Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Dec 2020
Spinal anesthesia in a designated block bay for total joint arthroplasty: improving operating room efficiency.
Creating highly efficient operating room (OR) protocols for total joint arthroplasty (TJA) is a challenging and multifactorial process. We evaluated whether spinal anesthesia in a designated block bay (BBSA) would reduce time to incision, improve first case start time and decrease conversion to general anesthesia (GA). ⋯ BBSA had limited impact on time to incision for TJA, with a small decrease for single OR days and no improvement on OR days with two rooms. BBSA was associated with improved first case start time and decreased rate of conversion to GA. Further research is needed to identify how BBSA affects the efficiency of TJA.
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Reg Anesth Pain Med · Nov 2020
Opioid use among veterans undergoing major joint surgery managed by a multidisciplinary transitional pain service.
Chronic postsurgical pain and opioid use is a problem among patients undergoing many types of surgical procedures. A multidisciplinary approach to perioperative pain management known as a transitional pain service (TPS) may lower these risks. ⋯ These data suggest that a TPS is an effective strategy for preventing new COU and reducing overall opioid use following orthopedic joint procedures in a Veterans Affairs hospital.
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Reg Anesth Pain Med · Nov 2020
Observational StudyImpact of video games on ultrasound-guided regional anesthesia skills.
There is an association between video game practice and laparoscopic expertize in trainee surgeons. Ultrasound-guided regional anesthesia has many parallels with laparoscopic surgery. The aim of this study was to explore whether video game experience is associated with enhanced performance in a simulated ultrasound-guided task in novice operators. ⋯ Video game practice is associated with increased mental rotation ability and enhanced technical performance in a simulated ultrasound-guided task.
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Reg Anesth Pain Med · Nov 2020
Randomized Controlled TrialAnalgesic efficacy of infiltration between the popliteal artery and capsule of the knee (iPACK) block added to local infiltration analgesia and continuous adductor canal block after total knee arthroplasty: a randomized clinical trial.
A combination of motor-sparing analgesia with local infiltration analgesia (LIA) and continuous adductor canal block (CACB) may improve postoperative pain and functional recovery for total knee arthroplasty (TKA). We hypothesized that the addition of a novel technique for posterior knee block, known as the infiltration between the popliteal artery and capsule of the knee (iPACK) block, to LIA with CACB would reduce opioid requirements. ⋯ The addition of an iPACK block to the LIA and CACB does not reduce the postoperative opioid consumption nor improve analgesia. However, it may improve immediate functional performance and reduce the length of hospitalization after TKA.
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Reg Anesth Pain Med · Nov 2020
CommentImages in anesthesiology: three safe, simple, and inexpensive methods to administer the sphenopalatine ganglion block.
The sphenopalatine ganglion (SPG) block is a simple and valuable technique that was discovered over a century ago, but, unfortunately, very few anesthesiology providers are familiar with this block. After some of our recent publications, physicians from different countries have reached out to us requesting more specifics on how we perform our version of the block. In this report, we provide a brief history of the block and demonstrate our three effective, simple, readily available, and inexpensive methodologies with images. We are proud to share that our three SPG block techniques have so far effectively relieved patients of chronic migraines, acute migraines, tension headaches, moderate-to-severe back pain, and post-dural puncture headaches.