Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Aug 2020
Local anesthetic resistance in a Crohn's patient undergoing cesarean delivery.
Patient resistance to local anesthetics is rarely considered as the cause of regional anesthesia failure. ⋯ Resistance to local anesthetics may be more common than we think, especially among patients with chronic pain. Providers should consider local anesthetic resistance when regional anesthesia is unsuccessful. Further research is needed to determine if skin wheal tests and/or a different local anesthetic could improve results.
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Reg Anesth Pain Med · Aug 2020
Current versus revised anatomical targets for genicular nerve blockade and radiofrequency ablation: evidence from a cadaveric model.
Recent studies have proposed revised anatomical targets to improve accuracy of genicular nerve (GN) radiofrequency ablation (RFA). This study aims to compare the accuracy of classical and revised techniques for fluoroscopic-guided GN-RFA in cadaveric models. ⋯ This study demonstrates that the revised targets are more accurate than the current targets for GN-RFA.
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Reg Anesth Pain Med · Aug 2020
Sharing the pain: an observational analysis of Twitter and pain in Ireland.
Studies involving Twitter and chronic pain can provide highly valuable patient-generated information. The aim of this paper was to examine pain-related tweets in Ireland over a 2-week period from 22 June 2017 to 5 July 2017 using pain-related keywords. We wished to identify Twitter user gender profile; most common discussion topics; sentiment analysis; and dissemination of tweets. ⋯ A substantial discussion of pain-related topics took place on Twitter during our study period. This provided real-time, dynamic information from individuals on discussion topics in pain medicine. This can be used to gain a greater understanding of the pain experience. As patients are increasingly acquiring healthcare information through online sources, high-quality information from approved sources should be promoted on such platforms.
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Reg Anesth Pain Med · Aug 2020
Evaluating the extent of lumbar erector spinae plane block: an anatomical study.
The erector spinae plane (ESP) block is a relatively new interfascial block technique. Previous cadaveric studies have shown extensive cephalocaudal spread with a single ESP injection at the thoracic level. However, little data exist for lumbar ESP block. The objective of this study was to examine the anatomical spread of dye following an ultrasound-guided lumbar ESP block in a human cadaveric model. ⋯ A lumbar ESP injection has limited craniocaudal spread compared with injection in the thoracic region. It has consistent spread to dorsal rami, but no anterior spread to ventral rami or paravertebral space.