Regional Anesthesia & Pain Medicine最新文献

{"title":"Single-center cross-sectional study of high opioid prescribing among U.S. veterans with peripheral arterial disease","authors":"J. Stern, A. Kou, Aditi Kapoor, Samantha Regala, Han He, R. Stafford, E. Mariano, Seshadri C. Mudumbai","doi":"10.1136/rapm-2022-103574","DOIUrl":"https://doi.org/10.1136/rapm-2022-103574","url":null,"abstract":"Division of Vascular & Endovascular Surgery, Stanford University School of Medicine, Stanford, California, USA Surgical Service, VA Palo Alto Health Care System, Palo Alto, California, USA Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"37 1","pages":"651 - 652"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80129492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics","authors":"","doi":"10.1136/rapm-2021-103115corr1","DOIUrl":"https://doi.org/10.1136/rapm-2021-103115corr1","url":null,"abstract":"","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"166 1","pages":"e3 - e3"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77858335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial","authors":"","doi":"10.1136/rapm-2021-103228corr1","DOIUrl":"https://doi.org/10.1136/rapm-2021-103228corr1","url":null,"abstract":"Zheng J, Pan D, Zheng B, et al. Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebocontrolled trial. Reg Anesth Pain Med 2022;47:155–160. doi: 10.1136/rapm2021103228 The correct affiliation for the corresponding author, Xiangcai Ruan, is: Department of Anesthesiology and Pain Medicine, The Sixth Affiliated Hospital, Sun Yatsen University, Guangzhou, China.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"33 1","pages":"e4 - e4"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80018703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between thoracic epidural block and major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia","authors":"K. Onoe, Hiroki Ogata, Takuma Okamoto, H. Okutani, R. Ueki, N. Kariya, T. Tatara, M. Hashimoto, S. Hasegawa, Y. Matsuki, Munetaka Hirose","doi":"10.1136/rapm-2022-103688","DOIUrl":"https://doi.org/10.1136/rapm-2022-103688","url":null,"abstract":"Introduction A curative-intent surgical procedure, pleurectomy/decortication, for malignant pleural mesothelioma is accompanied by a high incidence of major postoperative complications. Although epidural block, which suppresses nociception during and after surgery, reportedly has both benefits and disadvantages in terms of outcomes after thoracic surgery for other diseases, the effects of epidural block on major complications after pleurectomy/decortication have not been evaluated. The aim of this study was to evaluate the association between epidural block and major postoperative complications following pleurectomy/decortication. Methods In a single-institutional observational study, consecutive adult patients undergoing pleurectomy/decortication under general anesthesia were enrolled from March 2019 to December 2021. Multivariable logistic regression analysis was performed to determine the association between perioperative variables and major complications. Next, patients were divided into two groups: general anesthesia with and without epidural block. Incidences of major postoperative complications, defined as Clavien-Dindo grades≥III, were compared between groups. Results In all patients enrolled with American Society of Anesthesiologists (ASA) physical status II or III (n=99), general anesthesia without epidural block was identified as a sole risk factor for major complications among perioperative variables. The incidence of major complications was 32.3% (95% CI 19.1% to 49.2%) in patients with epidural block (n=34), which was significantly lower than 63.1% (95% CI 50.9% to 73.8%) in patients without epidural block (n=65). In sensitivity analysis in patients with ASA physical status II alone, the same results were obtained. Conclusion Epidural block is likely associated with reduction of the incidence of major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"33 1","pages":"494 - 499"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78118122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a correlation between Altmetric Attention Scores and citation count in Regional Anesthesia and Pain Medicine journal articles?","authors":"Taras Grosh, James Kim, Veena Graff, E. Mariano, N. Elkassabany","doi":"10.1136/rapm-2022-103554","DOIUrl":"https://doi.org/10.1136/rapm-2022-103554","url":null,"abstract":"To cite: Grosh T, Kim J, Graff V, et al. Reg Anesth Pain Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/rapm-2022103554 Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"92 1","pages":"649 - 650"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80378371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical spine ligamentum flavum gaps: MR characterisation and implications for interlaminar epidural injection therapy","authors":"Jatin Joshi, M. Roytman, R. Aiyer, E. Mauer, J. L. Chazen","doi":"10.1136/rapm-2022-103552","DOIUrl":"https://doi.org/10.1136/rapm-2022-103552","url":null,"abstract":"Background Cervical epidural steroid injections are commonly performed to manage pain from cervical spine disease. Cadaveric studies have demonstrated incomplete ligamentum flavum fusion in the central interlaminar region with resultant midline gaps. We performed an MR-based characterization of cervical ligamentum flavum midline gaps to improve understanding of their prevalence and guide interventionalists in procedural planning. Methods Fifty patients were retrospectively reviewed following institutional review board approval. Axial T2-weighted spinecho sequences were used to evaluate ligamentum flavum integrity at the interlaminar spaces of C5–C6, C6–C7 and C7–T1. Interlaminar spaces were further subdivided into superior, middle, and inferior portions, yielding 150 interlaminar regions characterized from C5 to T1. Subsequently, a novel categorization of gap morphology was performed, highlighting gap morphology (anterior, posterior, full, or no gap). Results Full gaps of the ligamentum flavum, with direct epidural space exposure, were observed with variable prevalence at all three levels evaluated. The highest incidence of full ligamentum flavum gaps were observed at C7–T1, occurring in 71.4% of patients at both its middle and inferior portions. The inferior aspect of C5–C6 demonstrated the lowest observed rates of full ligamentum flavum gap (2%). Conclusions Ligamentum flavum gaps occur in the lower cervical spine at high rates, with the highest prevalence of full thickness ligamentum flavum gaps at C7–T1. Interventionists must be aware of these important normal variants and evaluate preprocedural MRI to plan interventions.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"50 1","pages":"459 - 463"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85850093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lidocaine infusions for refractory chronic migraine: a retrospective analysis","authors":"E. Schwenk, Aaron Walter, M. Torjman, Sarah Mukhtar, Harsh T Patel, Bryan Nardone, George Sun, Bhavana Thota, C. Lauritsen, S. Silberstein","doi":"10.1136/rapm-2021-103180","DOIUrl":"https://doi.org/10.1136/rapm-2021-103180","url":null,"abstract":"Introduction Patients with refractory chronic migraine have poor quality of life. Intravenous infusions are indicated to rapidly ‘break the cycle’ of pain. Lidocaine infusions may be effective but evidence is limited. Methods The records of 832 hospital admissions involving continuous multiday lidocaine infusions for migraine were reviewed. All patients met criteria for refractory chronic migraine. During hospitalization, patients received additional migraine medications including ketorolac, magnesium, dihydroergotamine, methylprednisolone, and neuroleptics. The primary outcome was change in headache pain from baseline to hospital discharge. Secondary outcomes measured at the post-discharge office visit (25–65 days after treatment) included headache pain and the number of headache days, and percentage of sustained responders. Percentage of acute responders, plasma lidocaine levels, and adverse drug effects were also determined. Results In total, 609 patient admissions met criteria. The mean age was 46±14 years; 81.1% were female. Median pain rating decreased from baseline of 7.0 (5.0–8.0) to 1.0 (0.0–3.0) at end of hospitalization (p<0.001); 87.8% of patients were acute responders. Average pain (N=261) remained below baseline at office visit 1 (5.5 (4.0–7.0); p<0.001). Forty-three percent of patients were sustained responders at 1 month. Headache days (N=266) decreased from 26.8±3.9 at baseline to 22.5±8.3 at the post-discharge office visit (p<0.001). Nausea and vomiting were the most common adverse drug effects and all were mild. Conclusion Lidocaine infusions may be associated with short-term and medium-term pain relief in refractory chronic migraine. Prospective studies should confirm these results.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"68 1","pages":"408 - 413"},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81696658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of regional anesthesia and analgesia in enhanced recovery after colorectal surgery: a systematic review of randomized controlled trials.","authors":"Kariem El-Boghdadly, James M Jack, Aine Heaney, Nick D Black, Marina F Englesakis, Henrik Kehlet, Vincent W S Chan","doi":"10.1136/rapm-2021-103256","DOIUrl":"10.1136/rapm-2021-103256","url":null,"abstract":"<p><strong>Background: </strong>Effective analgesia is an important element of enhanced recovery after surgery (ERAS), but the clinical impact of regional anesthesia and analgesia for colorectal surgery remains unclear.</p><p><strong>Objective: </strong>We aimed to determine the impact of regional anesthesia following colorectal surgery in the setting of ERAS.</p><p><strong>Evidence review: </strong>We performed a systematic review of nine databases up to June 2020, seeking randomized controlled trials comparing regional anesthesia versus control in an ERAS pathway for colorectal surgery. We analyzed the studies with successful ERAS implementation, defined as ERAS protocols with a hospital length of stay of ≤5 days. Data were qualitatively synthesized. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.</p><p><strong>Findings: </strong>Of the 29 studies reporting ERAS pathways, only 13 comprising 1170 patients were included, with modest methodological quality and poor reporting of adherence to ERAS pathways. Epidural analgesia had limited evidence of outcome benefits in open surgery, while spinal analgesia with intrathecal opioids may potentially be associated with improved outcomes with no impact on length of stay in laparoscopic surgery, though dosing must be further investigated. There was limited evidence for fascial plane blocks or other regional anesthetic techniques.</p><p><strong>Conclusions: </strong>Although there was variable methodological quality and reporting of ERAS, we found little evidence demonstrating the clinical benefits of regional anesthetic techniques in the setting of successful ERAS implementation, and future studies must report adherence to ERAS in order for their interventions to be generalizable to modern clinical practice.</p><p><strong>Prospero registration number: </strong>CRD42020161200.</p>","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"28 1","pages":"282-292"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73469156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided selective trunk block (SeTB): a cadaver anatomic study to evaluate the spread of dye after a simulated injection","authors":"B. Songthamwat, P. Luangjarmekorn, Wirinaree Kampitak, R. Sivakumar, M. Karmakar","doi":"10.1136/rapm-2022-103630","DOIUrl":"https://doi.org/10.1136/rapm-2022-103630","url":null,"abstract":"Background and objectives Recent reports suggest that a selective trunk block (SeTB) can produce sensorimotor blockade of the entire upper extremity, except for the T2 dermatome. There are no data demonstrating the anatomic mechanism of SeTB. This cadaver study aimed to evaluate the spread of an injectate after a simulated ultrasound-guided (USG) SeTB. Methods USG SeTB (n=7) was performed on both sides of the neck in four adult human cadavers with 25 mL of 0.1% methylene blue dye. Anatomic dissection was performed to document staining (deep, faint, and no stain) of the various elements of the brachial plexus from the level of the roots to the cords, including the phrenic, dorsal scapular, and long thoracic nerves. Only structures that were deeply stained were defined as being affected by the SeTB. Results All the trunks and divisions of the brachial plexus, as well as the ventral rami of C5–C7 and suprascapular nerve, were deeply stained in all (100%) the simulated injections. The ventral rami of C8 and T1 (86%), dorsal scapular and long thoracic nerve (71%), and the phrenic nerve (57%) were also deeply stained in a substantial number of the injections. Conclusion This cadaver study demonstrates that an USG SeTB consistently affects all the trunks and divisions of the brachial plexus, as well as the suprascapular nerve. This study also establishes that SeTB may not be phrenic nerve sparing. Future research to evaluate the safety and efficacy of SeTB as an all-purpose brachial plexus block technique for upper extremity surgery is warranted. Trial registration number Registered at https://www.thaiclinicaltrials.org on December 13, 2021 under the trial registration number TCTR20211213005.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"22 1","pages":"414 - 419"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83725916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of epidurography in the perioperative and acute pain setting","authors":"J. R. Coleman, P. Hartmann, Matthew Kona, Robert Thiele, Reza Salajegheh, N. Hanson","doi":"10.1136/rapm-2021-103274","DOIUrl":"https://doi.org/10.1136/rapm-2021-103274","url":null,"abstract":"Ensuring proper placement of epidural catheters is critical to improving their reliability for pain control and maintaining confidence in their continued use. This article will seek to address the role of objective confirmation of successful epidural placement via either single view or continuous epidural contrast studies, each creating an ‘epidurogram.’ Furthermore, the pertinent anatomical corollaries of continuous fluoroscopy used frequently in chronic pain medicine, from which these techniques emerged, will be addressed. Technical radiographic information needed to better understand and troubleshoot these studies is also included. Image examples which highlight the patterns key for successful interpretation of epidurograms will be provided. The aim of this paper was to provide an anesthesiologist unfamiliar with fluoroscopic evaluation of epidural catheters with the tools necessary to successfully conduct and interpret such an examination.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"8 1","pages":"445 - 448"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80137899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}