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Regional Anesthesia and Pain Medicine

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28085788/essentials-of-our-current-understanding-abdominal-wall-blocks
#3
Ki Jinn Chin, John G McDonnell, Brendan Carvalho, Aidan Sharkey, Amit Pawa, Jeffrey Gadsden
Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings...
January 12, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079754/ultrasound-guided-needle-technique-accuracy-prospective-comparison-of-passive-magnetic-tracking-versus-unassisted-echogenic-needle-localization
#4
Angela N Johnson, Jeffery S Peiffer, Nahi Halmann, Luke Delaney, Cindy A Owen, Jeff Hersh
BACKGROUND AND OBJECTIVES: Ultrasound-guided regional anesthesia facilitates an approach to sensitive targets such as nerve clusters without contact or inadvertent puncture. We compared accuracy of needle placement with a novel passive magnetic ultrasound needle guidance technology (NGT) versus conventional ultrasound (CU) with echogenic needles. METHODS: Sixteen anesthesiologists and 19 residents performed a series of 16 needle insertion tasks each, 8 using NGT (n = 280) and 8 using CU (n = 280), in high-fidelity porcine phantoms...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079753/synergistic-effects-of-serotonin-or-dopamine-combined-with-lidocaine-at-producing-nociceptive-block-in-rats
#5
Ching-Hsia Hung, Chong-Chi Chiu, Kuo-Sheng Liu, Yu-Wen Chen, Jhi-Joung Wang
BACKGROUND: The purpose of this experiment was to investigate the interactions of the local anesthetic lidocaine combined with an agent (serotonin or dopamine) as infiltrative anesthetics. METHODS: Cutaneous analgesia was characterized by the blockade of the cutaneous trunci muscle reflex following 6 skin pinpricks on the rat back. Serotonin or dopamine at producing cutaneous analgesia in a dosage-dependent fashion was compared with lidocaine. Drug-drug interactions were calculated using the isobolographic analysis...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079752/changes-in-dorsal-root-ganglion-gene-expression-in-response-to-spinal-cord-stimulation
#6
Dana M Tilley, David L Cedeño, Courtney A Kelley, Margaret DeMaegd, Ramsin Benyamin, Ricardo Vallejo
BACKGROUND AND OBJECTIVES: Spinal cord stimulation (SCS) has been shown to influence pain-related genes in the spinal cord directly under the stimulating electrodes. There is limited information regarding changes occurring at the dorsal root ganglion (DRG). This study evaluates gene expression in the DRG in response to SCS therapy. METHODS: Rats were randomized into experimental or control groups (n = 6 per group). Experimental animals underwent spared-nerve injury, implantation of lead, and continuous SCS (72 hours)...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079733/-a-tale-of-two-planes-deep-versus-superficial-serratus-plane-block-for-postmastectomy-pain-syndrome
#7
Mohammad M Piracha, Stephen L Thorp, Vinay Puttanniah, Amitabh Gulati
INTRODUCTION: Postmastectomy pain syndrome (PMPS) is a significant burden for breast cancer survivors. Although multiple therapies have been described, an evolving field of serratus anterior plane blocks has been described in this population. We describe the addition of the deep serratus anterior plane block (DSPB) for PMPS. METHODS: Four patients with history of PMPS underwent DSPB for anterior chest wall pain. A retrospective review of these patients' outcomes was obtained through postprocedure interviews...
January 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#8
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#9
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28059870/epinephrine-deteriorates-pulmonary-gas-exchange-in-a-rat-model-of-bupivacaine-induced-cardiotoxicity-a-threshold-dose-of-epinephrine
#10
Quan-Guang Wang, Cong Wu, Yun Xia, Jiao-Jiao Dong, Ting-Ting Lin, Qiao-Yan Liu, Thomas J Papadimos, Xu-Zhong Xu
BACKGROUND AND OBJECTIVE: The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS: Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (2.5 mg/kg per minute, 6 minutes) via the left femoral vein to induce cardiac depression. At the end of the bupivacaine infusion, each group was immediately given either isotonic sodium chloride solution (normal saline; NS group), 5-μg/kg epinephrine (Epi5 group), 10-μg/kg epinephrine (Epi10 group), or 20 μg/kg epinephrine (Epi20 group)...
January 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28059869/a-longitudinal-supra-inguinal-fascia-iliaca-compartment-block-reduces-morphine-consumption-after-total-hip-arthroplasty
#11
Matthias Desmet, Kris Vermeylen, Imré Van Herreweghe, Laurence Carlier, Filiep Soetens, Stijn Lambrecht, Kathleen Croes, Hans Pottel, Marc Van de Velde
BACKGROUND AND OBJECTIVES: The role of a fascia iliaca compartment block (FICB) for postoperative analgesia after total hip arthroplasty (THA) remains questionable. High-dose local anesthetics and a proximal injection site may be essential for successful analgesia. High-dose local anesthetics may pose a risk for local anesthetic systemic toxicity. We hypothesized that a high-dose longitudinal supra-inguinal FICB is safe and decreases postoperative morphine consumption after anterior approach THA...
January 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#12
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28033159/effect-of-perineural-dexamethasone-on-the-duration-of-single-injection-saphenous-nerve-block-for-analgesia-after-major-ankle-surgery-a-randomized-controlled-study
#13
Siska Bjørn, Frank Linde, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28002229/evaluation-of-ultrasound-assisted-thoracic-epidural-placement-in-patients-undergoing-upper-abdominal-and-thoracic-surgery-a-randomized-double-blind-study
#14
David B Auyong, Lucy Hostetter, Stanley C Yuan, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: The placement of thoracic epidurals can be technically challenging and requires a thorough understanding of neuraxial anatomy. Although ultrasound imaging of the thoracic spine has been described, no outcome studies on the use of this imaging have been performed. We evaluated whether preprocedural ultrasound of the thoracic spine would facilitate the process of epidural catheterization. METHODS: Subjects undergoing thoracic or upper abdominal surgery with planned thoracic epidural placement at T10 or higher were enrolled in this randomized double-blind study...
December 19, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28002228/defining-the-location-of-the-adductor-canal-using-ultrasound
#15
Wan Yi Wong, Siska Bjørn, Jennie Maria Christin Strid, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: The precise location of the adductor canal remains controversial among anesthesiologists. In numerous studies of the analgesic effect of the so-called adductor canal block for total knee arthroplasty, the needle insertion point has been the midpoint of the thigh, determined as the midpoint between the anterior superior iliac spine and base of patella. "Adductor canal block" may be a misnomer for an approach that is actually an injection into the femoral triangle, a "femoral triangle block...
December 19, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27997500/catheter-taping-methods-single-layer-versus-reinforced-double-layer-technique-a-volunteer-simulated-study
#16
Jeremy H Tsui, Luke W Murtha, Ban Chi-Ho Tsui
No abstract text is available yet for this article.
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27997499/reply-to-drs-la-colla-and-ben-david
#17
Kariem El-Boghdadly, Hesham Elsharkawy, Anthony Short, Ki Jinn Chin
No abstract text is available yet for this article.
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27997498/quadratus-lumborum-block-conundrums-and-questions
#18
Luca La Colla, Bruce Ben-David
No abstract text is available yet for this article.
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27997497/safety-and-subepineural-injections-a-reply-to-dr-bigeleisen
#19
Anthony Short, Vincent W S Chan, Anahi Perlas
No abstract text is available yet for this article.
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27997496/safety-and-subepineural-injections
#20
Paul E Bigeleisen
No abstract text is available yet for this article.
January 2017: Regional Anesthesia and Pain Medicine
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