Articles: pain-management.
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Reg Anesth Pain Med · Feb 2022
International consensus on anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia.
There is no universally agreed set of anatomical structures that must be identified on ultrasound for the performance of ultrasound-guided regional anesthesia (UGRA) techniques. This study aimed to produce standardized recommendations for core (minimum) structures to identify during seven basic blocks. An international consensus was sought through a modified Delphi process. ⋯ A "weak recommendation" is made for 36 and 20 structures, respectively. This study provides recommendations on the core (minimum) set of anatomical structures to identify during ultrasound scanning for seven basic blocks in UGRA. They are intended to support consistent practice, empower non-experts using basic UGRA techniques, and standardize teaching and research.
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Reg Anesth Pain Med · Feb 2022
Multicenter StudyMulticenter study evaluating factors associated with treatment outcome for low back pain injections.
There has been a worldwide surge in interventional procedures for low back pain (LBP), with studies yielding mixed results. These data support the need for identifying outcome predictors based on unique characteristics in a pragmatic setting. ⋯ Identifying treatment responders is a critical endeavor for the viability of procedures in LBP. Patients with greater disease burden, depression and obesity are more likely to fail interventions. Steps to address these should be considered before or concurrent with procedures as considerations dictate.
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Reg Anesth Pain Med · Feb 2022
Agents of change: the Gaston Labat awardees past, present, and future-the 2021 Gaston Labat Award lecture.
The prior recipients of the Gaston Labat Award can be thought of as change agents because of their driving desire to challenge and improve the status quo. All of us are interconnected and should seek to collectively work toward meaningful change in our communities. The 2021 Gaston Labat lecture pays tribute to past agents of change and inspires those to come by urging everyone to become involved in the solution.
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Reg Anesth Pain Med · Feb 2022
Case ReportsHyaluronic acid injections for treatment of pediatric sickle cell avascular necrosis of the humeral head.
Avascular necrosis (AVN) can impact up to 50% of patients with sickle cell disease (SCD) and can result in significant pain, decline in physical function and decreased quality of life. While hyaluronic acid (HA) has been used in the adult population for shoulder osteoarthritic pain, we present the first published pediatric case of HA injections in the glenohumeral joint, used to improve function and pain control. ⋯ Conservative options to improve functioning and pain are especially important in pediatric patients where it may be desirable to delay surgical interventions until skeletal maturity. Our case report demonstrates the benefits of intra-articular HA as part of a multidisciplinary pain management plan to improve function and decrease pain related to AVN of the humeral head. Future studies should assess the long-term benefits of HA injections for AVN in the setting of SCD.