Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2014
Development of an Ultrasound Phantom for Spinal Injections With 3-Dimensional Printing.
This report describes a method for producing anatomically detailed, low-cost ultrasound phantoms of the spine with 3-dimensional printing. An implementation that involves representing a portion of the lumbar spine and the ligamentum flavum with 2 different printing materials and the surrounding soft tissues with agar gel is presented. ⋯ Ultrasound phantoms that are derived directly from patient anatomy have strong potential as learning tools for ultrasound-guided spinal insertions, and they could be used as preprocedural planning tools in cases involving pathologies, implants, or abnormal anatomies. Three-dimensional printing is a promising method for producing low-cost phantoms with designs that can be readily shared across clinical institutions.
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Reg Anesth Pain Med · Sep 2014
Observational StudyThe Incidence of Hematoma Formation in Patients With Continuous Femoral Catheters Following Total Knee Arthroplasty While Receiving Rivaroxaban as Thromboprophylaxis: An Observational Study.
Multimodal analgesia, including continuous femoral block, is often used to manage postoperative pain following total knee arthroplasty. To reduce the risk of deep vein thrombosis and pulmonary embolus formation, anticoagulation is also a part of the care for patients who undergo total knee arthroplasty. However, the concurrent use of continuous peripheral nerve block and anticoagulation can lead to hematoma formation. This prospective, single-center, observational study investigated the incidence of hematoma formation, causing neurovascular compromise, for patients with femoral catheters while taking the oral anticoagulant rivaroxaban. ⋯ In this prospective observational study, the concurrent administration of continuous femoral nerve block, the once-daily administration of the anticoagulant rivaroxaban, and the timed removal of the femoral catheter were not associated with hematoma formation resulting in neurovascular compromise at the femoral catheter insertion site or groin area.
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Reg Anesth Pain Med · Sep 2014
Case ReportsFentanyl Overdose Caused by Malfunction of SynchroMed II Intrathecal Pump: Two Case Reports.
Intrathecal drug delivery systems (intrathecal pumps) are used to treat patients with chronic refractory pain syndromes and spasticity. The objective of our case report was to demonstrate that intrathecal pump malfunction can lead to intrathecal overdosing of drugs. ⋯ We present 2 cases of intrathecal pump malfunction, which most likely led to overinfusion of fentanyl intrathecally. To reduce the risk of this complication, particular attention should be paid to drug reservoir volume discrepancies and overdose symptoms reported by patients.