Segregation for reduction of regulated medical waste in the operating room: a case report / 대한마취과학회지

One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR. The total mass of non-regulated medical waste (non-RMW) and blue wrap amounted to 30.5 kg (24.9%), and that of RMW to 92.1 kg (75.1%). In the course of the study, we noted that the non-RMW included recyclables, such as papers, plastics, cardboards, and various wrapping materials. The study showed that a reduction in RMW generation can be achieved through the systematic segregation of OR waste.

Bilateral variant locations of the musculocutaneous nerve during ultrasound-guided bilateral axillary brachial plexus block: A case report

Ultrasound-guided peripheral nerve block has several advantages over traditional techniques for nerve localization. One is a reduction of local anesthetic dose required for successful nerve block, which might allow bilateral brachial plexus block to be performed without risk of local anesthetic toxicity. Another advantage is the ability to detect anatomical variations in nerve and vascular anatomy. We report the case of a patient with unilateral anatomical variations of the musculocutaneous nerve found in ultrasound-guided bilateral axillary brachial plexus block.