The ELSO Guidelines list a BMI ≥ 40 kg/m2 among the relative contraindications to give ECMO treatment in SARS - COV2 patients. We describe a case of a 52-year-old with BMI 50.21 kg/m2, admitted to the intensive care unit (ICU) with severe respiratory conditions and successfully treated with extracorporeal membrane oxygenation (ECMO). The application of veno-venous (VV) ECMO will evolve as far as we understand the pathophysiology of the COVID-19 disease and will probably have a determinant role in management of patient with refractory hypoxemia, whose ventilation management is difficult, even in case of severe obesity.

Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial.

The pericapsular nerve group (PENG) block is a novel regional anaesthesia technique that aims to provide hip analgesia with preservation of motor function, although evidence is currently lacking. In this single-centre, observer-masked, randomised controlled trial, patients undergoing total hip arthroplasty received pericapsular nerve group block or no block (control group). Primary outcome measure was maximum pain scores (0-10 numeric rating scale) measured in the first 48 h after surgery. Secondary outcomes included postoperative opioid consumption; patient mobilisation assessments; and length of hospital stay. Sixty patients were randomly allocated equally between groups. The maximum pain score of patients receiving the pericapsular nerve group block was significantly lower than in the control group at all time-points, with a median (IQR [range]) of 2.5 (2.0-3.7 [0-7]) vs. 5.5 (5.0-7.0 [2-8]) at 12 h; 3 (2.0-4.0 [0-7]) vs. 6 (5.0-6.0 [2-8]) at 24 h; and 2.0 (2.0-4.0 [0-5]) vs. 3.0 (2.0-4.7 [0-6]) at 48 h; all p < 0.001. Moreover, the pericapsular nerve group showed a significant reduction in opioid consumption, better range of hip motion and shorter time to ambulation. Although no significant difference in hospital length of stay was detected, our results suggest improved postoperative functional recovery following total hip arthroplasty in patients who received pericapsular nerve group block.