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Introduction: Volume Controlled Ventilation (VCV) is traditionally used during One Lung Ventilation (OLV); however, it is associated with complications such as volutrauma and barotrauma. On the other hand, Pressure Controlled Ventilation (PCV) allows the delivery of a required tidal volume at lower airway pressures, leading to enhanced oxygenation and ventilation. Aim: To compare VCV and PCV modes for OLV in patients undergoing surgery for empyema thoracis. Materials and Methods: A randomised controlled trial was conducted among 50 patients requiring OLV. The participants were divided into two groups, namely Group-V and Group-P, with each group receiving VCV and PCV, respectively. The two groups were compared based on the partial pressure of oxygen (during the intraoperative and post-operative period), peak and plateau airway pressures, lung compliance, and complications. The groups were analysed using the Chi-square test, and the threshold of statistical significance was set at a p-value <0.05. Results: Fifty participants were divided into two groups: VCV (n=25) and PCV (n=25). Both study groups were found to be comparable in terms of demographic details, haemodynamic parameters, and duration of surgery. The mean age of the patients was 27.80 years in Group-V and 31.04 years in Group-P. The authors observed improved PaO2 levels, lung compliance, and reduced peak pressures during OLV in the PCV group. After lung isolation, PaO2 levels of Group-P patients (93.64±5.154 mmHg) were higher compared to Group-V (81.38±7.975 mmHg) at 50% FiO2 (p-value <0.001). Similarly, post-extubation PaO2 levels were better in Group-P (99.24±18.58 mmHg) than in Group-V (84.35±7.677 mmHg) at 36% FiO2 (p-value <0.001). The mean peak pressures were lower in Group-P (25.17±4.34 cm H2O) than in Group-V (28.22±4.51 cm H2O). Additionally, there was a statistically significant improvement in lung compliance among Group-P patients (p-value=0.0144). Conclusion: Thus, it can be inferred that PCV improves oxygenation and reduces airway pressures during OLV. However, there was no significant difference seen between the two modes in terms of post-operative pulmonary complications. [ABSTRACT FROM AUTHOR]

Background: Lumbar spine surgery is associated with a significant degree of moderate-to-severe perioperative pain which can be alleviated by using different pain-relieving modalities; of these, erector spinae plane block and intrathecal morphine have promise., Purpose: To compare the analgesic efficacy between intrathecal morphine (ITM) versus erector spinae plane block (ESPB) for perioperative analgesia in patients undergoing lumbar spine surgery., Method: A total of 74 patients aged between 20 and 65 years of either sex were posted for elective lumbar spine surgery. Patients were divided into two groups: Group A patients received 0.3 mg intrathecal morphine and Group B received bilateral erector spinae plane block at L3 level by using 30 mL of 0.5% ropivacaine before starting the surgery for perioperative analgesia. In the perioperative period, pain was assessed by hemodynamic parameters (heart rate and mean arterial pressure), numeric rating scale (NRS), and patient satisfaction score.  Result: The difference in heart rate and mean arterial pressure was found to be statistically significant between groups at three, six, 12, and 24 hours (p<0.05). The patients who required rescue analgesia in Group A and Group B were 23 (62.2%) and 37 (100%) patients in the first 24 hours. The rate of complication was higher in Group A than in Group B (45% vs 5.4%). The patient satisfaction score was found to be better in Group A than in Group B., Conclusion: Intrathecal morphine provides more substantial and extended analgesia up to 48 hours postoperatively as compared to erector spinae plane block., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King George's Medical University Institutional Ethics Committee issued approval XV-PGTSC-ⅡA/P43. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Lal et al.)

Background: A side effect of spinal anesthesia is post-dural puncture backache (PDPB), which is characterized by ongoing discomfort at the location of the spinal puncture without any radicular pain. This study aims to compare the incidence and severity of post-dural puncture back pain following spinal anesthesia by median versus paramedian technique in obese female patients., Methods:  A prospective randomized comparative study on 120 female patients, aged 20-50 years with a BMI of 30-40 kg/m 2 and American Society of Anesthesiologists physical status II, scheduled for elective surgery under spinal anesthesia, was included in the study. Patients were randomly divided into two groups, with 60 patients in each group. Group P uses the paramedian approach for spinal anesthesia, and group M uses the midline approach for spinal anesthesia., Results: Low back pain incidence was lower in group P than in group M at seven days, but at one month and after, its incidence remained the same in both groups. No difference in the severity of pain was observed., Conclusions: The occurrence of back pain in the first seven days of surgery was significantly more frequent with the median approach. The pain severity decreased as the time passed from day seven to three months of follow-up. There is no difference in the severity of pain with either approach at different intervals., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mishra et al.)