Pain physician
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Observational Study
Radiologic Analysis and Clinical Study of the Upper One-third Joint Technique for Fluoroscopically Guided Sacroiliac Joint Injection.
Sacroiliac intraarticular injection by the traditional technique can be challenging to perform when the joint is covered with osteophytes or is extremely narrow. ⋯ Sacroiliac intraarticular injections with the upper one-third joint technique are advisable when it is hard to perform them with the lower one-third joint technique.
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Genicular nerve block has recently emerged as a novel alternative treatment in chronic knee pain. The needle placement for genicular nerve injection is made under fluoroscopic guidance with reference to bony landmarks. ⋯ The result of this cadaveric study suggests that ultrasound-guided medial genicular nerve branch block can be performed accurately using the above-stated anatomic landmarks.
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Perioperative use of opioids is associated with the risk of opioid-induced respiratory depression. Naloxone is a competitive opioid antagonist typically administered to reverse opioid-induced respiratory depression. Postoperative administration of naloxone may be considered a proxy for significant postoperative opioid-induced respiratory depression and data regarding its use may be utilized as a quality measure. Few large studies have been done to characterize the population and define an incidence of naloxone recipients in the postoperative inpatient setting. ⋯ The overall incidence of postoperative naloxone administration over a 13 year period in approximately 450,000 patients was 0.1%. Demographics of this group were older, ASA 3 women, qualifying as overweight, but not obese, undergoing elective surgery with a general anesthetic technique. Average time to administration was 21 hours postoperatively.
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Review Meta Analysis
Effects of Systemic Magnesium on Post-operative Analgesia: Is the Current Evidence Strong Enough?
Clinical studies have been previously carried out on the efficacy of systemic magnesium to minimize postoperative pain, however, with controversial results. A quantitative meta-analysis was performed to evaluate the analgesic efficacy and safety of systemic magnesium on post-operative pain. ⋯ Our study suggests that systemic magnesium during general anesthesia significantly decreases post-operative pain scores without increasing adverse events. It should be noted that since there are 18 ongoing RCTs without published data, it is still premature to draw conclusions on the long-term analgesic effects of magnesium as well as potential gender or age difference.