Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2015
Observational StudyEvaluation of anxiety in procedure-naive patients during cervical and lumbar epidural steroid injection procedures.
The lack of studies that identify patient and procedural risk factors for increased levels of anxiety during spine injections represents a major barrier to the development of safe tailored sedation practices. We measured and compared anxiety in procedure-naive patients undergoing a cervical or lumbar interlaminar epidural steroid injection to identify predictors of patient movement and vasovagal responses in the periprocedural period. ⋯ No group differences in anxiety were seen between cervical and lumbar groups. Anxiety levels were not associated with patient movement or vasovagal symptoms. Our results suggest that the practice of routine prevention or treatment of injection-related anxiety in the procedure-naive general population with a duration of pain less than 6 months and without a history of an anxiety disorder should be reevaluated.
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Reg Anesth Pain Med · May 2015
Randomized Controlled TrialImpact of pregabalin on the occurrence of postthoracotomy pain syndrome: a randomized trial.
Postthoracotomy pain syndrome (PTPS) is a frequent cause of chronic postoperative pain. Pregabalin might reduce the incidence of chronic postoperative pain. The goal of this study was to evaluate the impact of perioperative pregabalin on the occurrence of PTPS, defined as any surgical site pain 3 months after surgery. ⋯ Pregabalin did not reduce the incidence of PTPS in this study. Future research on PTPS should focus on the impact of regional analgesia on central sensitization.
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Reg Anesth Pain Med · May 2015
ReviewTales From the Wild West of US Drug Pricing: The Case of Intravenous Acetaminophen.
This article aims to discuss and provide insight into the effects of the increased use and price (from $12.43 to $35.40 in 2014) of intravenous acetaminophen, which has rapidly gained acceptance in the field of perioperative medicine. Overall use and characteristics are described for selected surgeries with absolute use particularly high in orthopedic surgeries associated with substantial costs (up to an additional $160,000 per year per hospital for just orthopedic use). The availability of large-scale data on costs and use of intravenous acetaminophen in the United States will greatly benefit the ongoing discussions on its place in current practice.
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Reg Anesth Pain Med · May 2015
Practice GuidelineGuidelines for fellowship training in regional anesthesiology and acute pain medicine: third edition, 2014.
Directors for Regional Anesthesiology and Acute Pain Medicine fellowships develop and maintain guidelines for fellowship training in the subspecialty. The first edition of the guidelines was published in 2005 with a revision published in 2010. This set of guidelines updates the 2010 revision. The guidelines address 3 major topics: organization and resources, the educational program, and the evaluation process.