Block Technique Research Articles

A Modification of the Intraocular Lens Blocking Technique Without Posterior Capsulorhexis for Intraocular Foreign Body Removal.

The intraocular lens blocking technique described for the removal of intraocular foreign bodies emerged as a result of an effort to prevent the foreign body from being retracted into the posterior segment because of the resistance encountered while removing it from the corneal incision. However, in the technique described, in addition to the difficulty of the surgical procedure, the new concern is to create a posterior capsulorhexis according to the size of the foreign body and to pass the foreign body through the capsulorhexis. Here, the authors describe a new approach to the intraocular lens blocking technique. In this approach, the intraocular foreign body, which is held with intraocular forceps without any opening in the posterior capsule, is held in a perpendicular position to the long axis, lifted directly into the anterior chamber, and safely removed from the front of the monoblock foldable intraocular lens. In all patients treated with this approach, IOFBs were successfully removed without intraoperative or postoperative complications, and postoperative intraocular lens centralization was achieved in all patients. This approach may provide practicality to the intraocular lens blocking technique.

Effect of dural puncture epidural block technique on fetal heart rate variability during labor analgesia

Purpose To explore the effect of dural puncture epidural (DPE) block technique on fetal heart rate variability (HRV) during labor analgesia. Methods Sixty full-term primiparas who were in our hospital from April 2021 to October 2021 were selected and randomized into epidural analgesia (CEA) and dural puncture epidural analgesia (DPEA) groups (n = 30). After a successful epidural puncture, routine epidural catheter (EC) was performed in CEA group, and spinal anesthesia needle (as an EC) was used to puncture the dura mater to subarachnoid space in DPE group. Anesthetics were injected through EC. The time when the temperature sensation plane reached T10 (W1) and visual analog pain score (VAS), baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 were recorded. Apgar scores at 1 min, 5 min, and 10 min of neonates after delivery were recorded. Results The onset time of anesthesia in CEA group was significantly longer than that in DPEA group (p < .05). However, there are no significant differences in W1, VAS, baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 between the two groups (p > .05). Moreover, the Apgar scores at 1 min, 5 min and 10 min of neonates after delivery were not notably different between the two groups (p > .05). Conclusion Compared with CEA, DPE block technique in labor analgesia relieves maternal pain without adverse effects on fetal HRV and newborns.

Costoclavicular block – single to double injection – time to see the premiere of triple injection

Sir,Securing the phrenic nerve when achieving effective anesthesia block for the upper limb has been a topic intriguing regional anesthesia enthusiasts ever since. Interscalene brachial plexus block is known to involve the phrenic nerve in 100% of the cases and costoclavicular block which has gained momentum since 2015 is declared to involve the phrenic nerve in 0% of the cases. Besides this the compact, reliable topography of the cords in the triangular costoclavicular space along with an expedited sensorimotor block with local anesthesia deposited in the center of the three cords makes costoclavicular block an attractive option for elbow and below elbow surgeries. According to the studies, the success rate of the blockade is 92.5% with single injection in the center of the cords. Another study by Sebastian, where apart from classical single injection, another injection was given after redirecting the needle, between the medial cord and subclavian artery (labeling it a corner pocket technique) for costoclavicular block. They concluded that the block’s onset time and total anesthesia-related time were significantly shortened with the double injection technique compared with single injection. The basis of this was explanation laid by Dr. Monzo and Hadzic where they proposed in a series of 40 patients a linear septum arising from the lateral part of axillary artery separating the lateral code from the posterior and the medial code, thus compartmentalizing the costoclavicular space. They reported a success rate of 97.5% in their study on 40 patients.4 Hence,double injection is used to overcome the septum “issue.” Pornpatra is defined a high definition ultrasonographic presence of paraneural sheath and facial compartments surrounding the brachial plexus cords at the lateral infraclavicular fossa and the costoclavicular space. We propose that a triple injection with 3rd injection in the vicinity of the lateral cord just before withdrawing the needle apart from the other two injections significantly shortens the onset time of sensory block from 16 min to 9 min. The various sites for injection are shown in the figure below, but the exact point of injection of the second and third is more prominent after giving the first injection. The chances of the median nerve sparing as has been reported in some cases in previous studies are almost nil by this technique - the corner pocket injection that involves the medial root of the median nerve and the lateral cord that is specifically blocked separately covering the lateral root of the median nerve. CONCLUSIONWe did a case series in 15 cases and although the sample size is small and this is definitely not a randomized control trial, to make such a bold statement, we would like to decipher a positive future of the costoclavicular block with triple injection technique with an RCT already underway.

Comparison of Inferior Alveolar Nerve Block and Infiltration Anesthesia Techniques for Pain Control in Primary Mandibular Molar Extractions in pediatric patients

Comparison of Inferior Alveolar Nerve Block and Infiltration Anesthesia Techniques for Pain Control in Primary Mandibular Molar Extractions in pediatric patients

Investigation of the exact spin channels in laser-induced spin dynamics in two mononuclear Cu(II) complexes.

In the quest to harness the potential of nanospintronic applications, we analyze and investigate the spin channels for the ultrafast spin dynamics in mononuclear Cu2+(tdp)Cl2 (Cutdp) and Cu2+(tdp)Cl2·MeCN (Cutdp·MeCN) using a high-level ab initio many-body theory. In that spirit, we select two slightly different polymerizations arising from one parent complex. We establish the difference in magnetic behavior between the two complexes which arises solely from the geometrical differences. We calculate the static magnetic properties, such as the magnetic anisotropy of the complexes, which is analyzed by means of the magnetic moment of the ground state. The asymmetry of the core Cu-Cl-Cu-Cl axial plane unit is also reflected in the ground state absorption spectra of the two complexes. Comparisons with the experimental data are in good agreement with the exception of one peak in the theoretical calculations for each of the complexes, confirming the reliability of theoretical methods employed. A major finding in this work is the distinction between classical and coherent superpositions of Λ processes. We employ the selective blocking and retention (SBR) technique to find the unique path or paths for spin dynamic scenarios like spin flip and spin transfer. Additionally, we also present two different scenarios in which intermediate states are involved in spin dynamic processes, (i) classical superposition of Λ processes (i.e., there are many unique paths for transition, even with just one intermediate state the transition completes successfully), and (ii) collective coherent superposition of Λ processes (i.e., there is only one path for the transition, which requires more than one intermediate state to be in a specific coherent superposition). As a consequence, we gain insight into the type of correlations (static or dynamic) involved in a particular spin dynamic scenario.

"The Mediterranean and the Baltic Sea as historic backgrounds of a modern notion of resistance

The Anthropocene has proven to be an epoch that is shaped by protest and resistance. It therefore makes sense to approach an anthropology of resistance on the basis of historical examples. The historian and demonstrative anti-soldier Erdmann, the Danish journalist Bergstrøm and the Croatian Jew and resistance fighter Goldstein – each of them had to deal with ambivalence and repression during the German National Socialist occupation and ended up in the resistance. In contrast to the right-wing techniques of blocking and insulting that are common today, the three stood up for a humanistic and liberal form of resistance.

Surgical Treatment of the Bony Mallet Injuries with Augmented Extension Block Technique: Clinical Outcomes of a New Modification

Surgical Treatment of The Bony Mallet Deformity with Augmented Extension Block Technique: Clinical Outcomes of a New Modification Introduction: Mallet finger deformity is a common pathology and the ‘Extension Block Technique’, is one of the most popular surgical techniques for the treatment of this condition. However, several complications may occur with this method such as fixation failure, compression failure of the dorsal part and loss of reduction. In the current study, it is aimed to report the result of our modification which is augmented extension block technique. Materials &amp; Method: The medical records of patients, who were operated with the diagnosis of bony mallet finger between 2015 and 2021, were evaluated retrospectively. Demographic data, mechanism of trauma, duration of operation, time from injury to surgery, follow-up period, implant removal time, and postoperative complications were collected from hospital records. Patients aged between 18 - 65 years who had been operated with augmented extension block technique with a minimum follow-up period of 6 months were included in the study. A total of 10 patients who met these criteria constituted the study group. Radiological evaluation of the cases was performed with anteroposterior and lateral radiographs. Range of motion and presence of pain were questioned and these data were evaluated according to Crawford criteria. Results: The mean age of the all patients was 40.2 ± 10.9 (range, 24-56) years. The mean follow-up period was 39.6 ± 26.7 (range, 13-76) months. Complete union was achieved in all patients on the final follow-up radiographs. According to Crawford evaluation criteria, the results were ‘excellent’ in six of the patients and ‘good’ in four of them. There were no patients with loss of flexion however, 5° extension loss was observed in four of the subjects. Discussion: This study demonstrates that the augmented extension block technique is a suitable option for the surgical treatment of bony mallet cases with lower complication rate and successful functional results. This modification can be considered as an alternative option for traditional extension block technique which avoids some related complications as postoperative reduction loss, rotational instability and extension loss. Keywords: Mallet finger, Bony mallet, Extension Block

Plexo braquial e pontos para bloqueio anestésico em preguiça-real e preguiça-comum

ABSTRACT This study presents a macroscopic description of the brachial plexus in the royal sloth, Choloepus didactylus, and the common sloth, Bradypus variegatus, to identify the points for anesthetic block to perform surgical procedures. Six C. didactylus and nine B. variegatus had their forelimbs dissected, exposing the brachial plexus, and the points for blockage were located subsequently. In general, the formation of the brachial plexus in C. didactylus involved C5-T1 nerves, whereas the brachial plexus in a few individuals of the species involved C4-T2. In B. variegatus, the brachial plexus was contributed by C6-T2. In both species, the ramifications gave rise to three trunks that joined together to form a common brachial plexus trunk. In the brachial plexus block technique, four accesses were performed: supraclavicular, infraclavicular, axillary, and distal. The results of this study contribute to surgical and anesthetic procedures and research on comparative anatomy among wild animals.

Comparison of Four Different Block Techniques for Postoperative Analgesia in Thoracotomy

Comparison of Four Different Block Techniques for Postoperative Analgesia in Thoracotomy

Use of Loco-regional Anesthesia in Austere Environments: A Review by and for Special Forces Medics.

Special Forces increasingly operate in austere environments, which are known to have limited medical support and prolonged evacuation times. On the battlefield, pain remains the first complaint of casualties and can impact direct autonomic stability, recovery, and the development of posttraumatic stress disorder. Although medical education has been improving, medical providers still encounter difficulties, such as lack of human and material resources, while trying to achieve pain management. This article summarizes a survey sent to 35 Special Operations medical providers and suggests possible strategies to address challenges to pain management on the battlefield. Potential solutions have been gathered through medical texts, medical/NATO documents, and medical expertise. Nerves blocks have been identified as valuable tools for pain management in the current battlefield environment, where prolonged evacuation and limited freedom of movement are the norm. The survey showed that, although the vast majority of providers had already received lectures on regional anesthesia, 83% were not trained in it, and 54% had never been made aware of multimodal analgesia. This lack of familiarity highlights knowledge and training gaps in nerve block techniques. Diffusion blocks are a very low-risk, useful, and safe pain management technique, which requires less skill sustainment and resources than more complex techniques. The use of epinephrine as adjunct can be useful for decreasing local anesthetic toxicity and increasing long-term pain management. The need for both education on and training in the use of nerve blocks has been identified by the Special Operations health provider community.

Extra-articular blocking technique for acetabular bone defect reconstruction.

The acetabular bone defect reconstruction is of great challenge in total hip arthroplasty (THA). Although several solutions such as autologous bone grafting, trabecular metal augment, or compromising techniques such as the medial protrusion, high inclination angle, and elevated hip center have been raised, their efficacy and reliability have not been fully substantiated. Traditional reconstruction methods may lead to bone resorption, aggravation of bone defects, unequal length of lower limbs, unbalance of hip-spine relationship, increased costs, and so on. Our team proved a new technique named extra-articular blocking to resolve this problem. The extra-articular blocking technique was a simple, economic and effective acetabular reconstructive method to resolve the massive acetabular bone defect in congenital (especially for developmental dysplasia of the hip, DDH), inflammatory, and osteolytic pathologies. This article organized as surgical technique, aims to report the surgical principle, indication, and procedure of using extra-articular blocking technique. With this technique, we have successfully solved the difficult problem of acetabular bone defect reconstruction. We found after 3 months of the surgery, there were fluoroscopic healing and remodeling. And there were no bone loss or graft absorption until the last follow-up as evidenced by radiographic observation. The survival rate of the acetabular component was 100%, no radiolucent line, changes in inclination and anteversion of the shell, as well as migration of the rotation center were identified.

Diagnostic Utility of Cell block and Immunocytochemistry in Differentiating Malignant from Non-malignant Effusions: A Cross-sectional Study

Introduction: Cytological evaluation of body cavity fluids has been widely employed in diagnosing the underlying aetiology. Differentiating reactive mesothelial cell proliferations from metastatic malignant cells based on cytomorphology alone is challenging. Therefore, the use of cell blocks in conjunction with immunocytochemistry can significantly improve diagnostic accuracy. Aim: To investigate the role of cell blocks and immunocytochemistry in distinguishing malignant from non- malignant effusion fluids. Materials and Methods: A prospective cross-sectional study was conducted on 70 serous effusion fluid samples (ascitic and pleural fluids) received in the Cytology section of the Pathology Department from October 2021 to November 2022. Relevant clinical details, including demographic information, age, gender, presenting complaints, and radiological and laboratory investigations, were documented from the patients’ medical records. All fluids underwent conventional cytology, and the remaining fluid was used for cell block preparations. Immunocytochemistry was performed using Ber-EP4 and Calretinin immuno-markers to differentiate between reactive mesothelial cells and malignant cells. The association between cytosmear/cell block and immunocytochemistry was calculated using the chi-square test. Results: Out of the 70 cases, 44 were pleural fluids, and 26 were ascitic fluids. Conventional cytology identified 11 positive cases, 20 suspicious cases, and 39 negative cases for malignancy. However, after cell block examination, the total number of positive cases reduced to 9, suspicious cases decreased to 12, and negative cases increased to 49, resulting in a 14.3% increase in diagnostic accuracy. Immunocytochemistry using Ber-EP4 showed strong positivity in 12 cases, indicating epithelial malignancy (adenocarcinoma), while 9 cases were Ber-EP4 negative. Calretinin positivity was observed in the mesothelial cells of all 21 cases where immunohistochemistry was performed, resulting in a 17.5% increase in diagnostic accuracy. Conclusion: The combination of cell block technique with conventional cytology improves the diagnostic yield and accuracy by providing better interpretation of architectural patterns and cytomorphology. Additionally, the application of immunocytochemistry using Ber-EP4 and Calretinin aids in distinguishing malignant from non-malignant serous effusions.

A bibliometrics and visualization analysis of ropivacaine research from 2000 to 2023.

Bibliometric and data visualization methods were used to identify the current status, key areas, and emerging frontiers in ropivacaine research. We conducted a comprehensive search of the Web of Science database for publications related to ropivacaine published from 2000 to 2023. The publication types were limited to original articles and reviews. We utilized CiteSpace, VOSviewer, and the online bibliometric platform to visualize and analyze the collected data. A total of 4,147 publications related to ropivacaine were identified, with a consistent growth in annual publications over time. The United States emerged as the most influential country in the field of ropivacaine research, and ranked first in the annual number of publications until 2014. China surpassed the United States in the number of publications for the first time in 2015 and has remained in first place ever since. Of all the research institutions in the field of ropivacaine, University of Copenhagen in Denmark exhibited the highest impact. Brian M. Ilfeld and Casati A were identified as the most influential authors. The leading researchers in this field primarily focused their publications on continuous nerve blocks for postoperative analgesia and ultrasound-guided nerve block techniques. An analysis of reference co-citation clustering revealed 18 distinct research clusters, with current hotspots including erector spinae plane block, dexmedetomidine, quadratus lumborum block, labor analgesia, and mitochondrial respiration. Additionally, keywords analysis indicated that "dexmedetomidine as an adjuvant in nerve blocks" currently represents a research hotspot in the field of ropivacaine. This bibliometric analysis provides a comprehensive overview of the research landscape in ropivacaine. It reveals research trends in this field and emerging areas for future investigations. Notably, the application of ropivacaine in nerve blocks is a prominent focus in current research, with a particular emphasis on its combination with dexmedetomidine.

Arthroscopic Posterior Bone Block Technique for Posterior Shoulder Instability With Glenoid Bone Loss

Background: Posterior instability can be difficult to treat if there is associated bone loss and debate remains about the amount of bone loss that requires intervention. Indications: Arthroscopic posterior bone block technique is useful for recurrent posterior instability with bone loss. It is reserved for patients who have failed soft tissue stabilization with bone loss greater than 10%. Technique Description: After diagnostic arthroscopy, an anterior-superior portal is established. A 30° scope is utilized, although, a 70° scope can be used. The posterior labrum is elevated and dissection is carried along the posterior glenoid neck. If an anterior labral tear is encountered, labral repair is performed. The posterior glenoid is cleared to allow for bone block seating. A fresh, non-frozen distal tibial allograft is prepared to size. Fixation can include screw or button fixation. Other types of fixation can be utilized including tightrope-type fixation, but screws are our preference. We have not had any complications with screw fixation. The graft is predrilled and assembled to the delivery device. A posterior incision is made and dissection is carried under the capsule and labrum to allow for shuttling. The bone block is fixed using two 3.5-mm cannulated screws. After fixation, anchors are placed and remaining capsule and labrum are shifted up to overly the bone block. Postoperative immobilization can be utilized with a standard UltraSling or a gunslinger brace. We typically do not obtain a computed tomography (CT) scan prior to return to activity. Results: There is little literature on arthroscopic posterior bone block, but early results are promising. Distal tibia allograft use in anterior instability has good outcomes and rates of union. Open posterior procedures demonstrate a recurrent dislocation risk of 10%. Current literature supports a similar rate in arthroscopically. Furthermore, there is a learning curve. Complications are similar to open complications, including graft resorption, fixation failure, recurrent dislocation, continued shoulder pain, and glenohumeral arthritis. In our experience, we have not had any wound complications. Discussion/Conclusion: Arthroscopic posterior bone block augmentation presents a reliable technique for posterior instability with associated glenoid bone loss. The use of distal tibia allograft minimizes donor site morbidity. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Comparison of the Effects of Adductor Canal and Femoral Nerve Blocks on Postoperative Opioid Consumption and Inflammatory Factor Levels in Elderly Patients After Total Knee Arthroplasty: A Prospective Observational Study.

Total Knee Arthroplasty (TKA) is a highly invasive procedure causing severe postoperative pain, which hampers early mobility. Effective pain management is crucial for optimal recovery. This study aimed to evaluate how adductor canal block (ACB) and femoral nerve block (FNB) affect opioid use and inflammation factor levels in elderly TKA patients. This prospective observational study included 120 patients who received TKA, and divided them into three groups, based on the different nerve block technique: ACB, FNB, and no intervention before general anesthesia (CON). Postoperative opioid consumption, pain assessment, inflammation factor, knee function recovery and other clinical indicators were recorded. The CON group had significantly higher cumulative sufentanil consumption compared to the ACB and FNB groups at both 12 h and 48h postoperative (P<0.001). Compared with the CON group, the ACB and FNB groups persistently had lower pain scores until 12 h at rest and 24 h during motion after surgery. The ACB group showed significantly lower serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) compared to the CON group at 24 h postoperative (P=0.017, P=0.009), and IL-6 levels remained significantly lower at 72 h postoperative (P=0.005). Both ACB and FNB groups achieved earlier ambulation compared to the CON group (P=0.002). On the first day postoperative, both the ACB and FNB groups showed significantly better knee motion (P<0.001), quadriceps strength (P<0.001), and daily mobilization (P<0.001) compared to the CON group. Additionally, the ACB group exhibited superior quadriceps strength (P<0.001) and daily mobilization (P<0.001) compared to the FNB group. The ACB and FNB groups exhibited comparable clinical efficacy outcomes in terms of pain scores and opioid consumption. However, the ACB group experienced reduced postoperative inflammation and improved knee recovery, especially in quadriceps strength.

Application of Exact Femoral Nerve Block Technique in Patella Fracture Anesthesia and Postoperative Analgesia

Application of Exact Femoral Nerve Block Technique in Patella Fracture Anesthesia and Postoperative Analgesia

A Comparative Study between Dexmedetomidine, Clonidine and Fentanyl as Adjuvants to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Introduction: Supraclavicular brachial block is a popular and widely used nerve block technique for perioperative anesthesia and analgesia for upper extremity surgery. The block is performed at level of distal trunks and the origin of divisions, where the brachial plexus is confined to its smallest surface area, thus producing a rapid and reliable block of the plexus. It is the popular technique of anesthesia for upper limb surgeries due to its effectiveness in terms of performance, cost, margin of safety and good post-operative analgesia. It provides rapid onset, dense upper limb anesthesia with a single injection. Materials and Methods: About 90 patients who underwent elective upper limb Orthopaedics surgery during the period of the study were randomly divided into three equal groups of participants each using a computer-based random number generator, i.e., group C, D and F. They were compared for the onset and duration of motor and sensory block and post operative analgesia. Results: Mean onset of sensory and motor block was minimum for fentanyl (7.13 ± 0.94, 9.77 ± 0.82 minutes) followed by dexmedetomidine (7.37 ± 1.06, 11.33 ± 1.61 minutes) and clonidine (8.73 ± 0.98, 12.23 ± 1.57 minutes). Duration of block amongst the three groups showed statistically significant difference, dexmedetomidine (585.13 ± 44.42, 546.07 ± 42.02 minutes) having maximum duration of sensory and motor block followed by clonidine (535.77 ± 32.11, 507.30 ± 33.59 minutes) and minimum for fentanyl (330.03 ± 44.25, 284.67 ± 59.96 minutes). Conclusion: We concluded that adding fentanyl to bupivacaine for supraclavicular brachial plexus block had a faster onset of sensory and motor blockade when compared to dexmedetomidine and clonidine, and dexmedetomidine prolonged the duration of analgesia when compared with clonidine and fentanyl.

Multidisciplinary Approach for Treating Vertical Ridge Defect: Case Report

Background: The outcomes of trauma may have a ridge defect, and it would be hard to replace it with a simple dental implant treatment technique. In some cases, horizontal and vertical bone augmentation therapy is needed for implant placement. Case presentation: The case report described a 24-year-old female diagnosed with a severe bony defect and was managed in collaboration with an orthodontic and periodontic treatment plan. Alveolar bone augmentation was approached using Misch&amp;apos;s fashion, an autogenous block graft harvested from intra-oral (ramus). Moreover, Khoury&amp;apos;s split bone block technique was applied to reconstruct the seat. Conclusion: For complicated abnormalities, autogenous bone is still the best choice. Autogenous bone is the gold standard for bone grafting due to its biocompatibility, absence of antigenicity, and osteoconductive and osteoinductive qualities. Further graft extenders or growth factors may result in better outcomes.

Detection of Circulating Tumor Cells by Cell Block Technique in Malignant Tumors.

Cancer is a leading cause of death worldwide and is a major cause of morbidity. To deal with this magnitude of cancers and their diagnostic and prognostics, a multitude of prognostic biomarkers for various cancers have been explored over the decades, with detection of circulating tumor cells (CTCs) in the peripheral blood being one of them. This study was undertaken to explore the routine procedure of cell block in the cytopathology lab to isolate and detect CTCs. In this cross-sectional study, 112 peripheral blood samples sent for routine blood investigations of various cancer patients were utilized for the preparation of cell block. The sections from the cell block were stained routinely and evaluated for the presence of CTCs. The statistical analysis was done using Mac Statplus software version 8.0. The malignancies were tabulated as per the International Classification of Diseases for Oncology, third edition (ICD-O-3). The maximum number of cases were from C 50 (breast) - 41/112 (36.6%), followed by C15-C26 (Digestive organs) - 19/112 (16.9%), and C00-C14 (lip, oral cavity, and pharynx) - 18/112 (16.07%) cases. CTC was detected in six (5.35%) out of 112 cases, out of which three were from the breast and one each from category C6.9 (mouth), C32.0 (glottis), and C53.8 (cervix uteri). Among various advanced and molecular techniques available for the detection of CTCs, the cell block technique proves to be one of the effective methods, especially in resource-limited settings as these can further be utilized for additional diagnostic techniques similar to the ones employed for routine paraffin blocks.

Effect of regional block technique on postoperative high-grade complications according to Clavien-Dindo classification in elderly patients with thoracic and abdominal cancer: a retrospective propensity score matching analysis.

Postoperative complications have an influence on postoperative rehabilitation, length of hospital stay and hospitalization expenses in elderly patients, especially those with higher Clavien-Dindo (C-D) classification. Patients with cancers often experience more serious postoperative complications after surgery. Different anesthesia methods can affect the postoperative outcomes of cancer patients. Regional block techniques have been recommended in guidelines for enhanced recovery after surgery. However, the relationship between regional blocks and high-grade postoperative complications remains unclear, thus, the study explored the relationship between regional block techniques and high-grade postoperative complications graded by C-D classification in elderly patients with thoracic and abdominal cancer. Retrospective enrollment of eligible elderly patients admitted to Peking University People's Hospital between January 2018 and March 2022 was conducted. Propensity score matching (PSM) and univariate and multivariate regression analyses were used to analyze the potential benefits of regional blocks for elderly patients in real world practice. A total of 2769 patients were enrolled in this study, including 568 who underwent colorectal resection, 2201 who underwent video-assisted thoracoscopic pneumonectomy. Among them, 2033 patients received regional block, while 736 patients did not. Statistical analysis indicated that regional blocks could reduce the incidence of postoperative complications of C-D classification Grade II or higher, with an Odds ratio (OR) of 0.742, 95% Confidence interval (CI) (0.552 to 0.996) (P = 0.047). Regional block is associated with a reduction in the occurrence of postoperative complications graded by C-D classification in elderly patients with thoracic and abdominal cancer. The application of regional blocks can lower the risk of high-risk complications and mortality.