Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2015
Randomized Controlled TrialNovice Performance of Ultrasound-Guided Needling Skills: Effect of a Needle Guidance System.
Ultrasound-guided needle placement is a widely used technical skill that can be challenging to learn. The SonixGPS is a novel ultrasound needle-tracking system that has the potential to improve performance over traditional ultrasound systems. The objective of our study was to determine if the use of the SonixGPS ultrasound system improves performance of novice practitioners in ultrasound-guided needle placement compared with conventional ultrasound in the out-of-plane approach on a simulation model. ⋯ Use of the SonixGPS ultrasound needle guidance system improves the performance of technical needling skills of novice trainees in an ex vivo model. The place of this technology in the wider education of ultrasound-guided regional anesthesia remains to be established.
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Reg Anesth Pain Med · Mar 2015
Review Meta AnalysisObesity and Chronic Pain: Systematic Review of Prevalence and Implications for Pain Practice.
The combination of obesity and pain may worsen a patient's functional status and quality of life more than each condition in isolation. We systematically searched PubMed/MEDLINE and the Cochrane databases for all reports published on obesity and pain. The prevalence of combined obesity and pain was substantial. ⋯ Screening for obesity, pain-related disability, and behavioral disorders as well as monitoring of functional performance should become routine in pain medicine practices. Such an approach requires additional physician and staff training. Further research should focus on better understanding the interplay between these 2 very common conditions and the development of effective treatment strategies.
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Reg Anesth Pain Med · Mar 2015
A Standardized Anesthetic and Surgical Clinical Pathway for Esophageal Resection: Impact on Length of Stay and Major Outcomes.
Esophageal cancer is a leading cause of cancer death worldwide, and esophageal resection is associated with extremely high perioperative morbidity and mortality. A perioperative clinical pathway for esophagectomy patients in which anesthetic care is both integral and standardized has not been described previously. ⋯ We present a detailed anesthetic and surgical perioperative pathway for esophageal resection, along with evidence of improved or stable patient outcomes despite an increase in comorbidity burden and increasingly advanced tumor stage.