Pain physician
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A survey on teaching ultrasound-guided chronic pain procedures in pain medicine fellowship programs.
Over the last decade ultrasound guidance (USG) has been utilized very successfully in acute pain procedures to confirm nerves' anatomic location and obtain live images. Not only the utilization, but the teaching, of USG has become an essential part of anesthesiology residency training. Prior to the introduction of USG, chronic pain procedures were always done either under fluoroscopy or blindly. USG offers advantages over fluoroscopy for completion of chronic pain procedures. USG decreases radiation exposure and the expenses associated with operating a fluoroscopy machine and allows live visualization of soft tissues and blood flow, a feature that fluoroscopy does not directly offer. Even today, the utilization and teaching of the technique for chronic pain procedures has not been as widely accepted as in acute pain management. ⋯ The teaching of ultrasound guided chronic pain procedures varies significantly between individual programs. Though many program directors do require that fellows demonstrate competency in the technique before graduation, as of today there is no ACGME guideline regarding this. The advancement in ultrasound technology and the increase in number of trained faculty may significantly impact the use of USG in training fellows to perform chronic pain procedures.
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Randomized Controlled Trial Comparative Study
Comparative efficacy of levobupivacaine and ropivacaine for epidural block in outpatients with degenerative spinal disease.
Levobupivacaine has less toxic potential on both the cardiovascular and central nervous system and has been widely used for postoperative epidural analgesia in surgical patients. However, there are few reports on the efficacy of epidural levobupivacaine in outpatients with lumbosacral radiculopathy. This study was carried out to evaluate the comparative efficacy of levobupivacaine and ropivacaine for epidural block in outpatients with degenerative spinal disease and sciatica. ⋯ The results showed that 0.125% levobupivacaine and 0.2% ropivacaine for epidural block by a caudal approach provide similar lumbosacral pain relief, hemodynamic effects, and the degree and the recovery of motor blockade in outpatients with degenerative spinal disease and sciatica.
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Ice hockey is a competitive sport and ice hockey injuries can be influenced by many physical and psychological factors. Young ice hockey players are especially vulnerable to injury due to their relative lack of experience and rapid physical growth during their juvenile years. Up to now there has been no survey of the physical, psychological, and environmental etiological factors based on the Korean high school ice hockey players population. ⋯ The multiple aspects of this etiological factor analysis showed modest results. However, based on our results, in order to reduce the long-term implications of youth ice hockey injuries and associated public health costs, comprehensive efforts, including psychological and environmental factor modification, should be put in place.