Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2015
Editorial CommentAbout bloody time!: interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the american society of regional anesthesia and pain medicine, European society of regional anaesthesia and pain therapy, american academy of pain medicine, international neuromodulation society, north american neuromodulation society, and world institute of pain.
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Reg Anesth Pain Med · May 2015
The training and careers of regional anesthesiology and acute pain medicine fellows, 2013.
Fellowships in regional anesthesiology and acute pain medicine (RAAPM) have grown exponentially during the past decade, both in terms of total programs and fellows trained. This survey-based study reports fellowship graduates' assessment of the strengths and weaknesses of their training and how the fellowship has affected their careers. ⋯ The results of this study should prove useful to fellowship directors as they refine the educational offerings of their programs.
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Reg Anesth Pain Med · May 2015
Observational StudyEvaluation of anxiety in procedure-naive patients during cervical and lumbar epidural steroid injection procedures.
The lack of studies that identify patient and procedural risk factors for increased levels of anxiety during spine injections represents a major barrier to the development of safe tailored sedation practices. We measured and compared anxiety in procedure-naive patients undergoing a cervical or lumbar interlaminar epidural steroid injection to identify predictors of patient movement and vasovagal responses in the periprocedural period. ⋯ No group differences in anxiety were seen between cervical and lumbar groups. Anxiety levels were not associated with patient movement or vasovagal symptoms. Our results suggest that the practice of routine prevention or treatment of injection-related anxiety in the procedure-naive general population with a duration of pain less than 6 months and without a history of an anxiety disorder should be reevaluated.
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Reg Anesth Pain Med · May 2015
The association between incentive spirometry performance and pain in postoperative thoracic epidural analgesia.
Effective use of postoperative incentive spirometry improves patient outcomes but is limited by pain after thoracic and upper abdominal surgery. Thoracic epidurals are frequently used to provide analgesia and attenuate postoperative pulmonary dysfunction. We hypothesized that, in patients with thoracic epidurals for thoracic and abdominal surgery, high pain scores would be associated with poorer incentive spirometry performance, even when accounting for other variables. ⋯ The present study suggests that pain with deep breathing is more indicative of thoracic epidural efficacy than is pain at rest. Furthermore, incentive spirometry performance could be used as another indicator of thoracic epidural efficacy. This may be particularly useful in patients reporting high pain scores postoperatively.