Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jun 2024
Cannabis use and acute postoperative pain outcomes in older adults: a propensity matched retrospective cohort study.
Cannabis use is increasing among older adults, but its impact on postoperative pain outcomes remains unclear in this population. We examined the association between cannabis use and postoperative pain levels and opioid doses within 24 hours of surgery. ⋯ This study showed that cannabis use in older adults was associated with increased postoperative pain levels and opioid doses.
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Reg Anesth Pain Med · Jun 2024
Effect of epidural anesthesia on the optic nerve sheath diameter in patients with pre-eclampsia: a prospective observational study.
Optic nerve sheath diameter (ONSD) reflects intracranial pressure and is increased in pre-eclampsia. Administrating a significant volume of epidural solution into the epidural space can potentially increase ONSD. We investigated the impact of epidural local anesthetic injection on ONSD in patients with pre-eclampsia. ⋯ Despite a higher baseline ONSD in pre-eclampsia, epidural anesthesia did not further increase ONSD. Our findings indicate that epidural anesthesia can be safely administered in patients with pre-eclampsia at risk of increased intracranial pressure, without other intracranial pathology.
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Reg Anesth Pain Med · Jun 2024
Anesthetic management with labor epidural analgesia of the parturient with severe factor VII deficiency: a case report.
Factor VII deficiency is considered a contraindication to neuraxial anesthesia due to the risk of an epidural hematoma. ⋯ This case highlights the safe management of an epidural catheter in a parturient with severe factor VII deficiency.
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Reg Anesth Pain Med · Jun 2024
Erector spinae plane infiltration and anterior rami of spinal nerve: a cadaveric study.
The erector spinae plane block (ESP block) is frequently employed for thoracic, abdominal, and spinal surgeries, yet its precise mechanism of action remains a subject of debate. While initially postulated to influence both ventral and dorsal rami of the spinal nerve, recent studies indicate a predominant impact on the dorsal rami with limited involvement of the ventral rami. To elucidate this mechanism, we conducted an observational study to assess the distribution of ESP infiltration to the ventral rami. ⋯ The infiltration of injectate into the ESP does not contact the ventral rami of segmental spinal nerves. The inference that an in vivo ESP block is a paravertebral "by-proxy" is, therefore, unlikely.
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Reg Anesth Pain Med · Jun 2024
ReviewEmotional and psychosocial function after dorsal column spinal cord stimulator implantation: a systematic review and meta-analysis.
The efficacy of spinal cord stimulation (SCS) in chronic pain studies is traditionally assessed by pain scores, which do not reflect the multidimensional nature of pain perception. Despite the evidence of SCS's influence on emotional functioning comprehensive assessments of its effect remain lacking. ⋯ CRD42023446326.