Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2025
Analysis of complications of minimally invasive approaches for symptomatic lumbar spinal stenosis.
Current treatment modalities of lumbar spinal stenosis range from conservative medical management and physical therapy to open surgical decompression. Minimally invasive lumbar decompression (MILD) and Superion interspinous spacers (SISS) Vertiflex offer the promise of effective pain relief with shorter recovery time and lesser potential complications compared with open surgical decompression procedures and general anesthesia. Despite their increasing utilization, their complication profile is not well established in the literature. ⋯ As with any new intervention, we must proceed with caution and evaluate the procedure performance over time. Such data should aid physicians to make informed decisions before choosing either technique for their patients. The findings from this study provide insight into the complication profile associated with both MILD and Vertiflex procedures, highlighting the need for continued evaluation and careful consideration in clinical decision-making.
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Reg Anesth Pain Med · Feb 2025
Primary neuraxial anesthetic for elective total knee arthroplasty in patient with left ventricular assist device.
There is a rising number of patients with left ventricular assist devices (LVADs) undergoing non-cardiac procedures, both emergent and elective. Historically, anesthetic options for these patients have been limited to general anesthesia. Limited data exists for the use of neuraxial anesthesia in patients with LVADs despite its common use in orthopedic procedures for non-LVAD patients. Given the benefits of neuraxial anesthesia and the rising population of LVAD patients undergoing elective procedures, a better understanding of LVAD patients' candidacy for neuraxial anesthesia needs further investigation. ⋯ Patients with LVADs should be considered candidates for neuraxial anesthesia with appropriate preoperative planning and perioperative management.
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Reg Anesth Pain Med · Feb 2025
ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine.
To provide recommendations on risk mitigation, diagnosis and treatment of infectious complications associated with the practice of regional anesthesia, acute and chronic pain management. ⋯ The recommendations are intended to be multidisciplinary guidelines for clinical care and clinical decision-making in the regional anesthesia and chronic interventional pain practice. The issues addressed are constantly evolving, therefore, consistent updating will be required.
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Reg Anesth Pain Med · Feb 2025
Anterior quadratus lumborum block in total hip arthroplasty: a two-center, randomized, placebo-controlled trial showing no additional benefit over multimodal analgesia.
Total hip arthroplasty (THA) frequently causes postoperative pain, hindering recovery and prolonging hospital stays. While multimodal analgesia aims to minimize opioid use and enhance outcomes, the optimal regional anesthesia technique is unclear due to the hip's complex innervation. ⋯ Adding anterior QLB to multimodal analgesia did not reduce opioid consumption or enhance postoperative pain control and functional recovery in THA patients. Anterior QLB may not provide additional benefits when combined with multimodal analgesia with NSAID for THA.