Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2021
Randomized Controlled TrialPericapsular nerve group (PENG) block provides improved short-term analgesia compared with the femoral nerve block in hip fracture surgery: a single-center double-blinded randomized comparative trial.
The femoral nerve block (FNB) may be used for analgesia in hip fracture surgery. The pericapsular nerve group (PENG) block is a novel regional technique and may provide better pain reduction while preserving motor function, but these blocks have not been directly compared. ⋯ Patients receiving a PENG block for intraoperative and postoperative analgesia during hip fracture surgery experience less postoperative pain in the recovery room with no difference detected by postoperative day 1. Quadriceps strength was better preserved with the PENG block. Despite the short-term analgesic benefit and improved quadriceps strength, there were no differences detected in the quality of recovery.
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Reg Anesth Pain Med · May 2021
Counting ribs and thoracic levels under ultrasound: a systematized technical protocol for both posterior and anterior approaches.
Over the last two decades, the clinical applications of diagnostic and interventional ultrasound have expanded rapidly. When analyzing the chest wall and thoracic region, ultrasound has previously been shown to reliably identify chest wall pathologies like rib fracture and slipping rib syndrome, as well as having fundamentally changed perioperative management and patient outcomes after the emergence of point-of-care ultrasound. ⋯ In this technical report, we systematize an ultrasound-guided protocol for counting ribs and thoracic levels for both posterior and anterior approaches, which does not require level confirmation by fluoroscopy. With this protocol, we hope to create an effective educational resource to support physicians from any specialty background as they engage in point-of-care ultrasound applications in the thoracic region.
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Reg Anesth Pain Med · May 2021
Prevalence of burnout and its relationship to health status and social support in more than 1000 subspecialty anesthesiologists.
Physician burnout may be at 'epidemic' proportions due to factors associated with modern healthcare practice and technology. Practice attributes vary appreciably among subspecialists. Understanding burnout incidence and its associated factors could illuminate potential causes and interventions. We evaluated burnFout, mental and physical health, and social support and coping skills in acute and chronic pain physicians and pediatric and cardiac anesthesiologists. ⋯ This study provides data on burnout prevalence and associated demographic, health and social factors in subspecialist anesthesiologists. Chronic pain anesthesiologists had significantly greater burnout than the other groups. The self-identified burnout metric performed well and may be an attractive alternative to the full MBI-HSS.