Cervical Epidural for an Urgent Bilateral Shoulder Surgery: A Case Report
Bibliographic record
Abstract
Effective postoperative analgesia for bilateral shoulder arthroplasties may represent a challenge to anesthesiologists. While the interscalene nerve block is commonly used to provide intraoperative and postoperative analgesia, bilateral interscalene block is not feasible due to phrenic nerve paralysis risk. Alternative phrenic nerve-sparing techniques may be considered; however, these often require multiple injections and may not offer comprehensive pain relief. We present a 62-year-old post-lung transplant man with bilateral shoulder dislocation and humerus fracture requiring urgent bilateral shoulder arthroplasties. A cervical epidural was used intraoperatively with general anesthesia and postoperatively for analgesia. The patient recovered uneventfully and was discharged postoperative day 6 (POD 6).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".