Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2008
Interactions between pulmonary performance and movement-evoked pain in the immediate postsurgical period: implications for perioperative research and treatment.
Previous data suggest that movement-evoked pain is more closely correlated with pulmonary performance than rest pain beyond 24 hours following lower abdominal surgery. Because adverse alterations in lung physiology are initiated intraoperatively and impact upon pulmonary morbidity, this study tests the hypothesis that movement-evoked pain correlates negatively with pulmonary performance in the immediate postoperative period. ⋯ Considering these and previous results, pulmonary function tests such as PEF should be considered for more routine use as functional surrogates of movement-evoked pain in analgesic trials of thoracic and abdominal surgery. Mechanisms of immediate postoperative movement-evoked pain may differ from those in effect at later time points after which tissue inflammation and spinal sensitization develop. Because pain adversely impacts upon postoperative rehabilitation, these results further imply that aggressive treatment of movement-evoked pain could improve the outcome of postoperative rehabilitation measures if both are implemented very early after surgery.
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Reg Anesth Pain Med · Jul 2008
New model for learning ultrasound-guided needle to target localization.
The acquisition of technical skills for the novice learner presents challenges for students and teachers alike. With the introduction of ultrasound techniques in regional anesthesia, there has been interest from residents, fellows, and staff to acquire the skills necessary to incorporate this technology into their everyday practice. However, as both ultrasound machines and commercial target models are inherently costly, there are often issues of accessibility that may affect the opportunity to learn the desired skills. ⋯ This report presents an inexpensive, variable complexity model for learning ultrasound-guided needle-to-target localization.