Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jun 2019
Enhanced needle visibility by microbubbles generated with negative pressure using an in-plane technique.
Our previous work found that needle visibility could be improved by introducing microbubbles into needles. The primary aim of this study was to test the hypothesis that the negative pressure method is superior to two other methods for enhancing needle visibility by introducing microbubbles into needles. The secondary aim was to evaluate the impacts of three factors on the visibility of microbubble-filled needles. ⋯ Needle visibility can be significantly improved by microbubbles generated with the negative pressure method when insertion angles are 40°, 50° and 60° in porcine meat.
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Reg Anesth Pain Med · Jun 2019
Antihyperalgesia effect of AMP-activated protein kinase (AMPK) activators in a mouse model of postoperative pain.
AMP-activated protein kinase (AMPK) activator drugs decrease hypersensitivity in mice with pain. This study examines if postsurgery treatment with the prototype AMPK activator metformin and a new mechanism-specific AMPK activator, O304, after plantar hindpaw incision in mice, would reduce mechanical hypersensitivity and produce changes in the AMPK pathway in the dorsal root ganglion (DRG). ⋯ Early treatment with the mechanism-specific AMPK activator O304 or the prototype AMPK activator metformin reduces mechanical hypersensitivity in a postoperative pain model in mice. These drugs also normalize the AMPK pathway in the DRG.
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Reg Anesth Pain Med · Jun 2019
Hospital safety net burden is associated with increased inpatient mortality and postoperative morbidity after total hip arthroplasty: a retrospective multistate review, 2007-2014.
Total hip arthroplasty (THA) is one of the most widely performed surgical procedures in the USA. Safety net hospitals, defined as hospitals with a high proportion of cases billed to Medicaid or without insurance, deliver a significant portion of their care to vulnerable populations, but little is known about the effects of a hospital's safety net burden and its role in healthcare disparities and outcomes following THA. We quantified safety net burden and examined its impact on in-hospital mortality, complications and length of stay (LOS) in patients who underwent THA. ⋯ Our study supports our hypothesis that patients who underwent THA at hospitals with higher safety net burden have poorer outcomes than patients at hospitals with lower safety net burden.
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Reg Anesth Pain Med · Jun 2019
Correlation between gestational age and level of sensory block in spinal anesthesia.
To identify a specific correlation between progression of gestational age and level of sensory block in spinal anesthesia in patients undergoing cervical cerclage. ⋯ Results demonstrated that as the gestational age progressed, sensory block level increased, blood pressure was decreased, and length of PACU stay increased after spinal anesthesia. Sensory block increased by 0.28 dermatomes when the pregnancy progressed 1 week. Further controlled prospective studies are needed to support this relationship.