A Systematic Review of the Usage of Lidocaine in Hip Replacement Surgery.

Hip replacement procedures, professionally known as hip arthroplasty, are one of the most common orthopedic procedures. Due to the variation in this procedure, the use and types of anesthetics differ. One such commonly used anesthetic is lidocaine. Since there are currently no standardized or general procedures for the application of lidocaine for perioperative hip arthroplasty procedures, this review aims to delve into this topic. A literature review surrounding the key terms "hip replacement" and "lidocaine" was performed on PubMed. After reviewing 24 randomized control trials, statistical analyses between groups that had no lidocaine versus groups that did were performed. The results showed that there was no statistical significance between various age groups and the use of lidocaine. One percent (1%) and 2% injected into the lumbar region were the most commonly reported doses of lidocaine, with 2% often being the first test dose. Other conclusions were that lidocaine was used for general anesthesia for individuals that underwent hip arthroplasty due to an underlying condition (cauda equina syndrome, ankylosing spondylitis, etc.). Lidocaine was also used for postoperative pain relief, which is a potential concern from its addictive qualities. This investigation outlines the current stance and usage of lidocaine in perioperative hip arthroplasty while noting its limitations.

Drugs in primary care that may alter COVID-19 risk and severity.

ABSTRACT: This article describes drugs used in primary care that could alter patients' risk for and severity of COVID-19. The risks and benefits of each drug class were differentiated according to the strength of evidence from 58 selected randomized controlled trials, systematic reviews, and meta-analyses. Most of the studies reported on drugs affecting the renin-angiotensin-aldosterone system. Other classes included opioids, acid suppressants, nonsteroidal anti-inflammatory drugs, corticosteroids, vitamins, biguanides, and statins. Current evidence has not fully differentiated drugs that may increase risk versus benefits in COVID-19 infection. Further studies are needed in this area.

The contribution of transport and chemical processes on coastal ozone and emission control strategies to reduce ozone.

The interaction between transport and chemistry is pivotal for local ozone (O3) concentration, especially for a coastal region where the upstream sources might change diurnally. In the current emission control policy, most pollutants, such as particulate matter, SO2, NOx, and CO, decrease while the annual O3 trend might increase due to the complex feedbacks of precursors. In this study, we investigate the influence of transport upon the wintertime O3 diurnal trend over ZuoYing Kaohsiung, an urban coastal site in southern Taiwan, by constructing a two-dimensional numerical model coupling both physical mechanisms and core chemical processes and provide a feasible emission control strategy. The transport process (i.e., import vs. export) for the daytime is determined using the Leighton Ratio (Φ), the ratio of O3-production over O3-loss rate, under the pseudo-steady-state condition. Φ shows a deviation of -9 to +13% from the photo-stationary state, and experiences a transition from import effect before 10:15 to weakening import or net export effect afterward associated with a net O3 production as sea breeze starts developing. The significantly higher Φ derived from observation than from simulation by a factor of 1.35 might be resulted from the over-reported NO2 due to NOy contribution on the NO2 measurement, and the influence of aerosol and cloud possibly reducing ∼30% on applied NO2 photolysis rate constant, associated with aerosol optical depth of 0.75 ± 0.15 and single scattering albedo of 0.85 ± 0.15. In this studied NOx-saturated regime, the addition of sea breeze convergence over the land enhances the maximal O3 by ∼10%, mainly due to the O3 accumulation (∼88%). Furthermore, the ozone isopleth analysis as a function of non-methane hydrocarbons and NOx emissions provides an achievable strategy to decrease both maximum daily ozone and the increment of ozone from morning to maximum by reducing hydrocarbons and NOx emissions, which can also eliminate the additional nitrate contribution on the aerosols.