Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2018
Comparative StudyEthnic Differences Identified by Pain Sensitivity Questionnaire Correlate With Clinical Pain Responses.
The Pain Sensitivity Questionnaire, English version (PSQ-E), is predictive of pain-related responses to experimental stimuli. Ethnic differences have been noted in experimental measures of pain sensation using quantitative sensory testing. The present study sought to determine if the PSQ-E also identified similar ethnic differences. ⋯ The study demonstrated significantly elevated pain sensitivity in AA compared with NHW patients as measured by the PSQ-E and experimental and clinical pain intensity scores. This shows that the PSQ reflects the known elevation of pain sensitivity in AA subjects and suggests that it may be useful in assessing pain treatment disparities by identifying and standardizing differences in pain sensitivity.
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Reg Anesth Pain Med · Feb 2018
Randomized Controlled TrialRelative Contributions of Adductor Canal Block and Intrathecal Morphine to Analgesia and Functional Recovery After Total Knee Arthroplasty: A Randomized Controlled Trial.
Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. ⋯ This study was registered at ClinicalTrials.gov, identifier NCT02411149.
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Reg Anesth Pain Med · Feb 2018
Review Practice GuidelineThe Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017.
The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity. ⋯ Contemporary case reports suggest a trend toward delayed presentation, which may mirror the increased use of ultrasound guidance (fewer intravascular injections), local infiltration techniques (slower systemic uptake), and continuous local anesthetic infusions. Small patient size and sarcopenia are additional factors that increase potential risk for LAST. An increasing number of reported events occur outside of the traditional hospital setting and involve non-anesthesiologists.