Regional Anesthesia and Pain Medicine最新文献_第10页

Real time continuous monitoring of injection pressure at the needle tip is better than ultrasound in early detecting intraneural injection. 实时连续监测针尖注射压力在早期发现神经内注射方面优于超声。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-14 DOI: 10.1136/rapm-2024-106086

Roberto Dossi, Christian Quadri, Xavier Capdevila, Andrea Saporito

{"title":"Real time continuous monitoring of injection pressure at the needle tip is better than ultrasound in early detecting intraneural injection.","authors":"Roberto Dossi, Christian Quadri, Xavier Capdevila, Andrea Saporito","doi":"10.1136/rapm-2024-106086","DOIUrl":"10.1136/rapm-2024-106086","url":null,"abstract":"Introduction: During peripheral nerve blocks, inadvertent intraneural injection is not infrequent. Recently, with sonographic nerve swelling, it has been shown that intraneural injection can be detected as early as 0.4 mL. A new method based on injection pressure monitoring at the needle tip, the real pressure in the tissues, is compared with sonographic performance in early detection of intraneural injection.Methods: This cadaver study was conducted on the upper limb of fresh cadavers. Senior anesthesiologists performed ultrasound guided intraneural injections of the nerves using a modified Visioplex needle with a fiberoptic sensor embedded. 12 injections were performed, two on each nerve (radial, ulnar, and median) for each anatomical preparation. 3 mL of saline methylene blue mix was injected at 10 mL/min. Recordings of ultrasound screen and pressure curves were blindly analyzed to evaluate nerve swelling and injection pressures.Results: An immediate increase in injection pressure from time zero was observed in all 12 intraneural injections, with similar trends. After only 0.2 mL, intraneural injection was clearly identified as the pressure curves had already risen to an average of 120 mm Hg (SD 5). Nerve swelling was observed in 10 of 12 injections (83%). This was evident after an average of 1.2 mL (SD 0.5). Following injections, dissection of specimens confirmed intraneural spread in all cases.Conclusion: Pressure monitoring at the needle tip consistently showed a pressure rise from the onset of injection and proved to be a more sensitive and earlier indicator of intraneural injection than sonographic nerve swelling.","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing risks in brachial plexus blocks: what you need to know - an infographic. 比较臂丛神经阻滞的风险：你需要知道的信息图。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-09 DOI: 10.1136/rapm-2024-106313

Hipolito Labandeyra, Ryan S D'Souza

引用次数: 0

Buprenorphine versus full agonist opioids for acute postoperative pain management: an infographic. 丁丙诺啡与完全激动剂阿片类药物用于急性术后疼痛管理：信息图。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-09 DOI: 10.1136/rapm-2024-106304

Thomas R Hickey, Gabriel P A Costa, Victor Javier Avila-Quintero, Joao P De Aquino

引用次数: 0

Deciphering risk factors for severe postherpetic neuralgia in patients with herpes zoster: an interpretable machine learning approach. 破译带状疱疹患者严重疱疹后神经痛的危险因素：一种可解释的机器学习方法。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-08 DOI: 10.1136/rapm-2024-106003

Soo Jung Park, Jinseon Han, Jong Bum Choi, Sang Kee Min, Jungchan Park, Suein Choi

{"title":"Deciphering risk factors for severe postherpetic neuralgia in patients with herpes zoster: an interpretable machine learning approach.","authors":"Soo Jung Park, Jinseon Han, Jong Bum Choi, Sang Kee Min, Jungchan Park, Suein Choi","doi":"10.1136/rapm-2024-106003","DOIUrl":"https://doi.org/10.1136/rapm-2024-106003","url":null,"abstract":"Introduction: Postherpetic neuralgia (PHN) is a common complication of herpes zoster (HZ). This study aimed to use a large real-world electronic medical records database to determine the optimal machine learning model for predicting the progression to severe PHN and to identify the associated risk factors.Methods: We analyzed the electronic medical records of 23,326 patients diagnosed with HZ from January 2010 to June 2020. PHN was defined as pain persisting for ≥90 days post-HZ, based on diagnostic and prescription codes. Five machine learning algorithms were compared with select the optimal predictive model and a subsequent risk factor analysis was conducted.Results: Of the 23,326 patients reviewed, 8,878 met the eligibility criteria for the HZ cohort. Among these, 801 patients (9.0%) progressed to severe PHN. Among the various machine learning approaches, XGBoost-an approach that combines multiple decision trees to improve predictive accuracy-performed the best in predicting outcomes (F1 score, 0.351; accuracy, 0.900; area under the receiver operating characteristic curve, 0.787). Using this model, we revealed eight major risk factors: older age, female sex, history of shingles and cancer, use of immunosuppressants and antidepressants, intensive initial pain, and the neutrophil-to-lymphocyte ratio. When patients were categorized into low-risk and high-risk groups based on the predictive model, PHN was seven times more likely to occur in the high-risk group (p<0.001).Conclusions: Leveraging machine learning analysis, this study identifies an optimal model for predicting severe PHN and highlights key associated risk factors. This model will enable the establishment of more proactive treatments for high-risk patients, potentially mitigating the progression to severe PHN.","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of long-acting local anesthetics versus their mixture with shorter-acting local anesthetics for peripheral nerve blocks guided by ultrasound: a systematic review with meta-analysis of randomized controlled trials. 长效局麻药与短时局麻药混合用于超声引导下周围神经阻滞的疗效：一项随机对照试验的系统综述和荟萃分析。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-08 DOI: 10.1136/rapm-2024-106104

Natanael Pietroski Dos Santos, Vanessa de Paula Silva, Guilherme Stéfano da Silva Oliveira, Victor Cardoso Musacchio, Vanessa Henriques Carvalho

{"title":"Efficacy of long-acting local anesthetics versus their mixture with shorter-acting local anesthetics for peripheral nerve blocks guided by ultrasound: a systematic review with meta-analysis of randomized controlled trials.","authors":"Natanael Pietroski Dos Santos, Vanessa de Paula Silva, Guilherme Stéfano da Silva Oliveira, Victor Cardoso Musacchio, Vanessa Henriques Carvalho","doi":"10.1136/rapm-2024-106104","DOIUrl":"https://doi.org/10.1136/rapm-2024-106104","url":null,"abstract":"Background/importance: Local anesthetic (LA) mixtures are used in peripheral nerve blocks (PNB) to improve onset, though study results remain conflicting.Objective: This systematic review and meta-analysis compared the efficacy outcomes of long-acting LA to their mixture with shorter-acting LA in ultrasound-guided PNB. The primary outcome was sensory block onset.Evidence review: We searched WoS, Scopus, MEDLINE, EMBASE, BVS/LILACS, and Cochrane databases from 1998 to 2024 for randomized controlled trials (RCTs). We conducted a random-effects meta-analysis, evaluated the risk of bias (RoB) with RoB 2.0, performed sensitivity analyses, assessed non-reporting bias with DOI plots and Luis Furuya-Kanamori index, and evaluated strength of evidence with Grading of Recommendations Assessment, Development and Evaluations.Findings: We included 10 RCTs (516 participants). Mixture of LA may have no effect on sensory block onset (mean difference (MD) -1.62 min, 95% CI: -4.04 to 0.81; I2=81.50%, 95% CI: 62.82% to 90.80%; prediction interval (PI)=-7.78 to 4.55; very low certainty) and motor block onset (MD -5.60 min; 95% CI: -14.54 to 3.33, I2=98.89%, 95% CI: 98.50% to 99.18%; PI=-31.90 to 20.69; very low certainty), while it may reduce the duration of sensory block (MD -2.16 hours, 95% CI: -4.16 to -0.17; I2=90.77%, 95% CI: 84.22% to 94.60%; PI=-7.24 to 2.92; very low certainty).Conclusions: LA mixtures may not affect sensory and motor block onset in ultrasound-guided PNB but could shorten the duration of sensory blockade.","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Years of potential life lost from COVID-19 and the opioid crisis in 2020-2021 in Northern New England. 新英格兰北部2020-2021年2019冠状病毒病和阿片类药物危机可能造成的数年生命损失。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-07 DOI: 10.1136/rapm-2023-104430

Jewelia A Durant, George C Rettaliata, Alessandra Cristine Bryan, Andreas H Taenzer, Alexander Abess

引用次数: 0

Emergence of xylazine as a public health threat: what does the anesthesiologist need to know for perioperative care? 作为一种公共卫生威胁出现的异丙嗪：麻醉医师在围手术期护理方面需要了解什么？

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-07 DOI: 10.1136/rapm-2023-105190

Pawan K Solanki, Samir Yellapragada, Brendan Lynch, Maria Eibel, Eugene R Viscusi, Trent Emerick

引用次数: 0

Efficacy of iliopsoas plane block for patients undergoing hip arthroscopy: a prospective, triple-blind, randomized, placebo-controlled trial. 髂腰肌平面阻滞对髋关节镜患者的疗效:一项前瞻性、三盲、随机、安慰剂对照试验。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-07 DOI: 10.1136/rapm-2023-104989

Christian Jessen, Lone Dragnes Brix, Thomas Dahl Nielsen, Ulrick Skipper Espelund, Bent Lund, Thomas Fichtner Bendtsen

{"title":"Efficacy of iliopsoas plane block for patients undergoing hip arthroscopy: a prospective, triple-blind, randomized, placebo-controlled trial.","authors":"Christian Jessen, Lone Dragnes Brix, Thomas Dahl Nielsen, Ulrick Skipper Espelund, Bent Lund, Thomas Fichtner Bendtsen","doi":"10.1136/rapm-2023-104989","DOIUrl":"10.1136/rapm-2023-104989","url":null,"abstract":"Background: Intraoperative stretching of the hip joint capsule often generates severe pain during the first 3 hours after hip arthroscopy. The short-lived severe pain mandates high opioid consumption, which may result in adverse events and delay recovery. The femoral nerve nociceptors are located anteriorly in the hip joint capsule. A femoral nerve block reduces pain and opioid demand after hip arthroscopy. It impedes, however, ambulation and home discharge after outpatient surgery. The iliopsoas plane block selectively anesthetizes the femoral sensory nerve branches innervating the hip joint capsule without compromising ambulation. We aimed to assess reduction of opioid consumption after iliopsoas plane block during the short-lived painful postsurgical period of time after hip arthroscopy.Methods: In a randomized, triple-blind trial, 50 patients scheduled for hip arthroscopy in general anesthesia were allocated to active or placebo iliopsoas plane block. The primary outcome was opioid consumption during the first three postoperative hours in the postanesthesia care unit. Secondary outcomes included pain, nausea, and ability to ambulate.Results: Forty-nine patients were analyzed for the primary outcome. The mean 3-hour intravenous morphine equivalent consumption in the iliopsoas plane block group was 10.4 mg vs 23.8 mg in the placebo group (p<0.001). No intergroup differences were observed for the secondary outcomes during the postoperative follow-up.Conclusion: An iliopsoas plane block reduces opioid consumption after hip arthroscopy. The reduction of opioid consumption during the clinically relevant 3-hour postsurgical period of time was larger than 50% for active versus placebo iliopsoas plane block in this randomized, triple-blind trial.","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"5-10"},"PeriodicalIF":5.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracoscopic surgery: a prospective randomized open-label non-inferiority trial. 视频辅助胸腔镜手术中的持续竖脊肌平面阻滞与胸硬膜外镇痛：一项前瞻性随机开放标签非劣效性试验。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-07 DOI: 10.1136/rapm-2023-105047

Renee J C van den Broek, Jonne M C Postema, Joseph S H A Koopman, Charles C van Rossem, Jules R Olsthoorn, Thomas J van Brakel, Saskia Houterman, R Arthur Bouwman, Barbara Versyck

{"title":"Continuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracoscopic surgery: a prospective randomized open-label non-inferiority trial.","authors":"Renee J C van den Broek, Jonne M C Postema, Joseph S H A Koopman, Charles C van Rossem, Jules R Olsthoorn, Thomas J van Brakel, Saskia Houterman, R Arthur Bouwman, Barbara Versyck","doi":"10.1136/rapm-2023-105047","DOIUrl":"10.1136/rapm-2023-105047","url":null,"abstract":"Background and objectives: The evolving surgical techniques in thoracoscopic surgery necessitate the exploration of anesthesiological techniques. This study aimed to investigate whether incorporating a continuous erector spinae plane (ESP) block into a multimodal analgesia regimen is non-inferior to continuous thoracic epidural analgesia (TEA) in terms of quality of postoperative recovery for patients undergoing elective unilateral video-assisted thoracoscopic surgery.Methods: We conducted a multicenter, prospective, randomized, open-label non-inferiority trial between July 2020 and December 2022. Ninety patients were randomly assigned to receive either continuous ESP block or TEA. The primary outcome parameter was the Quality of Recovery-15 (QoR-15) score, measured before surgery as a baseline and on postoperative days 0, 1, and 2. Secondary outcome parameters included pain scores, length of hospital stay, morphine consumption, nausea and vomiting, itching, speed of mobilization, and urinary catheterization.Results: Analysis of the primary outcome showed a mean QoR-15 difference between the groups ESP block versus TEA of 1 (95% CI -9 to -12, p=0.79) on day 0, -1 (95% CI -11 to -8, p=0.81) on day 1 and -2 (95% CI -14 to -11, p=0.79) on day 2.Conclusions: The continuous ESP block is non-inferior to TEA in video-assisted thoracoscopic surgery.Trial registration number: Dutch Trial Register (NL6433).","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"11-19"},"PeriodicalIF":5.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139426017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating factors impacting National Institutes of Health funding in pain medicine. 评估影响美国国立卫生研究院疼痛医学基金的因素。

IF 5.1 2区医学

Regional Anesthesia and Pain Medicine Pub Date : 2025-01-07 DOI: 10.1136/rapm-2024-106132

Christopher Kurian, Emil Kurian, Vwaire Orhurhu, Elizabeth Korn, Mariam Salisu-Orhurhu, Ariel Mueller, Timothy Houle, Shiqian Shen

{"title":"Evaluating factors impacting National Institutes of Health funding in pain medicine.","authors":"Christopher Kurian, Emil Kurian, Vwaire Orhurhu, Elizabeth Korn, Mariam Salisu-Orhurhu, Ariel Mueller, Timothy Houle, Shiqian Shen","doi":"10.1136/rapm-2024-106132","DOIUrl":"https://doi.org/10.1136/rapm-2024-106132","url":null,"abstract":"Background: While many medical specialties have established links between bibliometric indices, academic rank, leadership roles, and National Institutes of Health (NIH) funding, there exists a gap within the field of pain medicine. The purpose of our study is to examine the impact of research productivity (h-index, m-index, publications, citations), professional degrees (PhD, MPH, MBA), leadership positions (program director, division chief, chairman), and faculty demographics (gender, nationality of training) on attaining NIH grant funding among pain medicine faculty.Methods: A complete list of 98 civilian pain medicine programs was included in the study. Between September 1, 2022, and December 30, 2022, departmental websites were accessed to accrue a list of pain medicine faculty listings. Publicly available information was used to extract research productivities, professional degrees, leadership positions, faculty demographics, and NIH grant funding. Descriptive statistics were used for analysis, with NIH funding status as the primary outcome.Results: A total of 696 pain physicians within the academic community were identified. Markers of research productivity such as a higher h- or m-index, larger number of publications and citations, PhD status, and being senior faculty (full professor, division chief, or chairman) were independently associated with NIH funding. There was no statistical difference (p>0.05) among males and females in the number of R grants received.Conclusions: We have identified many factors associated with NIH funding status and failed to find significant gender disparities in NIH funding. These findings allow for chronic pain programs to have another set of tools to attract, promote, and retain faculty.","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0