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Regional Anesthesia and Pain Medicine

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https://www.readbyqxmd.com/read/28282364/lung-ultrasound-for-the-regional-anesthesiologist-and-acute-pain-specialist
#1
Stephen C Haskins, Ban C Tsui, Jemiel A Nejim, Christopher L Wu, Jan Boublik
In this article, we discuss the emerging role of lung point-of-care ultrasonography for regional anesthesiologists and pain management specialists. Lung ultrasonography is a well-established clinical tool that is used on a routine basis in emergency rooms and critical care units internationally to evaluate patients with respiratory distress; however, its benefits to the regional anesthesiologist and pain specialist are not as well known and are practiced less frequently. This review article covers the clinical evidence in support of lung point-of-care ultrasonography as a rapid and superior tool to traditional imaging modalities such as chest radiography and fluoroscopy...
March 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277420/regional-to-the-rescue-axillary-brachial-plexus-nerve-block-facilitates-removal-of-entrapped-transradial-catheter-placed-for-cardiac-catheterization
#2
Brian M Fitzgerald, Lee A Babbel, Ferdinand K Bacomo, Sandeep T Dhanjal
OBJECTIVE: Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm. CASE REPORT: A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become entrapped and refractory to conservative (warm compresses) and standard pharmacologic interventions (intracatheter verapamil, intravenous infusions of nitroglycerin and nicardipine, and subcutaneous lidocaine and topical nitroglycerin)...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277419/complications-after-continuous-posterior-lumbar-plexus-blockade-for-total-hip-arthroplasty-a-retrospective-cohort-study
#3
Catherine W Njathi, Rebecca L Johnson, Ruple S Laughlin, Darrell R Schroeder, Adam K Jacob, Sandra L Kopp
BACKGROUND AND OBJECTIVES: While benefits of regional anesthesia in total hip arthroplasty (THA) are well documented, data describing the incidence of complications related to the use of posterior lumbar plexus blockade for THA remain limited. Our primary aim was to evaluate the incidence of infectious, bleeding, and neurological complications related specifically to the use of continuous posterior lumbar plexus block for elective THA. METHODS: We reviewed the electronic medical records of all adult patients who underwent elective THA with continuous posterior lumbar plexus blockade between December 1, 2004, and April 30, 2015, using the Mayo Clinic Total Joint Registry...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277418/ultrasound-guided-interventional-procedures-myofascial-trigger-points-with-structured-literature-review
#4
Dinesh Kumbhare, Dhanveer Singh, Alasdair Rathbone H, Madison Gunn, Liza Grosman-Rimon, Brian Vadasz, Hance Clarke, Philip W H Peng
Ultrasound-guided injections in pain medicine are a common intervention. They have been used to manage myofascial trigger points (MTrPs) in different muscles of the body. The main objectives of this article were to review ultrasound-guided injection techniques used for treating MTrPs. We also summarize the anatomy and sonoanatomy of MTrPs using the upper trapezius muscle as an example.
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28272292/the-erector-spinae-plane-block-provides-visceral-abdominal-analgesia-in-bariatric-surgery-a-report-of-3-cases
#5
Ki Jinn Chin, Laith Malhas, Anahi Perlas
Postoperative pain after bariatric surgery can be significant and yet difficult to manage. These patients frequently have associated obstructive sleep apnea and are at risk of respiratory depression with opioid analgesia. Abdominal wall blocks such as the subcostal transversus abdominis plane block are not of significant benefit, probably in part because they provide only somatic analgesia. The ultrasound-guided erector spinae plane (ESP) block is a recently described regional anesthetic technique for providing thoracic analgesia when performed at the level of the T5 transverse process...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28272291/review-of-sympathetic-blocks-anatomy-sonoanatomy-evidence-and-techniques
#6
Samir Baig, Jee Youn Moon, Hariharan Shankar
The autonomic nervous system is composed of the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is implicated in situations involving emergent action by the body and additionally plays a role in mediating pain states and pathologies in the body. Painful conditions thought to have a sympathetically mediated component may respond to blockade of the corresponding sympathetic fibers. The paravertebral sympathetic chain has been targeted for various painful conditions. Although initially injected using landmark-based techniques, fluoroscopy and more recently ultrasound imaging have allowed greater visualization and facilitated injections of these structures...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#7
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28267071/use-of-a-dental-vibration-tool-to-reduce-pain-from-digital-blocks-a-randomized-controlled-trial
#8
Craig Pedersen, Michael Miller, K Tom Xu, Lynn Carrasco, Cynthia Smith, Peter B Richman
BACKGROUND AND OBJECTIVES: The infiltration of local anesthetic is consistently described as painful by patients. Vibration anesthesia has been studied in the dental literature as a promising tool to alleviate the pain from dental nerve blocks. Many of these studies used a specific device, the DentalVibe. To date, there have not been any studies applying this technology to digital blocks of the hand in human subjects. We hypothesized that the use of microvibratory stimulation during digital blocks of the hand would decrease pain reported by patients...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#9
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28267069/upgrading-a-social-media-strategy-to-increase-twitter-engagement-during-the-spring-annual-meeting-of-the-american-society-of-regional-anesthesia-and-pain-medicine
#10
Eric S Schwenk, Kellie M Jaremko, Rajnish K Gupta, Ankeet D Udani, Colin J L McCartney, Anne Snively, Edward R Mariano
Microblogs known as "tweets" are a rapid, effective method of information dissemination in health care. Although several medical specialties have described their Twitter conference experiences, Twitter-related data in the fields of anesthesiology and pain medicine are sparse. We therefore analyzed the Twitter content of 2 consecutive spring meetings of the American Society of Regional Anesthesia and Pain Medicine using publicly available online transcripts. We also examined the potential contribution of a targeted social media campaign on Twitter engagement during the conferences...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28267068/sensory-distribution-of-the-lateral-cutaneous-nerve-of-forearm-after-ultrasound-guided-block-potential-implications-for-thumb-base-surgery
#11
Christopher S Hasenkam, Gregory A Hoy, Paul F Soeding
Surgery of the wrist and hand commonly involves regional anesthesia of the median nerve and superficial radial nerve within the forearm. In this sonographic study, the contribution of the lateral cutaneous nerve of forearm (LCNF) to thumb cutaneous sensation was studied. Patients scheduled for thumb suspension arthroplasty (n = 35) were examined by ultrasound, with LCNF, median nerve, and superficial radial nerve identified. A single nerve was then injected with local anesthetic, and the area of cutaneous sensory loss mapped at 15 minutes...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28263244/a-cadaveric-study-of-ultrasound-guided-subpectineal-injectate-spread-around-the-obturator-nerve-and-its-hip-articular-branches
#12
Thomas D Nielsen, Bernhard Moriggl, Kjeld Søballe, Jens A Kolsen-Petersen, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local anesthetic spreads to anesthetize both the femoral and the obturator nerves. Evidence demonstrates that this presumption is unfounded, and knowledge about the analgesic effect of obturator nerve blockade in hip fracture patients presurgically is thus nonexistent...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#13
Jelliffe Jeganathan, Yanick Baribeau, Jeffrey Bortman, Feroze Mahmood, Marc Shnider, Muneeb Ahmed, Azad Mashari, Rabia Amir, Yannis Amador, Robina Matyal
BACKGROUND AND OBJECTIVES: Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model. METHODS: We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28257389/nerve-blocks-under-general-anesthesia-time-to-liberalize-indications
#14
Melissa M Masaracchia, Michael D Herrick, Ellen A Seiffert, Brian D Sites
No abstract text is available yet for this article.
March 2, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28257388/anterior-suprascapular-nerve-block-versus-interscalene-brachial-plexus-block-for-shoulder-surgery-in-the-outpatient-setting-a-randomized-controlled-patient-and-assessor-blinded-trial
#15
Martin Wiegel, Bernhard Moriggl, Peter Schwarzkopf, David Petroff, Andreas W Reske
BACKGROUND AND OBJECTIVES: The interscalene brachial plexus block (ISB), a potent option to control pain after shoulder surgery, has notable adverse effects. The anterior suprascapular nerve block (SSNB) might provide comparable analgesia and cause less grip-strength impairment. These characteristics were studied in this randomized controlled patient- and assessor-blinded trial. METHODS: Outpatients were randomized to single-shot ultrasound-guided SSNB (10 mL ropivacaine 1%) or ISB (20 mL ropivacaine 0...
March 2, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28252523/perineural-versus-intravenous-dexamethasone-as-an-adjuvant-for-peripheral-nerve-blocks-a-systematic-review-and-meta-analysis
#16
Matthew Alan Chong, Nicolas Matthew Berbenetz, Cheng Lin, Sudha Singh
BACKGROUND AND OBJECTIVES: Dexamethasone is a useful adjuvant in regional anesthesia that is used to prolong the duration of analgesia for peripheral nerve blocks. Recent randomized controlled trials (RCTs) have demonstrated conflicting results as to whether perineural versus intravenous (IV) administration is superior in this regard, and the perineural use of dexamethasone remains off-label. Therefore, we sought to perform a systematic review and meta-analysis of RCTs. METHODS: In accordance with PRISMA guidelines, we performed a random-effects meta-analysis of RCTs comparing perineural versus IV dexamethasone with duration of analgesia as the primary outcome...
March 1, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28178092/a-randomized-comparison-between-ultrasound-and-fluoroscopy-guided-sacral-lateral-branch-blocks
#17
Roderick J Finlayson, John-Paul B Etheridge, Maria Francisca Elgueta, Atikun Thonnagith, Frederick De Villiers, Bill Nelems, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)- and fluoroscopy-guided sacral lateral branch (SLB) blocks. We hypothesized that US would require a shorter performance time. METHODS: Forty patients who required unilateral sacral lateral branch blocks for chronic low back pain were randomized to US or fluoroscopy guidance. Before the performance of the assigned block, an investigator who was not involved in patient care carried out baseline analgesic testing...
February 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28157791/addition-of-liposome-bupivacaine-to-bupivacaine-hcl-versus-bupivacaine-hcl-alone-for-interscalene-brachial-plexus-block-in-patients-having-major-shoulder-surgery
#18
Catherine Vandepitte, Max Kuroda, Richard Witvrouw, Ludwig Anne, Johan Bellemans, Kristoff Corten, Pascal Vanelderen, Dieter Mesotten, Ine Leunen, Micheline Heylen, Sam Van Boxstael, Monika Golebiewski, Marc Van de Velde, Nebojsa Nick Knezevic, Admir Hadzic
BACKGROUND AND OBJECTIVES: We examined whether liposome bupivacaine (Exparel) given in the interscalene brachial plexus block lowers pain in the setting of multimodal postoperative pain management for major shoulder surgery. METHODS: Fifty-two adult patients were randomized to receive either 5 mL of 0.25% bupivacaine HCl immediately followed by 10 mL of liposome bupivacaine 133 mg (n = 26) or 15 mL of 0.25% standard bupivacaine alone (n = 26) in interscalene brachial plexus block...
February 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28092318/opening-injection-pressure-is-higher-in-intraneural-compared-with-perineural-injections-during-simulated-nerve-blocks-of-the-lower-limb-in-fresh-human-cadavers
#19
Kris Vermeylen, Marlies Hermans, Filiep Soetens, Evie Vereecke, Thorsten Steinfeldt, Gerbrand Groen, Admir Hadzic, Marc Van de Velde
BACKGROUND AND OBJECTIVES: Needle-induced nerve trauma and intraneural injection can lead to neurologic injury during peripheral nerve blocks. In this study, we assessed the utility of opening injection pressure (OIP), time to OIP, and rate of rise to OIP in detecting needle-nerve contact and intraneural injection. METHODS: Five common ultrasound-guided blocks of the femoral, saphenous, subgluteal sciatic, tibial, and common peroneal nerves were simulated in 10 fresh cadavers...
January 13, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28085789/reporting-of-design-features-and-analysis-details-in-randomized-clinical-trials-of-procedural-treatments-for-cancer-pain-an-acttion-systematic-review
#20
Daniel Rothstein, Rachel A Kitt, Shannon M Smith, Salahadin Abdi, Mitchell P Engle, Michael P McDermott, Srinivasa N Raja, Dennis C Turk, Robert H Dworkin, Jennifer S Gewandter
BACKGROUND AND OBJECTIVES: The objective of this study was to assess the reporting of randomized clinical trials investigating procedural treatments (eg, nerve blocks, targeted drug delivery) for cancer pain, with a focus on aspects that are particularly challenging in these trials. METHODS: This article presents results from a systematic review of reporting of randomized clinical trials of procedural interventions for cancer pain. Articles were identified by searching PubMed from 1966 to June 2014...
January 12, 2017: Regional Anesthesia and Pain Medicine
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