Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2024
ReviewApproaches to neuropathic amputation-related pain: narrative review of surgical, interventional, and medical treatments.
Neuropathic amputation-related pain can consist of phantom limb pain (PLP), residual limb pain (RLP), or a combination of both pathologies. Estimated of lifetime prevalence of pain and after amputation ranges between 8% and 72%. ⋯ Multimodal approaches combining pharmacotherapy, surgery and invasive neuromodulation procedures would appear to be the most promising strategy for preventive and treating PLP and RLP. Future efforts should focus on cross-disciplinary education to increase awareness of treatment options exploring best practices for preventing pain at the time of amputation and enhancing treatment of chronic postamputation pain.
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Reg Anesth Pain Med · Feb 2024
Mepivacaine dosing for spinal anesthesia in pediatric orthopedic surgery: a retrospective chart review.
Mepivacaine is an intermediate-acting local anesthetic used for spinal anesthesia in adults. Currently, there are no published dosing guidelines for spinal mepivacaine in patients under age 18. ⋯ We describe mepivacaine dosage as a function of age and weight in patients younger than 18 years. As age and weight increased, a lower dose of mepivacaine per kg was administered for spinal anesthesia.
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Reg Anesth Pain Med · Feb 2024
Complications and opioid-prescribing patterns following genicular nerve radiofrequency ablation versus intra-articular injection: a matched cohort study.
Genicular nerve radiofrequency ablation (GNRFA) is an emerging procedure used to relieve pain from severe knee osteoarthritis. While there have been rare reports of significant complications, their incidence has not been well established. The objective of this study was to examine complication rates at 30 and 90 days post treatment as well as characterize opioid-prescribing patterns before and after treatment. ⋯ Our study demonstrated that GNRFA possesses a safety profile similar to that of intra-articular injections although significant adverse events such as venous thromboembolism and septic arthritis may occur rarely. Although opioid utilization generally increased in the 30 days after ablation compared with intra-articular injection, similar reduction in opioid consumption at 6 months was seen in patients with prior opioid use in the ablation and control cohorts.
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Reg Anesth Pain Med · Jan 2024
Iliopsoas plane block does not improve pain after primary total hip arthroplasty in the presence of multimodal analgesia: a single institution randomized controlled trial.
The clinical analgesic efficacy of iliopsoas plane block remains a subject of discussion. This study aimed to assess the analgesic efficacy of iliopsoas plane block under general anesthesia using multimodal analgesia. ⋯ Iliopsoas plane block did not improve postoperative analgesia following total hip arthroplasty under general anesthesia with a multimodal analgesic regimen. The blockade of sensory femoral branches supplying the anterior hip capsule using iliopsoas plane block may not yield additional benefits concerning patient outcomes in the aforementioned clinical context.