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Regional Anesthesia and Pain Medicine

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https://www.readbyqxmd.com/read/28525409/preserved-analgesia-with-reduction-in-opioids-through-the-use-of-an-acute-pain-protocol-in-enhanced-recovery-after-surgery-for-open-hepatectomy
#1
Michael C Grant, Philip M Sommer, Cathy He, Sylvia Li, Andrew J Page, Alexander B Stone, Deborah Hobson, Elizabeth Wick, Christopher L Wu
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways are designed to restore baseline physiology, mitigate surgical stressors, and hasten recovery. Paramount to this approach is optimal pain control through multimodal analgesia and limiting reliance on opioid-based medications. Recent studies have fostered growing controversy surrounding the use of epidural analgesia in the ERAS setting, especially for higher-risk procedures. We examine the analgesic end points associated with the use of epidural within the ERAS framework for open hepatectomy...
May 18, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492441/residual-enoxaparin-activity-anti-xa-levels-and-concerns-about-the-american-society-of-regional-anesthesia-and-pain-medicine-anticoagulation-guidelines
#2
Daryl S Henshaw, James D Turner, Daniel J Forest, Garrett R Thompson, Robert S Weller
Currently, the American Society of Regional Anesthesia and Pain Medicine (ASRA) anticoagulation guidelines recommend that before the performance of a neuraxial procedure a minimum of 24 hours should elapse following a treatment dose of enoxaparin (1 mg/kg twice daily or 1.5 mg/kg once daily). The guidelines have since their inception also consistently recommended against the routine use of anti-Xa level monitoring for patients receiving enoxaparin. However, we noted in our clinical practice that anti-Xa levels were frequently still elevated despite patients meeting the time-based recommendation for treatment dose enoxaparin...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#3
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492439/retrobulbar-block-in-pediatric-vitreoretinal-surgery-eliminates-the-need-for-intraoperative-fentanyl-and-postoperative-analgesia-a-randomized-controlled-study
#4
Lan Yao, Hong Zhao, Bailin Jiang, Yi Feng
BACKGROUND AND OBJECTIVES: Pediatric ophthalmologic surgery is traditionally accomplished by general anesthesia with opioids, but respiratory depression remains a major concern. Our study compared the efficacy of retrobulbar block with systemic fentanyl on pain, hemodynamic, and stress response in pediatric vitreoretinal surgery. METHODS: A prospective double-blind, randomized controlled study was performed comparing retrobulbar block with intravenously administered fentanyl in 28 children aged 1 to 6 years undergoing vitreoretinal surgery...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492438/advancing-safety-in-intrathecal-analgesia-a-novel-web-based-pharmacologic-requisition-platform-and-data-repository-for-intrathecal-drug-delivery-devices
#5
Christopher M Sobey, Chad R Greene, Lindsay J Ford, Jenna L Walters, Marc A Huntoon
No abstract text is available yet for this article.
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492437/continuous-intrathecal-infusion-of-cannabinoid-receptor-agonists-attenuates-nerve-ligation-induced-pain-in-rats
#6
Sheng-Jie Shiue, Hsien-Yu Peng, Chung-Ren Lin, Shih-Wei Wang, Ruey-Horng Rau, Jen-Kun Cheng
BACKGROUND AND OBJECTIVES: Cannabinoid receptors (CB1R/CB2R) are known to play important roles in pain transmission. In this study, we investigated the effects of continuous intrathecal infusion of CB1/2R agonists in the L5/6 spinal nerve ligation pain model. METHODS: Under isoflurane anesthesia, rats received nerve ligation and intrathecal catheter connected to an infusion pump. After surgery, saline (1 μL/h), CB1/2R agonist WIN55,212-2, CB1R agonist ACEA, or CB2R agonist AM1241 (1 μmol/h) was given intrathecally for 7 days...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28492436/continuous-regional-anesthesia-and-inpatient-rehabilitation-for-pediatric-complex-regional-pain-syndrome
#7
Carolina Donado, Kimberly Lobo, María Fe Velarde-Álvarez, Joseph Kim, Anne Kenney, Deirdre Logan, Charles B Berde
BACKGROUND: Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy and cognitive-behavioral therapy. Some patients have persistent pain and/or limb dysfunction despite these treatments. We performed a retrospective study of pediatric patients with CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along with inpatient rehabilitation at Boston Children's Hospital. METHODS: After approval from the institutional review board, electronic medical records were reviewed for patients treated between September 2003 and September 2014...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28394849/inhibition-of-voltage-gated-na-channels-by-bupivacaine-is-enhanced-by-the-adjuvants-buprenorphine-ketamine-and-clonidine
#8
Carsten Stoetzer, Christine Martell, Jeanne de la Roche, Andreas Leffler
BACKGROUND AND OBJECTIVES: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na channels...
April 7, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28394848/a-new-step-toward-evidence-of-in-vivo-perineural-dexamethasone-safety-an-animal-study
#9
Philippe Marty, Mehdi Bennis, Benjamin Legaillard, Etienne Cavaignac, Fabrice Ferre, Julie Lebon, Anne Brouchet, Vincent Minville
BACKGROUND AND OBJECTIVES: The aim of this study was to analyze histological nerve toxicity of perineural dexamethasone administration in combination with ropivacaine on mice. Efficacy of perineural dexamethasone in combination with regional anesthesia is clearly demonstrated. However, the safety of this procedure is still a matter of debate. METHODS: A sciatic nerve block was performed on 90 mice. Five groups, each containing 18 mice assigned randomly, were used in these experiments: the sham group (isotonic saline solution), R group (perineural ropivacaine), D group (perineural dexamethasone), RDPN group (perineural ropivacaine and perineural dexamethasone), and the RDS group (perineural ropivacaine and systemic dexamethasone)...
April 7, 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
#10
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
#11
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/28267071/use-of-a-dental-vibration-tool-to-reduce-pain-from-digital-blocks-a-randomized-controlled-trial
#12
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/28267068/sensory-distribution-of-the-lateral-cutaneous-nerve-of-forearm-after-ultrasound-guided-block-potential-implications-for-thumb-base-surgery
#13
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/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#14
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/28419054/local-anesthetic-diffusion-of-bilateral-sternal-block-after-cardiac-surgery
#15
Vedat Eljezi, Nicolas DʼOstrevy
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28419053/reply-to-dr-price
#16
De Q Tran, Julian Aliste, Maria Francisca Elgueta, Roderick J Finlayson
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28419052/it-s-not-just-about-the-diaphragm
#17
Darcy Price
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28419051/reply-to-dr-eid-et-al
#18
Irfan Raza, Madankumar Narayanan, Arun Venkataraju
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28419050/periosteal-infusion-of-local-anesthetics-as-an-alternative-to-bilateral-subpectoral-interfascial-plane-catheters-in-patients-with-sternal-fractures
#19
Mohamed Eid, Ben Goodman, Jonathan Womack, Barry Paul
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28419049/an-anatomical-basis-for-naming-plane-blocks-of-the-anteromedial-chest-wall
#20
Ki Jinn Chin
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
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