Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2023
Randomized Controlled TrialPericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial.
The pericapsular nerve group block (PENG) is a novel technique that blocks the articular branches of the hip joint. This study aimed to compare its effectiveness to a sham block in elderly patients with hip fractures. ⋯ PENG block provided effective analgesia for acute traumatic pain following hip fracture. Further studies are required to validate the superiority of PENG blocks over other regional techniques.
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Reg Anesth Pain Med · Nov 2023
Rate of occurrence of respiratory complications in patients who undergo shoulder arthroplasty with a continuous interscalene brachial plexus block and associated risk factors.
Continuous interscalene nerve block techniques are an effective form of targeted non-opioid postoperative analgesia for shoulder arthroplasty patients. One of the limiting risks, however, is potential phrenic nerve blockade with resulting hemidiaphragmatic paresis and respiratory compromise. While studies have focused on block-related technical aspects to limit the incidence of phrenic nerve palsy, little is known about other factors associated with increased risk of clinical respiratory complications in this population. ⋯ Patient-related factors that can be measured preoperatively are associated with increased likelihood of respiratory complications after elective shoulder arthroplasty with CISB.
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Reg Anesth Pain Med · Nov 2023
Association between socioeconomic status and treatment in patients with low back or neck pain: a population-based cross-sectional study in South Korea.
Socioeconomic status affects the treatment of patients with low back pain and/or neck pain. We examined the relationship between socioeconomic status (occupation and household income level) and treatments such as chronic opioid use and interventional procedures among these patients. ⋯ Socioeconomic status factors are associated with treatment in patients with low back pain and/or neck pain.
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Reg Anesth Pain Med · Nov 2023
ReviewHow large language models can augment perioperative medicine: a daring discourse.
Interest in natural language processing, specifically large language models, for clinical applications has exploded in a matter of several months since the introduction of ChatGPT. Large language models are powerful and impressive. ⋯ We review three potential major areas in which it may be used to benefit perioperative medicine: (1) clinical decision support and surveillance tools, (2) improved aggregation and analysis of research data related to large retrospective studies and application in predictive modeling, and (3) optimized documentation for quality measurement, monitoring and billing compliance. These large language models are here to stay and, as perioperative providers, we can either adapt to this technology or be curtailed by those who learn to use it well.
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Reg Anesth Pain Med · Nov 2023
Postoperative neurological symptoms following arthroscopic shoulder surgery with interscalene block: an exploratory secondary analysis of pooled randomized controlled trial data.
Postoperative neurological symptoms (PONS) are recognized complications of regional anesthesia and orthopedic surgery. We aimed to better characterize prevalence and potential risk factors in a homogeneous population of randomized, controlled trial participants. ⋯ PONS are common after arthroscopic shoulder surgery performed with single injection ultrasound-guided interscalene blocks. No definitive mitigating risk factors were identified.