https://www.selleckchem.com/products/h2dcfda.html Opioid consumption was decreased in 50% of the trials assessing ketamine-based infusions and 75% of the studies comparing intercostal and paravertebral nerve blocks. Nausea was decreased in several of the ketamine-based infusion and intercostal and paravertebral nerve block studies. CONCLUSION Ketamine-including infusions or paravertebral and intercostal nerve blocks may represent superior methods of postoperative pain control for MIRPE. Further work is needed to confirm results. LEVEL OF EVIDENCE 2A [1]. BACKGROUND Nonneurological organ dysfunction (NNOD) occurs after traumatic brain injury (TBI) and is associated with mortality. The aim of our study was to evaluate the prevalence of NNOD and its association with outcomes in pediatric patients with TBI. We hypothesized that NNOD is associated with worse outcomes in pediatric patients with severe TBI. METHODS We performed a 4-year (2013-16) analysis of our prospectively maintained TBI database. All patients (age  less then  18) with an isolated-severe TBI (head-abbreviated injury scale AIS ≥ 3 & extracranial-AIS  less then  3) were included. NNOD was measured using the pediatric multiple organ dysfunction (P-MOD) score. Outcomes were in-hospital mortality, Glasgow Outcome Scale-Extended (GOS-E), and adverse discharge disposition rehabilitation or skilled nursing facility (SNF). Regression analysis was performed. RESULTS We analyzed 292 patients. Mean age was 11 ± 6 years, 57% were male and the mortality rate was 18.1%. The incidence of NNOD was 35%. The most common dysfunctional organ system was the respiratory (25%) followed by the cardiovascular (12%). On regression analysis, the presence of at least one NNOD was independently associated with in-hospital mortality (OR 2.1 [1.7-2.9]; p  less then  0.01), low GOS-E (OR 1.8 [1.5-2.3]; p  less then  0.01), and SNF disposition (OR 1.7 [1.2-2.1]; p  less then  0.01). CONCLUSION NNOD develops in one of every three severe