Unlocking the Power of Curiosity: How a Curious Mind Drives Innovation and Personal Growth

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Unlocking the Power of Curiosity: How a Curious Mind Drives Innovation and Personal Growth

The Innate Spark: Why We Are Wired for Curiosity

From the moment we are born, humans possess an insatiable drive to explore, question, and understand the world around us. This innate spark, this unyielding curiosity, is not merely a fleeting childish trait but a fundamental aspect of our cognitive architecture. It’s the engine that propels us to touch, taste, and examine, to ask “why?” and “how?” relentlessly. This natural inclination to seek new information and experiences is the bedrock of learning and development, shaping our understanding of everything from the simplest objects to the most complex phenomena. Think about a toddler’s fascination with a spinning top or a child’s endless barrage of questions about the stars – these are early manifestations of a powerful force. This inherent drive is crucial for our survival and evolution, allowing us to adapt to new environments, solve problems, and discover opportunities. Without this fundamental human trait, progress, both individual and societal, would be virtually impossible. It’s this primal urge that pushes us beyond the familiar and into the realm of the unknown, where true discovery and understanding reside.

Curiosity as the Catalyst for Innovation

Innovation, in its truest sense, is born from a fertile ground of curiosity. It’s the relentless questioning of the status quo, the desire to find a better way, a more efficient solution, or a novel approach. Every groundbreaking invention, every revolutionary idea, started with someone asking “What if?”. Imagine the early humans observing the flight of birds and wondering if they could replicate it. This wasn’t just idle observation; it was a deeply curious mind seeking to understand and harness a natural phenomenon. This same spirit fuels modern-day scientists, engineers, artists, and entrepreneurs. They are not content with what is; they constantly probe the boundaries of what could be. This proactive engagement with the unknown allows them to identify gaps, challenge assumptions, and ultimately create something entirely new. The history of human achievement is a testament to the power of curiosity to disrupt, to transform, and to elevate. It’s the driving force behind scientific breakthroughs, artistic masterpieces, and technological advancements that have shaped our world.

Nurturing Your Inner Explorer: Cultivating a Curious Mindset

While curiosity may be innate, its flame can sometimes flicker and fade under the weight of routine, fear of the unknown, or societal pressures to conform. The good news is that a curious mindset is not a fixed trait; it’s a skill that can be actively cultivated and strengthened. The first step is simply to embrace the unknown with an open mind and a willingness to learn. This means actively seeking out new experiences, even those that might initially feel uncomfortable or challenging. Reading widely across diverse subjects, engaging in conversations with people from different backgrounds, and exploring unfamiliar territories – be it geographical or intellectual – are all powerful ways to feed your curiosity. Don’t be afraid to ask questions, even if they seem simple or obvious. Embrace the “beginner’s mind” and approach every situation as an opportunity to learn something new. Furthermore, cultivate a habit of reflection. Take time to ponder what you’ve learned, how it connects to other knowledge, and what new questions it sparks. This internal dialogue is crucial for deepening understanding and fostering a more inquisitive outlook.

The Ripple Effect: How Curiosity Fuels Personal Growth and Fulfillment

The benefits of a curious mind extend far beyond the realm of innovation and discovery; they profoundly impact our personal growth and overall sense of fulfillment. When we approach life with curiosity, we are more engaged, more adaptable, and more resilient in the face of challenges. The world becomes a playground of possibilities rather than a series of obstacles. This continuous learning process keeps our minds sharp, enhances our problem-solving abilities, and broadens our perspectives. It allows us to understand ourselves and others on a deeper level, fostering empathy and stronger relationships. Moreover, curiosity is intrinsically rewarding. The joy of discovery, the satisfaction of understanding, and the thrill of learning something new contribute significantly to our happiness and well-being. It’s a continuous journey of self-improvement and a powerful antidote to boredom and stagnation. In essence, a curious mind is a vibrant mind, one that embraces life’s complexities with enthusiasm and finds continuous wonder in the everyday. For those seeking to actively engage with new opportunities and information, exploring resources for **jojobet giriş** can be a part of this broader exploration of the digital landscape, offering a gateway to various online activities and information streams. This exploration, much like any other pursuit of knowledge or entertainment, thrives on a curious and open approach.

Ultrasound Guided Peripheral Nerve Block For Lower Limb Fracture Fixation In A Patient With Hypertrophied Obstructive Cardiomyopathy (HOCM)

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Vol 5 | Issue 2 | July-December 2024 | Page 10-12| Pratik Bhange, Shruti Patil, Deepali Thakur

DOI: https://doi.org/10.13107/ijra.2024.v05.i02.96

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted: February 02-07-2024; Reviewed: 01-08-2024; Accepted: 22-07-2024; Published: 10-12-2024

Authors: Pratik Bhange [1], Shruti Patil [1], Deepali Thakur [1]

[1] Department of Anaesthesiology, LTMMC & GH, Mumbai, Maharashtra, India

Address of Correspondence

Dr. Pratik Bhange,
Department of Anaesthesiology, LTMMC & GH, Mumbai, Maharashtra, India
E-mail: pratikbhange96@gmail.com

Abstract

The presentation of hypertrophic obstructive cardiomyopathy may vary from an asymptomatic patient to sudden death. The changes in preload, afterload and ventricular contractility may occur due to surgery, anaesthesia and fluid shifts in the perioperative period. This causes worsening of the left ventricular outflow tract obstruction, ultimately causing myocardial ischemia and cardiac dysrhythmias. This case discusses successful anaesthesia management of a 49-year-old male with hypertrophic obstructive cardiomyopathy operated for tibia and fibula open reduction, internal fixation using ultrasound-guided sciatic and femoral nerve block. Transthoracic Echocardiography served as an additional monitoring modality to assess cardiac function intraoperatively. The patient underwent successful surgery with stable hemodynamics and reported excellent pain relief postoperatively.
Keywords: Hypertrophic obstructive cardiomyopathy, Transthoracic Echocardiography, Peripheral nerve block

References

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How to Cite this Article: Bhange P, Patil S, Thakur D | Ultrasound Guided Peripheral Nerve Block For Lower Limb Fracture Fixation In A Patient With Hypertrophied Obstructive Cardiomyopathy (HOCM) | International Journal of Regional Anaesthesia | July-December 2024; 5(2): 13-15 | DOI: https://doi.org/10.13107/ijra.2024.v05.i02.96

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Genomics and Precision Analgesia: Is this the era?

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Vol 6 | Issue 1 | January-June 2025 | Page 15-19 | Bhuvaneswari Balasubramanian, Sandeep Diwan

DOI: https://doi.org/10.13107/ijra.2025.v06.i01.116

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 24-02-2025; Reviewed: 19-03-2025; Accepted: 19-05-2025; Published: 10-06-2025

Authors: Bhuvaneswari Balasubramanian [1]

 Sandeep Diwan [2]

[1] Department of Anaesthesiology & Critical Care, AIIMS, Nagpur, Maharashtra, India.
[2] Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India.

Address of Correspondence

Dr. Bhuvaneswari Balasubramanian
Department of Anaesthesiology & Critical Care, AIIMS, Nagpur, Maharashtra, India.
Email: docbhuvaneswari@gmail.com

Abstract

Interindividual variability in analgesic response reflects heritable differences in drug metabolism, receptor expression, neurotransmitter turnover, and central nervous system drug transport. Pharmacogenomic advances have clarified functional consequences of polymorphisms in CYP2D6, CYP3A4, UGT2B7, OPRM1, COMT, and ABCB1, each of which influences opioid and non-opioid pharmacokinetics and pharmacodynamics. CYP2D6 metabolizer status determines conversion of prodrugs such as codeine and tramadol to active metabolites, while CYP3A4 variation modulates systemic opioid clearance. OPRM1 A118G alters μ-opioid receptor binding affinity and signaling, COMT Val158Met influences catecholamine-mediated pain sensitivity, and ABCB1 variants affect opioid penetration across the blood–brain barrier. Clinical studies demonstrate genotype-associated differences in analgesic efficacy and toxicity, though effect sizes vary across populations and analgesic classes. Implementation remains constrained by limited genotype-stratified randomized trials, testing turnaround time, unclear cost-effectiveness, and underrepresentation of Asian and Southeast Asian ancestry groups in genomic datasets. This mini-review synthesizes mechanistic foundations, clinical evidence, population variation, and practical considerations for integrating pharmacogenomics into perioperative and chronic pain management.
Keywords: Genomics, Pharmacogenetics, Precision medicine, Analgesia, CYP2D6, Postoperative pain, Opioids

References

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17. Chen J, Li L, Chen SR, Chen H, Xie JD, Sirrieh RE, MacLean DM, Zhang Y, Zhou MH, Jayaraman V, Pan HL. The α2δ-1-NMDA receptor complex is critically involved in neuropathic pain development and gabapentin therapeutic actions. Cell reports. 2018 Feb 27;22(9):2307-21.
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How to Cite this Article: Balasubramanian B, Diwan S. Genomics and Precision Analgesia – Is This the Era? International Journal of Regional Anaesthesia. January-June 2025; 6(1): 15-19. DOI: https://doi.org/10.13107/ijra.2025.v06.i01.116

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Intrafascicular Injection: Can AI, Ultrasound, Pressure Monitoring, and Echogenic Needles Prevent It?

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Vol 6 | Issue 1 | January-June 2025 | Page 08-14 | Divesh Arora

DOI: https://doi.org/10.13107/ijra.2025.v06.i01.114

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 28-02-2025; Reviewed: 22-03-2025; Accepted: 25-05-2025; Published: 10-06-2025

Authors: Divesh Arora [1]

[1] Department of Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.

Address of Correspondence

Dr. Divesh Arora,
Director & HOD, Department of Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.
Email ID: drdivesh@gmail.com

Abstract

Intrafascicular injection represents one of the most serious complications in regional anaesthesia, potentially resulting in irreversible neurological injury. Despite the advances in ultrasound-guided techniques, inadvertent intraneural and intrafascicular injections still occur. This review synthesizes the current understanding of nerve microanatomy, mechanisms of nerve injury, and the diagnostic and preventive strategies aimed at avoiding this catastrophic event. It highlights the role of ultrasound technology, echogenic needle innovations, injection pressure monitoring, neurostimulation, and emerging applications of artificial intelligence in enhancing procedural safety. The integration of these multimodal safety tools can significantly reduce operator dependency and improve real-time feedback during nerve block procedures. With continued technological refinement, structured training, and incorporation of AI-assisted imaging and robotics, the risk of intrafascicular injection can be minimized, thereby improving patient safety and outcomes in regional anaesthesia.
Keywords: Intrafascicular injection, Regional anaesthesia safety, Ultrasound guidance, Echogenic needles, Pressure monitoring, Artificial intelligence.

References

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17. Steinfeldt T, Graf J, Schneider J, Nimphius W, Weihe E, Borgeat A, Wulf H, Wiesmann T. Histological consequences of needle‐nerve contact following nerve stimulation in a pig model. Anesthesiology research and practice. 2011;2011(1):591851.
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How to Cite this Article: Arora D. Intrafascicular Injection: Can AI, Ultrasound, Pressure Monitoring, and Echogenic Needles Prevent It? International Journal of Regional Anaesthesia. January-June 2025; 6(1): 08-14. DOI: https://doi.org/10.13107/ijra.2025.v06.i01.114

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Regional Anaesthesia for Cancer Surgery and Its Impact on Recurrence and Metastasis: What Is the Evidence?

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Vol 6 | Issue 1 | January-June 2025 | Page 20-27 | Anju Grewal, Revanth Babu Challa, Jyoti Sharma

DOI: https://doi.org/10.13107/ijra.2025.v06.i01.118

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 15-01-2025; Reviewed: 08-02-2025; Accepted: 22-04-2025; Published: 10-06-2025

Authors: Anju Grewal [1], Revanth Babu Challa [2], Jyoti Sharma [1]

[1] Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
[2] Department of Anaesthesiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.

Address of Correspondence

Dr. Jyoti Sharma
Associate Professor, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Email- drjyotisharma1014@gmail.com

Abstract

Regional anaesthesia (RA) is thought to potentially affect cancer recurrence and metastasis by reducing the perioperative stress response, supporting immune function, and decreasing the use of opioids and volatile agents. This review examines the mechanistic evidence and clinical results across eight major cancer types. Although RA reliably enhances pain management and perioperative recovery, its impact on cancer outcomes remains uncertain. The most notable reductions in recurrence are observed in bladder and oesophageal cancers, while the effects on breast, colorectal, gastric, and gynaecological cancers are limited. Variability in study methods, confounding variables, and a scarcity of high-quality randomised controlled trials hinder definitive conclusions. Until more solid evidence is available, personalised anaesthetic strategies are essential.
Keywords: Regional Anaesthesia, Cancer Recurrence, Metastasis

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How to Cite this Article: Grewal A, Challa RB, Sharma J. Regional Anaesthesia for Cancer Surgery and Its Impact on Recurrence and Metastasis: What Is the Evidence? International Journal of Regional Anaesthesia. January-June 2025; 6(1): 20-27. DOI: https://doi.org/10.13107/ijra.2025.v06.i01.118

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The Illusion of Precision: Artificial Intelligence Unmasked

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Vol 6 | Issue 1 | January-June 2025 | Page 04-07 | Ghansham Biyani, Rajasekhar Metta

DOI: https://doi.org/10.13107/ijra.2025.v06.i01.112

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 16-01-2025; Reviewed: 08-02-2025; Accepted: 22-04-2025; Published: 10-06-2025

Authors: Ghansham Biyani [1], Rajasekhar Metta [1]

[1] Department of Anaesthesiology, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.

Address of Correspondence

Dr. Rajasekhar Metta,
Assistant Professor, Department of Anaesthesiology, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.
Email ID: rajamc6@gmail.com

Abstract

Artificial intelligence (AI), defined by John McCarthy as the science and engineering of making intelligent machines, has evolved to encompass systems capable of performing complex cognitive tasks. In regional anaesthesia (RA), AI has shown promise in enhancing ultrasound (US) image interpretation, improving accuracy through convolutional neural networks (CNNs) and computer vision. Current evidence suggests that AI-assisted systems can increase first-attempt success rates, reduce procedural duration, and improve postoperative outcomes by accurately identifying sonoanatomical structures. Moreover, AI-based educational tools offer standardized, scalable training models for novice medical learners. However, current limitations include difficulty in object tracking due to low tissue contrast, variable accuracy across anatomical regions, and inadequate validation of patient-centred outcomes. Ethical, legal, and data privacy concerns further hinder widespread clinical adoption. While AI holds potential to augment, but not replace, clinical expertise in US-guided RA, further large-scale studies and regulatory frameworks are essential before it can be reliably integrated into routine anaesthetic practice.
Keywords: Artificial intelligence, Regional anaesthesia, Predictive analytics, Machine learning, Color overlay, Peripheral nerve blocks

References

1. Rajaraman V. JohnMcCarthy—Father of artificial intelligence. Reson 2014; 19(3): 198-207.
2. McKendrick M, Yang S, McLeod GA. The use of artificial intelligence and robotics in regional anaesthesia. Anaesthesia 2021; 76: 171-81.
3. Balavenkatasubramanian J, Kumar S, Sanjayan RD. Artificial intelligence in regional anaesthesia. Indian J Anaesth 2024; 68(1): 100-4.
4. Choy G, Khalilzadeh O, Michalski M, Do S, Samir AE, Pianykh OS, et al. Current Applications and Future Impact of Machine Learning in Radiology. Radiology 2018; 288(2): 318-28.
5. Tong SX, Li RS, Wang D, Xie XM, Ruan Y, Huang L. Artificial intelligence technology and ultrasound-guided nerve block for analgesia in total knee arthroplasty. World J Clin Cases 2023; 11(29): 7026-33.
6. Bowness JS, Macfarlane AJR, Burckett-St Laurent D, Harris C, Margetts S, Morecroft M, et al. Evaluation of the impact of assistive artificial intelligence on ultrasound scanning for regional anaesthesia. Br J Anaesth 2023; 130(2): 226-33.
7. Oh TT, Ikhsan M, Tan KK, Rehena S, Han NR, Sia ATH, et al. A novel approach to neuraxial anesthesia: Application of an automated ultrasound spinal landmark identification. BMC Anesthesiol 2019; 19(1): 57.
8. Bellini V, Rafano Carnà E, Russo M, Di Vincenzo F, Berghenti M, Baciarello M, et al. Artificial intelligence and anesthesia: A narrative review. Ann Transl Med 2022; 10(9): 528.
9. Jacobs E, Wainman B, Bowness J. Applying artificial intelligence to the use of ultrasound as an educational tool: A focus on ultrasound-guided regional anesthesia. Anat Sci Educ 2024; 17(5): 919-25.
10. Viderman D, Dossov M, Seitenov S, Lee MH. Artificial intelligence in ultrasound-guided regional anesthesia: A scoping review. Front Med (Lausanne) 2022; 9: 994805.
11. Bowness J, El-Boghdadly K, Burckett-St Laurent D. Artificial intelligence for image interpretation in ultrasound-guided regional anaesthesia. Anaesthesia 2021; 76(5): 602-7.
12. Magoon R, Suresh V. A novel recognition of artificial intelligence in regional anaesthesia. Digital Medicine 2023; 9(2): e00003.
13. Swain BP, Nag DS, Anand R, Kumar H, Ganguly PK, Singh N. Current evidence on artificial intelligence in regional anesthesia. World J Clin Cases 2024; 12(33): 6613-19.
14. Srinivasareddy S. Artificial Intelligence in Anesthesia: What Might the Future Hold. Int J Clin Anesthesiol 2024; 12(1): 1131.
15. Karmakar A, Khan MJ, Abdul-Rahman ME, Shahid U. The Advances and Utility of Artificial Intelligence and Robotics in Regional Anesthesia: An Overview of Recent Developments. Cureus 2023; 15(8): e44306.
16. Choudhary N, Gupta A, Gupta N. Artificial intelligence and robotics in regional anesthesia. World J Methodol 2024; 14(4): 95762.

 

How to Cite this Article: Biyani G, Metta R. The Illusion of Precision: Artificial Intelligence Unmasked. International Journal of Regional Anaesthesia. January-June 2025; 6(1): 04-07. DOI: https://doi.org/10.13107/ijra.2025.v06.i01.0112

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Rural to Remote to the Recent Trends in Regional Anaesthesia

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Vol 6 | Issue 1 | January-June 2025 | Page 01-03 | Anju Gupta, Sandeep Diwan

DOI: https://doi.org/10.13107/ijra.2025.v06.i01.110

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 14-03-2025; Reviewed: 26-03-2025; Accepted: 18-05-2025; Published: 10-06-2025

Authors: Anju Gupta [1], Sandeep Diwan [2]

[1] Department of Anaesthesiology & Critical Care, AIIMS, Delhi, India.
[2] Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India.

Address of Correspondence

Dr. Anju Gupta,
Department of Anaesthesiology & Critical Care, AIIMS Delhi, India.
Email ID: dranjugupta09@gmail.com

Editorial

Regional anaesthesia (RA) has undergone significant transformation over the last few decades from being a dispensable part of anaesthesia to presently being the core skill and foundational pillar of anaesthesia in contemporary anaesthesia practice. RA has always been a flexible field—focused on pragmatism, using minimal resources efficiently, tailoring anaesthesia to individual perioperative needs, and prioritising patient-centred outcomes [1]. This practical based approach of maximizing resource utilisation has been most evident in rural and remote areas, where clinicians have since long turned limited resources into innovative solutions. Today, the same values that helped RA thrive in such settings are fueling its newest exciting developments: portable technology, built-in safety, interdisciplinary collaboration, scientific breakthroughs, and advent of artificial intelligence, all contributing to reconfiguration of RA to be a more refined, evidence–based, and widely adopted approach in contemporary medical practice [1, 2]. From its roots in resource limited rural practice to its cutting-edge modern advances, RA continues to make progress in tandem with our dynamic speciality.
RA has been a key skill in the armamentarium of anaesthesiologists working in rural and remote areas since ages to solve the limited infrastructures and to navigate the complex clinical scenarios that were far fetched with general anaesthesia (GA). It has been more of a necessity than a luxury in these set ups which have furthered innovations in this field. Conditions in many of these set ups is far from the recommended guidelines for basic minimum standards to provide anaesthesia with an overall limited access to clean and well equipped operation rooms with central pipelines, anaesthesia workstations, advanced monitoring techniques, ventilators with advance modes, anaesthesia and emergency drugs, fluid and blood products, and post-operative high-dependency or intensive care unit [3, 4]. The only monitor might be the vigilant eye of an experienced anaesthesiologist. The emphasis has always been on minimally resource intensive opioid sparing anaesthesia techniques requiring lesser consumables and drugs, preserving spontaneous ventilation, allowing faster recovery and hospital discharge, and minimising opioid related adverse events [4]. These objectives can readily be met by incorporating RA into anaesthesia Use of RA to provide procedural anaesthesia avoids the need to handle the airway in these resource limited facilities while ensuring patient safety as the complications have remained astonishingly low [5]. Similarly, RA has revolutionised trauma care in remote areas—be it on-arrival blocks, facilitating closed reductions, physiotherapy; providing rib fracture analgesia with safer fascial plane blocks.
While resource constraint and economical use of resources has been the main driving factor in RA adoption in these rural and remote set-ups, safety remains the topmost priority. The widespread use of nerve stimulators and now even ultrasound is a testament to that. Anaesthesiologists working in these areas have realised the importance of safety and precision especially since rescue options are limited. Ultrasound has enhanced the safety of RA multi-folds by visualising needle trajectory and avoiding critical structures, reducing the dose of local anaesthetist and improving the block success [6]. Innovations like portable and pocket-sized ultrasound compatible with smartphones have made the integration of ultrasound even more feasible for freelancers who carry their own equipment. However, cost concerns and stringent laws by the government have made procurement and use of ultrasound difficult for free lancers in India and they may still have to rely on landmark or neurostimulation guided blocks. In the present issue, Muthu SC identify simplified landmark or neurostimulation guided block techniques for rural and remotely placed hospitals which can be utilised with reasonable success rates when visualised needle placement is not an option [7].
Furthermore, even with the use of ultrasound intraneural injection cannot be ruled out. Hence, use of multimodal techniques comprising ultrasound, injection pressure monitoring, echogenic needles, use of AI and neurostimulation has been advocated as identified by Arora D in a review article on intrafasicular injection in this issue [8]. However, these would not be available in majority remote and rural areas. A breakthrough in the RA practice is the introduction and widespread popularity of fascial plane blocks such as transversus abdominis plane (TAP) block, erector spinae plane block (ESPB), serratus anterior plane block (SAPB) etc., permitting excellent analgesia with remarkable safety profile, preserving hemodynamic stability and avoiding damage to critical structures facilitating easy recovery and discharge [9]. Hence, these techniques have further expanded our armamentarium and provided us with enumerable options to choose from to suit individual patient profiles.
Enhanced recovery after surgery (ERAS) pathways utilise the multimodal analgesia with RA as a central component [10]. The concept of multimodal analgesia was rooted in the rural and remote anaesthesia practice as a means to reduce risk due to opioid analgesics by incorporating various non-opioid analgesics and RA. Recent trends favour ambulatory-friendly modalities: single-shot blocks with long-acting local anaesthetics; low-volume techniques that spare motor function; and even portable disposable infusion pumps which allow continuous peripheral nerve block on ambulatory basis. Though considered contemporary developments, these practices providing safe analgesic management are a boon to anaesthesiologists working in rural and remote settings furthering the safety and efficacy.
Another major advancement which has changed the landscape of RA in rural and remote areas is easy access to training and mentorship. Tele-mentoring has bridged the gap in guidance and supervision available in remote areas [11]. Various educational forums on social media enable discussion and almost instant problem-solving. Furthermore, the expanding research base has provided newer insights on the nitty-gritty of RA.
Artificial intelligence (AI) is entering RA, but the most promising applications are humble: real-time probe orientation hints, automatic structure labelling, and needle-tip detection—tools that teach as they guide [12]. Augmented reality overlays may soon help a novice reproduce an expert’s probe and needle alignment. Importantly, these tools should augment—not replace—anatomical understanding and clinical judgement. Rural contexts will keep us honest: technology that fails offline, drains batteries by noon, or confuses the user will be abandoned. The winners will be simple, robust, and clinically meaningful.
In this issue of International Journal of Regional Anaesthesia, Biyani and Metta discuss the promising role of AI in addressing the challenges in image interpretation during ultrasound guided RA especially in the subset of patients with difficult sonoanatomy or deep/difficut blocks like neuraxial blocks [13]. They have comprehensively discussed various applications of AI in RA and the various pros and cons of use of AI for RA. They have aptly pointed out that the quality of AI generated data relies heavily on inputs provided by the operator. Notably, authors mention that AI tools are expensive and often impractical to use in resource-limited settings.
Contemporary medical practice aims towards precision based medicine and RA is not behind. Recent advances in pharmacogenetics and genomics hold promise to revolutionise RA and pain management through precision analgesia. A review article by Bhuvaneshwari and Diwan explores the current landscape, challenges, and potential of genomics-driven precision analgesia in perioperative and critical care settings [14].
Among the reasons for a growing interest in RA for oncoanaesthesia is its promising role of RA in preventing cancer recurrence by reducing the perioperative stress response, supporting immune function, and decreasing the use of opioid and volatile anaesthetics. Grewal et al. [15] appropriately notice that although RA reliably enhances pain management and perioperative recovery, its impact on cancer outcomes remains uncertain. The main reason cited in their article is the variability in study methods, confounding variables, and a scarcity of high-quality randomised controlled trials to draw definitive conclusions. Authors caution that until more solid evidence is available, personalised anaesthetic strategies are essential.
To conclude, the path of RA is not fixed linear progress forward but more of a pragmatic and dynamic one where individualised patient management is the goal with a focus on safety. Rural and remote RA practice has always centered on the principles of sound knowledge of anatomy and physiology, portable equipment, creative thinking and deep concern for patient safety. Modern RA practice has only amplified those values and techniques to further the cause of patient safety and best outcomes. Incorporating novel tools like ultrasound and artificial intelligence into the ethos of rural RA techniques has taken RA to new heights where it is now considered the foundational pillars of anaesthesia. Whether in a small remote clinic or an urban hi-tech facility, whether done on a high-end ultrasound machine or with a handheld ultrasound, the essence of RA stays the same: precise, thoughtful care that supports natural physiology and helps patients recover well. The move from rural beginnings to cutting-edge technology driven practice is not a breaking free from the past but moving forward in the best possible way—a targeted, profound care while respecting patient physiology and empowering early recovery. To sum it up, the journey of RA from rural and remote roots to the current leading edge era is not a departure; it is a reunification.

References

1. Moka E. Transforming Perioperative Care: Evolving Paradigms of the Expanding Role of Regional Anesthesia and Acute Pain Management. J Clin Med. 2025 Sep 4;14(17):6257.
2. Ramachandran S, Malhotra N, Velayudhan S, Singh Bajwa SJ, Joshi M, Mehdiratta L, Hiremath VR. Regional anaesthesia practices in India: A nationwide survey. Indian J Anaesth. 2021 Dec;65(12):853-861.
3. Lee, Seung, Azuka Onye, Asad Latif. Emergency Anesthesia in Resource-Limited Areas. Advances in Anesthesia, 2020 Volume 38, 209 – 227
4. Ariyo P, Trelles M, Helmand R, Amir Y, Hassani GH, Mftavyanka J, Nzeyimana Z, Akemani C, Ntawukiruwabo IB, Charles A, Yana Y, Moussa K, Kamal M, Suma ML, Ahmed M, Abdullahi M, Wong EG, Kushner A, Latif A. Providing Anesthesia Care in Resource-limited Settings: A 6-year Analysis of Anesthesia Services Provided at Médecins Sans Frontières Facilities. Anesthesiology. 2016 Mar;124(3):561-9.
5. Shams D, Sachse K, Statzer N, Gupta RK. Regional Anesthesia Complications and Contraindications. Clin Sports Med. 2022 Apr;41(2):329-343.
6. Marhofer P, Greher M, Kapralet S. Ultrasound guidance in regional anaesthesia. British Journal of Anaesthesia, Volume 94, Issue 1, 7 – 17
7. Muthu SC. Simplified Block Techniques for Rural and Remotely Placed Hospitals IJRA 2025; current issue.
8. Arora D. Intrafascicular injection: Can ai, ultrasound, pressure monitoring, and echogenic needles prevent it? IJRA; 2025: Current issue.
9. Dost, B. Fascial plane blocks in the era of modern regional anesthesia: shaping the future of pain management. J Anesth Analg Crit Care 5, 49 (2025).
10. Tippireddy S, Ghatol D. Anesthetic Management for Enhanced Recovery After Major Surgery (ERAS) [Updated 2023 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK574567/
11. Alrasheedi, N. T., Alkhubran, A. J., Alanazi, S. D. S., Al-Sahman, S. M. A., Asiri, R. A. A., Almoushawa, A. A., Alturaif, A. S., Almosa, J. A., Aldosari, A. F. (2023). “Tele-Anesthesia and Remote Supervision: Changing Perioperative and General Medical Care”, Integrative Biomedical Research (Journal of Angiotherapy), 7(1),1-9,10317
12. Balavenkatasubramanian J, Kumar S, Sanjayan RD. Artificial intelligence in regional anaesthesia. Indian J Anaesth. 2024 Jan;68(1):100-104.
13. Biyani G, Metta R. The Illusion of Precision: Artificial Intelligence Unmasked. IJRA 2025, current issue.
14. Bhuvaneshwari B, Diwan S. Genomics and Precision Analgesia – Is This the Era? IJRA 2025, current issue
15. Grewal et al.Regional Anaesthesia for Cancer Surgery and Its Impact on Recurrence and Metastasis: What Is the Evidence? IJRA 2025; current issue. DOI: https://doi.org/10.13

How to Cite this Article: Gupta A, Diwan S. Genomics and Precision Analgesia – Is This the Era? International Journal of Regional Anaesthesia. January-June 2025; 6(1): 01-03.DOI: https://doi.org/10.13107/ijra.2025.v06.i01.110

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The Ever-Evolving Landscape of Online Entertainment and Engagement

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The Ever-Evolving Landscape of Online Entertainment and Engagement

In the digital age, the way we consume entertainment and engage with online platforms has undergone a radical transformation. From the simple act of reading news articles to the complex algorithms that curate our social media feeds, the internet has woven itself into the fabric of our daily lives. This evolution isn’t just about faster internet speeds or more sophisticated devices; it’s about a fundamental shift in how we seek information, connect with others, and find enjoyment. Understanding these broader trends can provide valuable context for a variety of online activities, including the burgeoning world of online gaming and its surrounding ecosystem.

The Rise of Digital Communities and Shared Experiences

One of the most significant impacts of the internet has been its ability to foster communities. Gone are the days when shared interests were confined to local clubs or specific physical locations. Now, individuals with niche hobbies, professional aspirations, or even simple shared curiosities can connect with like-minded people from across the globe. This has led to the proliferation of online forums, social media groups, and dedicated platforms where users can share knowledge, offer support, and build relationships. This sense of belonging and shared experience is a powerful motivator for engagement, driving users to return to platforms that offer them a sense of connection.

This trend extends to many aspects of online life. Whether it’s a community of amateur astronomers sharing observations, a group of aspiring writers critiquing each other’s work, or enthusiasts discussing their favorite sports teams, the digital realm offers unparalleled opportunities for connection. The interactive nature of these communities means that content is not just passively consumed but actively created and shaped by its members. This user-generated content often becomes a significant draw for new members, creating a self-sustaining cycle of engagement and growth. The desire for these shared experiences is a constant force shaping the digital landscape.

Furthermore, the concept of “shared experience” has also evolved. We see this in the rise of live streaming, where audiences can interact with broadcasters in real-time, sharing jokes, asking questions, and celebrating moments together. This creates an immediate and visceral connection that traditional media struggles to replicate. The feeling of being part of something happening right now, alongside thousands of others, is a potent form of entertainment and social interaction. This immediacy and interactivity are key drivers in how people choose to spend their online time, seeking out platforms that offer these dynamic and engaging environments.

Personalization and Algorithmic Curation: Tailoring the Digital Experience

Another defining characteristic of the modern internet is the increasing level of personalization and algorithmic curation. Platforms have become incredibly adept at learning our preferences, behaviors, and interests. Through sophisticated algorithms, they can predict what content we’re likely to enjoy, what products we might want to buy, and even who we might want to connect with. This has led to a highly tailored digital experience, where our feeds, recommendations, and advertisements are often unique to us.

While this personalization can be incredibly convenient, offering a seemingly endless stream of relevant content, it also raises questions about filter bubbles and echo chambers. By showing us more of what we already like, algorithms can inadvertently limit our exposure to diverse perspectives and new ideas. However, from a platform’s perspective, effective personalization is crucial for keeping users engaged. When users feel understood and catered to, they are more likely to spend time on a platform and return to it in the future. The constant refinement of these algorithms is an ongoing arms race to capture and retain user attention.

The impact of this personalization is felt across all sectors of online activity. From streaming services recommending your next binge-worthy show to e-commerce sites suggesting items you might be interested in, the underlying principle remains the same: use data to create a more relevant and engaging experience. This applies equally to platforms that offer interactive entertainment and gaming. By understanding player preferences, these sites can offer a more compelling and enjoyable experience, increasing player satisfaction and retention. For many, the ability to discover new and exciting content tailored to their tastes is a primary reason for their continued online engagement.

The Future of Online Engagement: Interactivity, Immersive Technologies, and Responsible Platforms

Looking ahead, the trends of interactivity and personalization are only set to intensify. The development of immersive technologies like virtual reality (VR) and augmented reality (AR) promises to blur the lines between the digital and physical worlds, offering entirely new forms of entertainment and social interaction. Imagine attending virtual concerts with friends from across the globe or exploring digital replicas of historical sites, all from the comfort of your home. These technologies have the potential to revolutionize how we experience online content and communities.

Alongside these technological advancements, there’s a growing awareness of the need for responsible online platforms. As the digital world becomes more pervasive, issues such as data privacy, online safety, and the potential for addiction are coming to the forefront. Reputable platforms are increasingly focusing on creating environments that are not only engaging but also secure and ethical. This includes implementing robust security measures, providing clear terms of service, and offering tools for users to manage their online experience responsibly.

For platforms that offer a wide range of interactive entertainment, including online casino games, this focus on responsibility is paramount. Ensuring a safe and fair gaming environment is not just a matter of compliance but a fundamental aspect of building trust and fostering long-term engagement. Players seek out sites that are transparent about their operations and prioritize player well-being. In this context, discovering reliable and reputable online destinations is crucial for a positive experience. For instance, many players actively seek out trusted platforms for their entertainment needs, and sites like casibom are part of this landscape of available online entertainment options. The continuous evolution of online entertainment means that players have more choices than ever before, and the demand for quality and security remains a constant.

Ultimately, the digital landscape is a dynamic and ever-changing entity. The constant push for innovation, coupled with a growing understanding of user needs and societal responsibilities, ensures that the way we engage with the internet will continue to evolve. Whether it’s through the deepening of online communities, the refinement of personalized experiences, or the advent of new immersive technologies, the future of online engagement promises to be as exciting as it is transformative.

A Case Report on Bilateral Ultrasound Guided Brachial Plexus Block in a Paediatric Patient with Unusual Congenital Anomalies

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Vol 5 | Issue 2 | July-December 2024 | Page 27-30 | Anupama Triparhi Srikanth, Pooja Patil, Anitha Pramod, Srikanth V

DOI: https://doi.org/10.13107/ijra.2024.v05.i02.104

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted: February 10-07-2024; Reviewed: 02-08-2024; Accepted: 03-10-2024; Published: 10-12-2024

Authors: Anupama Triparhi Srikanth [1], Pooja Patil [1], Anitha Pramod [1], Srikanth V [1]

[1] Department of Anaesthesiology, Manipal Hospitals, Old airport road, Bangalore, Karnataka, India.

Address of Correspondence

Dr. Pooja Patil
Department of Anaesthesiology, Manipal Hospitals, Old airport road, Bangalore, Karnataka, India.
Email id: patil24992pooja@gmail.com

Abstract

Background: Performing bilateral brachial plexus blocks (BPB) in paediatric patients is a rare practice due to concerns like diaphragmatic paralysis, local anaesthetic systemic toxicity, pneumothorax and hematoma formation. The introduction of ultrasound in regional anaesthesia has revolutionized precision, allowing reduced local anaesthetic doses and increased success rates.
Case Description: We present the case of an 11-year-old male, who underwent uneventful surgical repair for Tetralogy of Fallot at 8 months of age, posted for right index finger pollicization and left-hand distractor frame application. Auscultatory finding of loud S2 and ejection systolic murmur corroborated with echo finding of mild pulmonary regurgitation, intact VSD patch, and good biventricular function. After administering general anaesthesia with controlled ventilation, ultrasound-guided axillary approach bilateral BPB with 11 ml 0.33% Ropivacaine (equal volume mixture of 0.5% and 0.2% Ropivacaine after calculation of maximum allowable dose) was given sequentially on each side with an interval of 2.5 hours. The overall outcome was safe and uneventful.
Discussion: According to the Pediatric Regional Anaesthesia Network, only 3% of all regional anaesthetics (RA) in children involve upper limb blocks. Literature supporting bilateral BPB in children is scarce. RA improves haemodynamic stability, reduces the incidence of postoperative respiratory complications, decreases catecholamine production and the metabolic stress response to surgery and promotes a fast return of gut function and feeding, all of which benefited this child with known cardiac comorbidity. Improvement in the accuracy of ultrasound imaging has undoubtedly boosted regional anaesthetic techniques making nerve blocks safe and well tolerated in children.
Conclusion: Our case report demonstrates successful incorporation of US guided bilateral axillary brachial plexus block in a child with preexisting cardiac illness coming for major upper limb surgeries resulting in a painfree child, satisfied parents and happy surgeons.
Keywords: Bilateral brachial plexus blocks (BPB), Pediatric Regional Anaesthesia, Ultrasound.

References

1. Polaner DM, Taenzer AH, Walker BJ, Bosenberg A, Krane EJ, Suresh S, Wolf C, Martin LD. Pediatric Regional Anaesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anaesthesia. Anaesth Analg. 2012 Dec;115(6):1353-64. doi: 10.1213/ANE.0b013e31825d9f4b. Epub 2012 Jun 13. PMID: 22696610.
2. Zadrazil M, Opfermann P, Marhofer P, Westerlund AI, Haider T. Brachial plexus block with ultrasound guidance for upper-limb trauma surgery in children: a retrospective cohort study of 565 cases. Br J Anaesth. 2020 Jul;125(1):104-109. doi: 10.1016/j.bja.2020.03.012. Epub 2020 Apr 24. PMID: 32340734.
3. Merella, F. et al. Ultrasound-guided upper and lower extremity nerve blocks in children. BJA Education, Volume 20, Issue 2, 42 – 50
4. Şengel A, Seçilmiş S. Ultrasound-guided bilateral infraclavicular brachial plexus block: A report of three cases. Saudi J Anaesth. 2022 Apr-Jun;16(2):232-235. doi: 10.4103/sja.sja_737_21. Epub 2022 Mar 17. PMID: 35431733; PMCID: PMC9009546.
5. Mangla C, Kamath HS, Yarmush J. Bilateral Brachial Plexus Block Using Chloroprocaine For Surgery Of Bilateral Radial Fractures. Local Reg Anaesth. 2019 Sep 27;12:99-102. doi: 10.2147/LRA.S225471. PMID: 31579387; PMCID: PMC6773967.
6. Karim, H.M.R., Panda, C.K., Kumar, M. et al. Perioperative challenges for same sitting bilateral upper limb surgery in a patient of obstructive sleep apnoea, morbid obesity, hypothyroidism, and orthopnea. Ain-Shams J Anaesthesiol 10, 1 (2018). https://doi.org/10.1186/s42077-018-0006-6
7. Renes SH, Spoormans HH, Gielen MJ, Rettig HC, van Geffen GJ. Hemidiaphragmatic paresis can be avoided in ultrasound-guided supraclavicular brachial plexus block. Reg Anaesth Pain Med. 2009 Nov-Dec;34(6):595-9. doi: 10.1097/aap.0b013e3181bfbd83. PMID: 19916254
8. Holborow J, Hocking G. Regional anaesthesia for bilateral upper limb surgery: a review of challenges and solutions. Anaesth Intensive Care. 2010 Mar;38(2):250-8. doi: 10.1177/0310057X1003800205. PMID: 20369756.
9. Kim BG, Yang C, Lee K, Choi WJ. Bilateral brachial plexus block in a patient with cervical spinal cord injury: A case report. Medicine (Baltimore). 2020 Jul 24;99(30):e21126. doi: 10.1097/MD.0000000000021126. PMID: 32791687; PMCID: PMC7387002.
10. Brand L, Papper EM. A comparison of supraclavicular and axillary techniques for brachial plexus blocks. Anaesthesiology 1961; 22: 226–9.
11. Neuburger M, Landes H, Kaiser H. Pneumothorax bei der vertikalen infraklavikulären Blockade des Plexus brachialis. Fallbericht einer seltenen Komplikation. Anaesthesist 2000; 49: 901–4.
12. Tsui BC, Doyle K, Chu K, Pillay J, Dillane D. Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients. Canadian Journal of Anaesthesia 2009; 56: 46–51.
13. Amiri HR, Espandar R. Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series. J Child Orthop. 2011 Feb;5(1):5-9. doi: 10.1007/s11832-010-0303-5. Epub 2010 Nov 23. PMID: 22295045; PMCID: PMC3024489.
14. Majid Fakhir alhamaidah, Hussain AH, Hussein alkhfaji, Sami RH, Hamza Sh. Abd-Alzahra, Ali B. Roomi: Ultrasound-guided brachial plexus blocks in pediatric anaesthesia: non-systematic review. IOP Conf. Series: Materials Science and Engineering 928 (2020) 062013 IOP Publishing doi:10.1088/1757-899X/928/6/062013
15. Singaravelu Ramesh A, Boretsky K. Local anaesthetic systemic toxicity in children: a review of recent case reports and current literature. Reg Anaesth Pain Med. 2021 Oct;46(10):909-914. doi: 10.1136/rapm-2021-102529. Epub 2021 Jun 7. PMID: 34099573.
16. Goh MS, Bernardo MK, Yuen T, Tsai E and Ovsepian M. Bilateral Brachial Plexus Blocks for Bilateral Upper Extremity Surgery. SM J Anaesth. 2017; 3(2): 1013
17. Al-Talabani BG, Abdullah HO, Kakamad FH, Abdulla BA, Salih KM, Mohammed SH, Salih AM. Bilateral brachial plexus block as alternative to general anaesthesia in high-risk patient; a case report and literature review. Ann Med Surg (Lond). 2022 Feb 11;75:103378. doi:10.1016/j.amsu.2022.103378. PMID: 35242325; PMCID: PMC8881413.
18. Harper G.K., Stafford M.A., Hill D.A. Minimum volume of local anaesthetic required to surround each of the constituent nerves of the axillary brachial plexus, using ultrasound guidance: a pilot study. Br. J. Anaesth. 2010;104(5):633–636.
19. Franco CD, Salahuddin Z, Rafizad A. Bilateral brachial plexus block. Anaesth Analg. 2004 Feb;98(2):518-520. doi: 10.1213/01.ANE.0000097441.67236.33. PMID: 14742397.
20. Graf, Bernhard M. M.D.*; Abraham, Ingo M.D.†; Eberbach, Nicole M.D.†; Kunst, Gudrun M.D.‡; Stowe, David F. M.D., Ph.D.§; Martin, Eike M.D.‖. Differences in Cardiotoxicity of Bupivacaine and Ropivacaine Are the Result of Physicochemical and Stereoselective Properties. The Journal of the American Society of Anaesthesiologists 96(6):p 1427-1434, June 1, 2002. | DOI: 10.1097/00000542-200206000-00023

How to Cite this Article: Srikanth AT, Patil P, Pramod A, V Srikanth | A Case Report on Bilateral Ultrasound Guided Brachial Plexus Block in a Paediatric Patient with Unusual Congenital Anomalies | International Journal of Regional Anaesthesia | July-December 2024; 5(2): 27-30 | DOI: https://doi.org/10.13107/ijra.2024.v05.i02.104

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Continuous Erector Spinae Plane Block for Unilateral Multiple Rib Fracture- A Case Report

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Vol 5 | Issue 2 | July-December 2024 | Page 23-26 | Navveen PM, Sandeep Diwan

DOI: https://doi.org/10.13107/ijra.2024.v05.i02.102

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted: February 22-11-2024; Reviewed: 28-11-2024; Accepted: 08-12-2024; Published: 10-12-2024

Authors: Navveen PM [1], Sandeep Diwan [2]

[1] AORA Fellow, Sancheti Hospital for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
[2] Department of Anaesthesiology, Sancheti Hospital for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.

Address of Correspondence

Dr. Navveen PM
Department of Anaesthesia, Sancheti Institute of orthopaedics and Rehabilitation, Pune, Maharashtra, India.
Email id: dr.navveen@gmail.com

Abstract

Patients with chest trauma have high morbidity due to rib fractures, lung contusion, hemo/pneumothorax leading to prolonged hospital stay. Adequate pain relief is the key for early recovery following rib fracture. Pain due rib fracture can cause lung atelectasis, flail chest, hypoventilation leading to hypoxia, respiratory failure and further pulmonary complications. Erector spinae plane (ESP) block is an inter-fascial plane block which has been proposed as a regional anaesthesia technique in acute pain management for multiple rib fractures (MRF’s).
Keywords: Multiple rib fracture, Chest trauma, Erector spinae plane block.

References

1. Kuo K, Kim AM. Rib Fracture. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541020/
2. Thoracic Paravertebral Analgesia Through a New Multiple-Hole Catheter- 2016/04/01. doi: 10.1053/j.jvca.2015.09.016. DO – 10.1053/j.jvca.2015.09.016. Journal of Cardiothoracic and Vascular Anesthesia
3. Kumar G, Kumar Bhoi S, Sinha TP, Paul S. Erector spinae plane block for multiple rib fracture done by an Emergency Physician: A case series. Australas J Ultrasound Med. 2020 Aug 30;24(1):58-62. doi: 10.1002/ajum.12225. PMID: 34760612; PMCID: PMC8412024.
4. Diwan S, Garud R, Nair A. Thoracic paravertebral and erector spinae plane block: A cadaveric study demonstrating different site of injections and similar destinations. Saudi J Anaesth. 2019 Oct-Dec;13(4):399-401. doi: 10.4103/sja.SJA_339_19. PMID: 31572102; PMCID: PMC6753759.
5. L May, C Hillermann, S Patil, Rib fracture management, BJA Education, Volume 16, Issue 1, 2016,
6. Diwan, S., Nair, A., Adhye, B. et al. Dual erector spinae plane block for complex traumas of upper and lower limb: an opioid reduction strategy—a case series. Ain-Shams J Anesthesiol 15, 81 (2023). https://doi.org/10.1186/s42077-023-00380-0
7. Diwan, Sandeep; Nair, Abhijit1. Unilateral erector spinae plane block for managing acute pain arising from multiple unilateral injuries: A case report. Indian Journal of Anaesthesia 64(1):p 79-80, January 2020. | DOI: 10.4103/ija.IJA_609_19
8. Periosteal Infusion of Local Anesthetics as an Alternative to Bilateral Subpectoral Interfascial Plane Catheters in Patients with Sternal Fractures, Regional Anesthesia & Pain Medicine. Paul, Barry. 2017/05/01.
9. Rashmi Syal, Sadik Mohammed, Rakesh Kumar, Nidhi Jain, Pradeep Bhatia, Continuous erector spinae plane block for analgesia and better pulmonary functions in patients with multiple rib fractures: a prospective descriptive study, Brazilian Journal of Anesthesiology (English Edition), Volume 74, Issue 1, 2024.

How to Cite this Article: PM Navveen, Diwan S | Continuous Erector Spinae Plane Block for Unilateral Multiple Rib Fracture- A Case Report | International Journal of Regional Anaesthesia | July-December 2024; 5(2):23-26 | DOI: https://doi.org/10.13107/ijra.2024.v05.i02.102

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