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https://www.readbyqxmd.com/read/28633155/regional-anesthesia-and-pain-medicine-us-anesthesiology-resident-training-the-year-2015
#1
Joseph M Neal, Anne Gravel Sullivan, Richard W Rosenquist, Dan J Kopacz
BACKGROUND AND OBJECTIVES: The Anesthesiology Review Committee of the Accreditation Council for Graduate Medical Education sets core requirements for residency program accreditation. We periodically report and analyze the US anesthesiology residents' training experience in regional anesthesia and pain medicine. METHODS: Resident caseload, procedure, and pain medicine evaluation data were aggregated for the resident cohort who graduated in 2015. These data were analyzed for present-day experience and compared with previous reports from years 1980, 1990, and 2000 graduates...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28627724/comparative-echogenicity-of-an-epidural-catheter-and-2-new-catheters-designed-for-ultrasound-guided-continuous-peripheral-nerve-blocks
#2
Daniel M Moy, T Edward Kim, T Kyle Harrison, Jody C Leng, Brendan Carvalho, Steven K Howard, Cynthia Shum, Alex Kou, Edward R Mariano
Visualization of the catheter during ultrasound-guided continuous nerve block performance may be difficult but is an essential skill for regional anesthesiologists. The objective of this in vitro study was to evaluate 2 newer catheters designed for enhanced echogenicity and compare them to a widely used catheter not purposely designed for ultrasound guidance. Outcomes were the numbers of first-place rankings among all 3 catheters and scores on individual echogenicity criteria as assessed by 2 blinded reviewers...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28625735/analgesic-and-physiological-effect-of-electroacupuncture-combined-with-epidural-lidocaine-in-goats
#3
Lu-Ying Cui, Ni-Ni Guo, Yu-Lin Li, Meng Li, Ming-Xing Ding
OBJECTIVE: To investigate physiological and antinociceptive effects of electroacupuncture (EA) with lidocaine epidural nerve block in goats. STUDY DESIGN: Prospective experimental trial. ANIMALS: Forty-eight hybrid male goats weighing 27 ± 2 kg. METHODS: The goats were randomly assigned to six groups: L2.2, epidural lidocaine (2.2 mg kg(-1)); L4.4, epidural lidocaine (4.4 mg kg(-1)); EA; EA-L1.1, EA with epidural lidocaine (1...
January 12, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28625308/the-role-of-ultrasonography-in-obstetric-anesthesia
#4
REVIEW
Allison Lee, John P R Loughrey
Ultrasonography is increasingly being viewed as an everyday tool in obstetric anesthesia. For the administration of spinal or epidural anesthesia, it reduces needle redirection attempts in patients with difficult anatomy. In the less frequent scenario of a collapsed patient, it helps with assessment in the form of transthoracic echocardiography. Abdominal blocks require ultrasound guidance for safe and anatomically correct placement. Accurate assessment of gastric volume status with ultrasound would be a useful everyday skill if it is adopted into mainstream practice...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28620569/the-optimal-pain-management-approach-for-a-laboring-patient-a-review-of-current-literature
#5
REVIEW
Albert Kelly, Quang Tran
There is a general agreement that a patient in labor should be given the option to have an epidural block for pain management. Despite this consensus, there are differences in practice patterns as to when to initiate an epidural and how to minimize its impact on the duration and outcome of a patient's labor. A review of the literature suggests epidural analgesia does prolong stages one and two of labor, but not significantly. Cesarean delivery rates are not affected by the early initiation of epidural analgesia...
May 10, 2017: Curēus
https://www.readbyqxmd.com/read/28611929/epidural-anesthesia-for-cesarean-section-in-a-pregnant-woman-with-marfan-syndrome-and-dural-ectasia
#6
Franco Pepe, Mariagrazia Stracquadanio, Francesco De Luca, Agata Privitera, Elisabetta Sanalitro, Puccio Scarpinati
Marfan syndrome (MFS) is a genetic disorder of connective tissue, characterized by variable clinical features and multisystem complications. The anesthetic management during delivery is debated. Regional anesthesia has been used with success during cesarean delivery, but in some MFS patients there is a probability of erratic and inadequate spread of intrathecal local anesthetics as a result of dural ectasia. In these cases, epidural anesthesia may be a particularly useful technique during cesarean delivery because it allows an adequate spread and action of local anesthetic with a controlled onset of anesthesia, analgesia, and sympathetic block and a low risk of perioperative complications...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28607343/failed-epidural-for-labour-what-now
#7
Emilia Guasch, Fabrizio Iannuccelli, Nicolas Brogly, Fernando Gilsanz
Labour epidural failure is a challenging situation for the obstetric anaesthetist, especially when associated to high risk of caesarean delivery, obesity, and difficult airway predictors. Labour epidural failure is still not standardly defined, consequently its incidence is uncertain: improving the knowledge of risk factors related to failure will increase epidural block success rate. Prolonged labours, previous history of epidural failure, and repeated topups needed during labour are recognized risk factors for failure...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#8
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28577077/-pain-therapy-during-labour
#9
REVIEW
Stefan Jochberger, Clemens Ortner, Klaus Ulrich Klein
To date the gold standard of treating labour pain is regional analgesia by application of epidural analgesia. When offering epidural analgesia, the programmed intermittent epidural bolus (PIEB) is more effective in terms of pain reduction, less motor blocks and higher satisfaction of the parturient compared to continuous application via perfusor pump. An upcoming alternative to epidural analgesia is remifentanil, a short acting and potent opioid. Remifentanil, however, requires haemodynamic monitoring as cardiac and respiratory impairment has been described...
June 2, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28576500/the-efficacy-of-conventional-radiofrequency-denervation-in-patients-with-chronic-low-back-pain-originating-from-the-facet-joints-a-meta-analysis-of-randomized-controlled-trials
#10
REVIEW
Chang-Hyun Lee, Chun Kee Chung, Chi Heon Kim
BACKGROUND CONTEXT: Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. PURPOSE: We aimed to elucidate the precise effects of radiofrequency denervation in patients with low back pain originating from the facet joints relative to those obtained using control treatments, with particular attention to consistency in the denervation protocol...
May 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28575334/characterization-of-peripheral-and-central-sensitization-after-dorsal-root-ganglion-intervention-in-patients-with-unilateral-lumbosacral-radicular-pain-a-prospective-pilot-study
#11
V Mehta, S Snidvongs, B Ghai, R Langford, T Wodehouse
Background.: Quantitative sensory testing (QST) has been used to predict the outcome of epidural steroid injections in lumbosacral radicular pain and has the potential to be an important tool in the selection of appropriate treatment (such as epidural steroid injections vs surgery) for patients with chronic radicular pain. In addition, QST assists in identification of the pain pathways of peripheral and central sensitization in selected groups of patients. Methods.: Twenty-three patients were given dorsal root ganglion (DRG) infiltration with local anaesthesia and steroid ('DRG block'), and those who demonstrated at least 50% pain relief were offered pulsed radiofrequency (PRF) to the DRG...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28566779/pain-management-in-total-knee-arthroplasty-by-intraoperative-local-anesthetic-application-and-one-shot-femoral-block
#12
Aykut Sigirci
BACKGROUND: Pain after total knee arthroplasty (TKA) is a big problem in orthopaedic surgery. Although opioids and continuous epidural analgesia remain the major options for the postoperative pain management of TKA, they have some undesirable side effects. Epidural analgesia is technically demanding, and the patient requires close monitoring. Different types of local anesthetic applications can successfully treat TKA pain. Local anesthetics have the advantage of minimizing pain at the source...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28551594/awake-caudal-anaesthesia-in-neonates-young-infants-for-improved-patient-safety
#13
Wan Yen Lim, Sujani Anuruddhika Wijeratne, Evangeline Hua Ling Lim
Caudal epidural block in a conscious infant is a recognised technique that allows the avoidance of general anaesthesia and risks associated with it. It is also technically easier to perform reliably compared with an awake subarachnoid block in skilled hands.(1) While local anaesthetic systemic toxicity is a rare complication of caudal anaesthesia, this case illustrates the potential for caudal anaesthesia done awake in enhancing patient safety through early recognition of local anaesthetic systemic toxicity...
May 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28549524/-quadratus-lumborum-block-are-we-aware-of-its-side-effects-a-report-of-2-cases
#14
Miguel Sá, José Miguel Cardoso, Hugo Reis, Marta Esteves, José Sampaio, Isabel Gouveia, Pilar Carballada, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The quadratus lumborum block was initially described in 2007 and aims at blocking the same nerves as the ones involved on the Transverse Abdominis Plane block, while accomplishing some visceral enervation as well due to closer proximity with the neuroaxis and sympathetic trunk. Given its versatility, we have successfully used it in a wide range of procedures. We report two cases where we believe the dispersion of local anesthetic is likely to have led to a previously undescribed complication...
May 23, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#15
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28535567/radiation-dose-and-procedure-time-for-994-ct-guided-spine-pain-control-procedures
#16
Matthew S Lazarus, Rebecca B Forman, Alan L Brook, Todd S Miller
BACKGROUND: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. OBJECTIVE: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28526487/ultrasound-guided-thoracic-paravertebral-injection-in-dogs-a-cadaveric-study
#17
Diego A Portela, Luis Campoy, Pablo E Otero, Manuel Martin-Flores, Robin D Gleed
OBJECTIVE: To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance. STUDY DESIGN: Anatomic cadaver study. ANIMALS: Seven dog cadavers. METHODS: One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0...
February 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#18
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28515518/is-segmental-epidural-anaesthesia-an-optimal-technique-for-patients-undergoing-percutaneous-nephrolithotomy
#19
Devangi A Parikh, Geeta A Patkar, Mayur S Ganvir, Ajit Sawant, Bharati A Tendolkar
BACKGROUND AND AIMS: Neuraxial anaesthesia has recently become popular for percutaneous nephrolithotomy (PCNL). We conducted a study comparing general anaesthesia (GA) with segmental (T6-T12) epidural anaesthesia (SEA) for PCNL with respect to anaesthesia and surgical characteristics. METHODS: Ninety American Society of Anesthesiologists Physical Status-I and II patients undergoing PCNL randomly received either GA or SEA. Overall patient satisfaction was the primary end point...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#20
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
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