Regional Anesthesia and Pain Medicine最新文献

{"title":"Outcome measures in studies on regional anesthesia.","authors":"Renee Jc van den Broek, Jonne Mc Postema, Joseph Sha Koopman, R Arthur Bouwman, Barbara Jb Versyck","doi":"10.1136/rapm-2025-106460","DOIUrl":"10.1136/rapm-2025-106460","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1231"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123998","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}

{"title":"Accuracy matters: estimating gastric volume in patients with gastric sleeve using a novel equation.","authors":"Ryan S D'Souza, Alexander S Doyal, Jacob R Wrobel, Sara Amaral","doi":"10.1136/rapm-2025-106898","DOIUrl":"10.1136/rapm-2025-106898","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1195-1196"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337263","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}

{"title":"The impact of local anesthetic systemic toxicity advisories on reporting to the National Poison Data System (NPDS).","authors":"Michael Fettiplace, Guy Weinberg, Heather Nixon, Alexandra Barabanova, Christopher Chiang, Marina Gitman","doi":"10.1136/rapm-2025-106464","DOIUrl":"10.1136/rapm-2025-106464","url":null,"abstract":"<p><strong>Introduction: </strong>In 2010, multiple anesthesia societies introduced recommendations for treating local anesthetic systemic toxicity, but the impact of those recommendations is uncertain.</p><p><strong>Objective: </strong>To test the hypothesis that reports of local anesthetic-related poisoning and mortality have declined since the publication of advisories in 2010.</p><p><strong>Methods: </strong>We analyzed reports of local anesthetic poisoning and mortality from the American Poison Centers National Poison Data System (NPDS) spanning 1983-2022. We conducted a case-non-case disproportionality analysis using the reporting odds ratio (ROR) to evaluate the effect of the 2010 recommendations on reports of poisoning and death to the NPDS by comparing reports of poisoning and death from 2011 to 2022 relative to 2001-2010. Multiple linear regression and Poisson regression were used for confirmation, together with exploratory analyses of individual cases of mortality.</p><p><strong>Results: </strong>In the decade following the introduction of recommendations (2011-2022), reports of local anesthetic poisoning decreased relative the prior decade (2001-2010, ROR=0.77, 95% CI 0.76 to 0.78, p<0.0001), driven by a decrease in non-lidocaine-related reports. Conversely, reports of lidocaine poisoning and reports of lidocaine mortality increased after 2010 (ROR=2.7 95% CI 1.3 to 5.6, p=0.0094). Case analysis revealed a decrease in reports of death in the operating room from 47% before 2010 to 15% after 2010, but an increase in reports of death from intravenous lidocaine delivery (3% to 27%, respectively).</p><p><strong>Discussion: </strong>The decrease in poisoning reports aligns with the implementation of professional recommendations and advancements, such as ultrasound-guided nerve blocks and lipid emulsion therapy. However, the rise in reports of lidocaine-related deaths-primarily in emergency settings-underscores significant risks. These findings emphasize the need for improved guidance on lidocaine use and dosing strategies to prevent lidocaine-related mortality.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1205-1211"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the non-inferiority conclusion true?","authors":"Soleil S Schutte","doi":"10.1136/rapm-2025-106430","DOIUrl":"10.1136/rapm-2025-106430","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1232"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123637","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}

{"title":"Trial within the trial: my journey of growth as a first-time principal investigator.","authors":"Clinton F Pillow","doi":"10.1136/rapm-2025-106910","DOIUrl":"10.1136/rapm-2025-106910","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1203-1204"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692479","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}

{"title":"Assessing the completeness of safety reporting in clinical trials of regional anesthesia interventions: a registry-publication comparison systematic review.","authors":"Caitlin McCormick, Danielle Waller, Ahmed Elghzali, Logan Corwin, Tag Harris, Rachel Hazlitt, Daniel Archer, Alicia I Ford, Matt Vassar","doi":"10.1136/rapm-2025-107055","DOIUrl":"10.1136/rapm-2025-107055","url":null,"abstract":"<p><strong>Background: </strong>Incomplete or inconsistent reporting of adverse events (AEs) undermines the interpretability of randomized trials. In interventional regional anesthesia (RA), where procedural risks must be clearly communicated, such discrepancies may obscure safety profiles. This study evaluates concordance between AE data reported in ClinicalTrials.gov and corresponding peer-reviewed publications.</p><p><strong>Methods: </strong>We conducted a systematic review of interventional RA trials registered on ClinicalTrials.gov with published results. AE data were extracted in duplicate across four domains: serious adverse events, other adverse events, treatment-related discontinuations, and all-cause mortality. Descriptive statistics characterized trial features. Bland-Altman and funnel plots assessed reporting concordance and bias. χ² tests compared reporting completeness by regulatory status. A composite 0-7 AE reporting score, derived from Food and Drug Administration Amendments Act Final Rule-mandated fields, was analyzed using linear and segmented regressions to identify predictors of reporting and temporal trends.</p><p><strong>Results: </strong>Among included trials, substantial discrepancies were observed in AE counts between ClinicalTrials.gov and publications. Funnel plot asymmetry suggested possible underreporting in smaller studies. Trials subject to FDA reporting requirements were significantly more likely to report complete AE data (p<0.05). Composite AE reporting scores were higher in industry-sponsored and drug-focused trials. Segmented regression identified a modest post-Final Rule increase in reporting completeness, though recent-year instability limits interpretation.</p><p><strong>Discussion: </strong>In RA trials, AE reporting is frequently incomplete or discordant across sources, with regulatory oversight linked to greater transparency. These findings highlight the need for standardized safety reporting and alignment between registries and publications to ensure accurate risk communication in anesthesiology research.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1212-1220"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276669","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}

{"title":"Response to the letter to the editor.","authors":"Thomas Hickey, Victor Javier Avila-Quintero, Joao P De Aquino","doi":"10.1136/rapm-2025-106481","DOIUrl":"10.1136/rapm-2025-106481","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1230"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392431","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}

{"title":"Risk of dementia following gabapentin prescription in chronic low back pain patients.","authors":"Nafis B Eghrari, Isabella H Yazji, Bryan Yavari, Gustaf M Van Acker, Chong H Kim","doi":"10.1136/rapm-2025-106577","DOIUrl":"10.1136/rapm-2025-106577","url":null,"abstract":"<p><strong>Introduction: </strong>Gabapentin is widely used to treat chronic pain, but its association with cognitive decline and dementia remains unclear. This study examined whether gabapentin prescription is associated with dementia in adults with chronic low back pain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX national database of de-identified patient records from 2004 to 2024. Adults diagnosed with chronic low back pain were included; those with prior gabapentin use, dementia, epilepsy, stroke, or cancer were excluded. Propensity score matching controlled for demographics, comorbidities, and pain medications. Patients were stratified by age and gabapentin prescription frequency. Primary outcomes were dementia and mild cognitive impairment.</p><p><strong>Results: </strong>26,416 adults we analyzed following propensity-score matching. Patients with six or more gabapentin prescriptions had an increased incidence of dementia (RR: 1.29; 95% CI: 1.18-1.40) and mild cognitive impairment (RR: 1.85; 95% CI: 1.63-2.10). When stratified by age, non-elderly adults (18-64) prescribed gabapentin had over twice the risk of dementia (RR: 2.10; 95% CI: 1.75-2.51) and mild cognitive impairment (RR: 2.50; 95% CI: 2.04-3.05) compared to those not prescribed gabapentin. Risk increased further with prescription frequency: patients with 12 or more prescriptions had a higher incidence of dementia (RR: 1.40; 95% CI: 1.25-1.57) and mild cognitive impairment (RR: 1.65; 95% CI: 1.42-1.91) than those prescribed gabapentin 3-11 times.</p><p><strong>Conclusions: </strong>Gabapentin prescription in adults with chronic low back pain is associated with increased risk of dementia and cognitive impairment, particularly in non-elderly adults. Physicians should monitor cognitive outcomes in patients prescribed gabapentin.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1118-1123"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610355","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}

{"title":"Lost in scope: inadequate reporting of scoping reviews in neuromodulation for chronic pain.","authors":"Mahmoud Morsi, Mark Chedraoui, Hunter Soleymani, Nasir Hussain, Larry Prokop, Ryan S D'Souza","doi":"10.1136/rapm-2025-106807","DOIUrl":"10.1136/rapm-2025-106807","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1191-1194"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295313","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}

{"title":"Point-of-care ultrasound of the diaphragm after proximal brachial plexus block for shoulder surgery: a prospective observational study.","authors":"Michelle Chong, Laura Girón-Arango, Kim Wild, Qixuan Li, Ella Huszti, Jayanta Chowdhury, Vincent Chan, Anahi Perlas","doi":"10.1136/rapm-2024-106222","DOIUrl":"10.1136/rapm-2024-106222","url":null,"abstract":"<p><strong>Introduction: </strong>This observational study evaluates diaphragmatic excursion and thickening fraction before and after proximal analgesic brachial plexus block in 99 patients undergoing shoulder surgery.</p><p><strong>Methods: </strong>This study has a prospective, observational, blinded design and evaluates three methods of sonographic assessment: (1) the excursion of the dome of the diaphragm, (2) the thickening fraction of the zone of apposition, and (3) the excursion of the zone of apposition. All three methods of assessment were used prior to and within 30 min of a proximal brachial plexus block for shoulder surgery. The blocks were all ultrasound-guided and were either an interscalene block or a superior trunk block with 15-20 mL of ropivacaine 0.5% or bupivacaine 0.25% with 1:400 000 epinephrine. The type of block was not randomized and was left to the discretion of the anesthesiologist performing the nerve block.</p><p><strong>Results: </strong>Assessment of the excursion of the zone of apposition and the thickening fraction was possible bilaterally in all patients. Assessment of the excursion of the dome of the diaphragm was consistently possible on the right side but only possible in about half of the patients (48.8% preblock and 46.3% postblock) on the left hemithorax. The median decrease in diaphragmatic function was between 42% and 82% dependent upon the type of nerve block, patient sex, and method of evaluation. One patient developed complete plegia, and three-quarters of all patients developed >50% weakness. Female sex and interscalene block were associated with greater weakness.</p><p><strong>Conclusion: </strong>The data suggest that the assessment of the excursion of the zone of apposition on the lateral aspect of the chest using a linear probe is consistently successful in measuring both baseline and postblock values of diaphragmatic excursion, and thus it may be a helpful tool in the perioperative period. Future studies are needed to establish use in other clinical settings as well as assessment of learning curves and reliability of this emerging technique.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"1137-1143"},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789261","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}