Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2023
Randomized Controlled TrialComparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial.
We compared analgesic outcomes between single-orifice and multiorifice wire-reinforced catheters under 480 mL/hour delivery rate with programmed intermittent epidural bolus administration. ⋯ Single-orifice catheters used for programmed intermittent epidural bolus at 480 mL/hour for epidural labor analgesia had improved analgesic efficacy than multiorifice catheters.
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Reg Anesth Pain Med · Feb 2023
Review Meta AnalysisAnalgesic benefits of single-shot versus continuous adductor canal block for total knee arthroplasty: a systemic review and meta-analysis of randomized trials.
Adductor canal block (ACB) can provide important analgesic benefits following total knee arthroplasty (TKA), however, the extent to which these benefits can be enhanced or prolonged by a continuous catheter-based infusion compared with a single-shot injection of local anesthetic is unclear. ⋯ Our results suggest that continuous catheter-based ACB does not enhance or prolong the analgesic benefits when compared with single-shot ACB for TKA over the first 48 hours postoperatively. Overall, the results of our meta-analysis do not support the routine use of continuous ACB for postoperative analgesia after TKA.
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Reg Anesth Pain Med · Feb 2023
Clinical TrialSpread of local anesthetics after erector spinae plane block: an MRI study in healthy volunteers.
Erector spinae plane block (ESPB) is a truncal fascial block with a disputed mechanism and anatomical site of effect. This study aimed to perform a one-sided ESPB and use MRI to investigate the spread of the local anesthetic (LA) and the corresponding cutaneous loss of sensation to pinprick and cold. ⋯ We found that LA consistently spreads to the intercostal space, the paravertebral space, and the neural foramina after an ESPB. Epidural spread was evident in four volunteers. Sensory testing 30-50 min after an ESPB shows highly variable results, and generally under-represents what could be expected from the visualized spread on MRI 60 min after block performance.
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Reg Anesth Pain Med · Feb 2023
American Society of Regional Anesthesia and Pain Medicine 2021 John J. Bonica Award Lecture.
I am as deeply inspired and humbled to receive this prestigious award, as I am profoundly indebted to the Bonica Award selection committee and the American Society of Regional Anesthesia and Pain Medicine Board of Directors for recognizing my contributions to the development, teaching, and practice of pain medicine in the tradition of Dr John J Bonica. I would also like to recognize my parents, Aura and Tito for providing me with the support and the environment to fulfill my professional goals. Moreover, the support that I have gotten from my team at the hospital, and the Chair of my Department, Dr Mark Lema needs to be underscored.
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Reg Anesth Pain Med · Feb 2023
Reduced BDNF expression in the auditory cortex contributed to neonatal pain-induced hearing impairment and dendritic pruning deficiency in mice.
Procedural pain in neonates is associated with impaired neurodevelopment. Whether hearing development is impaired, however, remains unknown. This study examined potential cause-and-effect relationship between neonatal pain and subsequent hearing loss in mice. ⋯ Chronic pain during the neonatal period resulted in impaired hearing in adulthood in mice, possibly via the brain-derived neurotrophic factor signaling pathway and dendritic spine pruning deficiency in auditory cortex.