Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2021
Anatomical considerations for obturator nerve block with fascia iliaca compartment block.
This report reviews the topographical and functional anatomy relevant for assessing whether or not the obturator nerve (ON) can be anesthetized using a fascia iliaca compartment (FIC) block. The ON does not cross the FIC. ⋯ Such a phenomena would require the creation of one or more artificial passageways to the ON in the retro-psoas compartment or the retroperitoneal compartment by disrupting the normal anatomical integrity of the FI. Due to this requirement for an artificial pathway, an FIC block probably does not block the ON.
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Reg Anesth Pain Med · Sep 2021
Randomized Controlled TrialSerratus anterior plane versus paravertebral nerve blocks for postoperative analgesia after non-mastectomy breast surgery: a randomized controlled non-inferiority trial.
Paravertebral and serratus plane blocks are both used to treat pain following breast surgery. However, it remains unknown if the newer serratus block provides comparable analgesia to the decades-old paravertebral technique. ⋯ Serratus blocks provided inferior analgesia compared with paravertebral blocks. Without a dramatic improvement in safety profile for serratus blocks, it appears that paravertebral blocks are superior to serratus blocks for postoperative analgesia after non-mastectomy breast surgery.
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Reg Anesth Pain Med · Sep 2021
Randomized Controlled TrialOne-year results from a randomized comparative trial of targeted steroid injection via epidural catheter versus standard transforaminal epidural injection for the treatment of unilateral cervical radicular pain.
The objective of this study was to evaluate the long-term effectiveness of catheter-directed cervical interlaminar epidural steroid injection with triamcinolone compared with cervical transforaminal steroid injection with dexamethasone for the treatment of refractory unilateral radicular pain. ⋯ Both cervical catheter-directed interlaminar epidural injection and cervical transforaminal steroid injection were effective in reducing pain and disability in the majority of participants with refractory unilateral cervical radiculopathy for up to 1 year.
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Reg Anesth Pain Med · Sep 2021
Machine learning approaches in predicting ambulatory same day discharge patients after total hip arthroplasty.
With continuing financial and regulatory pressures, practice of ambulatory total hip arthroplasty is increasing. However, studies focusing on selection of optimal candidates are burdened by limitations related to traditional statistical approaches. Hereby we aimed to apply machine learning algorithm to identify characteristics associated with optimal candidates. ⋯ Machine learning algorithm exhibited acceptable model quality and accuracy. Machine learning algorithms highlighted the as yet unrecognized impact of laboratory testing on future patient ambulatory pathway assignment.
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Reg Anesth Pain Med · Sep 2021
Case ReportsSpinal anesthesia in a patient on monoclonal antibody treatment: a poisoned chalice? A case report.
Paraplegia is a rare complication of spinal anesthesia. ⋯ The presented case warrants caution when performing neuraxial anesthesia in patients on monoclonal antibody therapies.