Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2019
Pain medicine fellow neuromodulation surgical skill assessment tool: a pilot.
Spinal cord stimulation (SCS) is an evidence-based therapy for the treatment of refractory pain. Current American College of Graduate Medical Education requirements for pain medicine fellowship graduation include observation of five neuromodulation cases. Matriculating fellows have varying degrees of technical skill, training, and experience. The purpose of this study was to use an innovative skill-based assessment tool using the validated Zwisch scale to evaluate fellow surgical performance during SCS cases. ⋯ The diverse nature of primary specialty backgrounds observed in pain medicine fellowship training offers a unique opportunity to assess and improve fellow skill and surgical competence in the field of neuromodulation. Both faculty and fellows reported improved satisfaction, consistency and efficiency with feedback provided. Importantly, this pilot project observed that implementation of a skill assessment tool was beneficial for both the faculty and fellow as the feedback received was viewed as strongly beneficial to the educational experience.
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Reg Anesth Pain Med · Nov 2019
Caregiver Patient Reported Outcomes Measurement Information System (PROMIS) profiles in patients undergoing total joint arthroplasty and spine surgery: a prospective observational cohort study.
The role of caregiver psychosocial characteristics and their relation to postsurgical caregiving capability remains unclear. The objective of this study was to explore caregiver psychosocial variables following surgery of patients undergoing total joint arthroplasty and spine surgery. ⋯ While there were transient worsening in PROMIS scores, it is unclear whether these were clinically meaningful. Postsurgical caregivers reporting baseline pain were characterized by worse functioning across all PROMIS scales.
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Reg Anesth Pain Med · Nov 2019
Influence of age, laterality, patient position, and spinal level on the interlamina space for spinal puncture.
The lumbar interlamina space height is an important determinant of successful spinal puncture. We aimed to evaluate the influence of age, laterality, patient position, and spinal level on the height of the interlamina window using ultrasonography. ⋯ Scanning both sides and all spinal levels before selecting a puncture site for ultrasound-guided spinal anesthesia is recommended. The L5/S1 spinal level is a good option for spinal puncture in the elderly.
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Reg Anesth Pain Med · Nov 2019
Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial.
Erector spinae plane block (ESPB) is a novel regional anesthesia technique that is gaining popularity for postoperative pain management. This randomized controlled trial evaluated the effect of ESPB on quality of recovery (QoR) in patients undergoing modified radical mastectomy. ⋯ A single preoperative injection of ESPB with ropivacaine may improve QoR postoperatively and acute postoperative analgesia in patients undergoing a modified radical mastectomy.
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Reg Anesth Pain Med · Nov 2019
Exploration of Gender-Specific Authorship Disparities in the Pain Medicine Literature.
Given the readily increasing membership of the pain physician community, efforts toward correcting notable gender disparities are instrumental. The under-representation of women is particularly prevalent within leadership roles in academic medicine, thought to be driven largely by diminished research efforts. Consequently, we aimed to characterize gender differences among the highest impact pain literature. ⋯ In our analysis of authorship between genders within the context of pain medicine literature, we found trends, although non-significant, toward women being lesser represented in the more impactful literature. We suggest that these inequities are possibly resultant of a markedly small and outnumbered female pain physician membership that has yet to achieve a critical mass and possible implicit gender biases that may restrict female authorship. However, further exploration and analysis of this issue are necessary to more clearly illuminate which systemic deficits exist and how they may, in turn, be corrected with cultural and macroscopic organizational-driven change.