Real-World Positivity, Procedural Events, and Management Changes After Intravenous Methylergometrine Provocation Testing for Coronary Vasospasm: A Single-Center Study of 139 Patients - Cureus

High-flow arteriovenous malformations (AVMs), particularly in the facial region, present challenges to management due to the complex surrounding anatomy. Bleomycin electrosclerotherapy (BEST) is a treatment option for facial AVMs. In these instances, the bleomycin is most commonly administered intralesionally or via selective intra-arterial injection. We report the case of a 28-year-old man with a congenital glabellar AVM that has progressively enlarged and developed a palpable pulsation over the preceding few years. A soft tissue ultrasound and contrast-enhanced computer tomography (CT) confirmed a high-flow glabellar AVM with arterial feeders arising from the ophthalmic arteries and the external carotid arteries bilaterally. Due to the proximity of the ophthalmic arteries, direct sclerosant injection and embolisation were considered high risk for visual compromise. The patient underwent BEST under general anaesthesia, with 15,000 units of bleomycin administered intravenously followed by electroporation targeted to the lesion nidus. The procedure was completed without immediate complication. At eight weeks post-procedure, there was only marginal improvement in lesion size and puls

Intravenous lidocaine is effective in various surgical procedures, but its efficacy in oral cancer surgery is uncertain. We hypothesised that intraoperative intravenous lidocaine infusion can reduce 24-hour postoperative opioid consumption and reduce postoperative pain in patients undergoing oral cancer surgery with free perforator flap reconstruction. In this blinded, randomised, placebo-controlled trial, a total of 64 patients scheduled for elective oral cancer surgery with free perforator flap reconstruction were enrolled and randomly assigned to either the lidocaine group receiving intravenous lidocaine, or the control group receiving normal 0.9% saline. The primary outcome was the cumulative consumption of opioids at the first 24 h postoperatively. Secondary outcomes included the cumulative consumption of opioid drugs intraoperatively within 48 h and 72 h postoperatively, NRS scores at 24, 48, and 72 h postoperatively, lidocaine-related adverse events, incidence of chronic pain and neuropathic pain at 3 months postoperatively. From August 2024 to December 2024, a total of 102 patients were screened for eligibility, 64 patients were included.

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