Regional Anesthesia and Pain Medicine back issues from May 2005:
Fellowship Training in Regional Anesthesia
May 01, 2005; ... This issue of Regional Anesthesia and Pain Medicine contains two manuscripts that focus on the training of anesthesiologists in regional anesthesia. Neal et al.1 and Hargett et al.2 shed additional light on past and future training in regional anesthesia. Both articles appear to take the "high ...
Clinical Efficacy of the Brachial Plexus Block via the Posterior Approach
May 01, 2005; ... Background and Objectives: The posterior approach to the brachial plexus remains underused. We assessed the clinical effectiveness of this technique for shoulder surgery. Methods: One hundred eighty-seven consecutive patients scheduled to undergo shoulder surgery were assessed after a ...
The Training and Careers of Regional Anesthesia Fellows-1983-2002
May 01, 2005; ... Background and Objectives: The education and subsequent careers of regional anesthesia fellows have not been examined but may provide insight into improving future fellowship training and/or the future of the subspecialty. Methods: Regional anesthesia fellows educated during a 20-year ...
Intrathecal Sufentanil Is More Potent Than Intravenous for Postoperative Analgesia After Total-Hip Replacement
May 01, 2005; ... Background and Objectives: In our clinical experience, sufentanil is more effective when administered intrathecally than intravenously. To test this hypothesis, we compared the analgesic characteristics of 7.5 µg of intrathecal or intravenous sufentanil for pain relief after total-hip ...
Two-Pore Domain Potassium Channels: New Sites of Local Anesthetic Action and Toxicity
May 01, 2005; ... Potassium (K+) channels form the largest family of ion channels with more than 70 such genes identified in the human genome. They are organized in 3 superfamilies according to their predicted membrane topology: (1) subunits with 6 membrane-spanning segments and 1-pore domain, (2) subunits with 2 ...
The Impact of Technology on the Analgesic Gap and Quality of Acute Pain Management
May 01, 2005; ... National surveys continue to document the undertreatment of acute postoperative pain, despite the availability of evidence-based, clinical practice guidelines and the Joint Commission on Accreditation of Healthcare Organizations standards. This article surveys factors that contribute to ...
An Imaging Review of Sacroiliac Joint Injection Under Computed Tomography Guidance
May 01, 2005; ... Chronic low-back pain is a common disease that is also the most common and expensive cause of disability. Low-back pain has multiple generators, such as vertebral bone pain, spondylosis and "facet syndrome," and the intervertebral discs. Additionally, the sacroiliac joint (SIJ) may be a pain ...
A Modified Approach to Transcrural Celiac Plexus Block
May 01, 2005; ... Objectives: Transcrural celiac block using the needle "walking off" the L1 vertebra technique may cause complications. We used patient-specific computed tomography (CT) images as a roadmap to perform the block under fluoroscopy. We present 1 case to describe the technique. Case Report: ...
Re: Combination of Intraneural Injection and High-Injection Pressure Leads to Fasicular Injury and Neurologic Deficits in Dogs/Reply to Dr. Selander
May 01, 2005; ... To the Editor: With great interest, I read the experimental study by Hadzic et al.1 on pressure recordings and other effects of intraneural injections in dogs. To some extent, the study is a repetition of an earlier study by Selander and Sjöstrand,2 and the results of the two studies ...
Labeling as a Tool to Reduce Drug Error in Anesthesia Practice
May 01, 2005; ... To the Editor: I read with interest the article by Drs. Fuzier and Singelyn,1 in which the authors describe a case of unintentional atracurium injection instead of local-anesthetic agent during an axillary brachial plexus block. Drugrelated errors are a major factor associated with ...
High Potential for Epidural Analgesia Neuraxial Block-Associated Hypotension in Conjunction with Heated Intraoperative Intraperitoneal Chemotherapy
May 01, 2005; ... To the Editor: During the past decade, results of combining cytoreductive surgery with perioperative heated intraperitoneal chemotherapy (HIIC) gave hope of curing carcinomatosis in selected patients.1 Aggressive cytoreductive surgery attempts to remove all visible tumor by extensive ...
A Similar Case of Traumatic Syrinx After Implantation of an Intrathecal Catheter/Reply to Dr. Gorback
May 01, 2005; ... To the Editor: The recent case report by Drs. Harney and Victor1 brings to mind a similar case I observed last year, in which an InDura catheter (Medtronic, Minneapolis, MN) was threaded up through the substance of the spinal cord to the lower thoracic level. That case and the one ...
Guidelines for Regional Anesthesia Fellowship Training
May 01, 2005; ... Background: The number of regional anesthesia fellowships has grown over the past 2 decades. There currently exist no guidelines for what constitutes ideal regional anesthesia fellowship training. Methods: Regional anesthesia fellowship program directors and other advocates of regional ...
Resident Versus Staff Anesthesiologist Performance: Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique
May 01, 2005; ... Objectives: Infraclavicular brachial plexus block with double stimulation (ICB) is a safe technique for upper-limb anesthesia. However, the experience of learning this technique by anesthesiology residents has not been reported. The aim of this study was to compare staff with resident ...
Peripheral Block of the Hyperpolarization-Activated Cation Current (I^sub h^) Reduces Mechanical Allodynia in Animal Models of Postoperative and Neuropathic Pain
May 01, 2005; ... Background and Objectives: Block of the hyperpolarization-activated inward current (I^sub h^) reduces excitability of peripheral axons during stimulation and decreases ectopic discharges in axotomized sensory neurons. Changes in I^sub h^ expression in DRG neurons have been suggested to partially ...
Extended-Duration Analgesia: Update on Microspheres and Liposomes
May 01, 2005; ... Local anesthetics delivered peripherally or to the neuraxis constitute an important component of multimodal management of acute postoperative pain and certain chronic pain conditions. Besides providing excellent analgesia at rest and with movement, the opioid-sparing effects of local anesthetics ...
Medial Canthus Single-Injection Peribulbar Anesthesia: A Prospective Randomized Comparison With Classic Double-Injection Peribulbar Anesthesia
May 01, 2005; ... Background and Objectives: The authors report the first prospective randomized comparison of the medial canthus single-injection peribulbar anesthesia (also called caruncular anesthesia) with the classic double-injection peribulbar technique. Methods: One hundred patients scheduled for ...
Iontophoresis: The Process Behind Noninvasive Drug Delivery
May 01, 2005; ... In the last 2 decades, many advances have been made in the field of drug delivery, with resulting enhancements in the efficacy and safety of treatment and in the timeliness and convenience of treatment for the patient.1 Some of the more dramatic developments include technologies that allow for ...
Rapid Onset of Massive Subdural Anesthesia
May 01, 2005; ... Objective: This case report describes the accidental placement of a lumbar labor epidural catheter into the subdural space resulting in the rapid onset of massive subdural anesthesia. Case Report: A single-orifice open-ended catheter was accidentally placed in the lumbar subdural space ....
Unilateral Tremor of the Upper and Lower Limb After an Axillary Brachial Plexus Block
May 01, 2005; ... To the Editor: We read with interest the case of Moorthy and Dill1 who reported a tremor of the forearm during performance of axillary brachial plexus block. We would like to describe a case that developed unilateral tremors that were not limited to upper limb but extended to the lower ...
Use of Colored Syringes Reduces the Incidence of Syringe Swap During Anesthesia
May 01, 2005; ... To the Editor: We read with interest the case report that described syringe swaps between local anesthetics and muscle relaxants during axillary brachial plexus nerve block.1 We recommend the use of colored syringes to prevent syringe swap. In our operating theater, 5 syringe swaps were ...
Veterans Administration-National Surgical Quality Improvement Program/Reply to Dr. Srinivasa
May 01, 2005; ... To the Editor: We read with interest the article by Wu et al.1 The authors analyzed a sample of Medicare claims data and found that the presence of epidural analgesia was associated with significantly lower odds of death at 7 and 30 days after surgery. They have acknowledged the ...
Maximum Recommended Doses of Local Anesthetics: A Constant Cause of Confusion
May 01, 2005; ... To the Editor: I am glad that Rosenberg et al.1 addressed the important question of maximum safe doses of local anesthetics, but the reasons the subject needs reappraisal may be even wider than their excellent review implies. Adverse effects of local anesthetic may be as ...
"Postdural" Is an Ambiguity/Reply to Dr. Colclough/Editor's Reply to Dr. Colclough
May 01, 2005; ... To the Editor: I enjoyed Dr. Brian Harrington's comprehensive review, "Postdural Puncture Headache and the Development of the Epidural Blood Patch."1 I would like to comment on the use of the term "postdural" by Dr. Harrington and by the Editor. This word has been a standard part of ...