Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2012
Effect of acute versus continuous glycemic control on duration of local anesthetic sciatic nerve block in diabetic rats.
The duration of nerve block is longer in streptozotocin (STZ)-induced diabetic rats for all local anesthetics (with and without adjuvants) compared with normal rats. Perioperative glycemic control is currently practiced to reduce adverse events in many at-risk patients, especially in diabetic patients, to prevent neuropathy, poor wound healing, and greater incidence of infection. The aim of this study was to investigate in diabetic rats the importance of glycemic control before peripheral nerve block. ⋯ With continuous glycemic control in diabetic rats, the duration of sensory and motor nerve block was about 40 minutes shorter than that in the untreated diabetic rats and similar to that of normal rats. However, acute glycemic control did not affect nerve block duration, suggesting that this neuropathy cannot be rapidly reversed.
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Reg Anesth Pain Med · Nov 2012
Education in regional anesthesia: caseloads, simulation, journals, and politics: 2011 Carl Koller Lecture.
This special article is an essay version of the European Society of Regional Anaesthesia and Pain Therapy 2011 Carl Koller Award lecture. Historically, evaluations of a trainee's regional anesthesia learning focused on caseload numbers. The deficiency of this unidimensional approach is that case numbers alone say little about the resident's mastery of the nontechnical aspects of regional anesthesiology. ⋯ Journals play an important role in regional anesthesia education for both trainees and mature anesthesiologists. Editorial boards build valuable educational foundations by providing critical analysis of new technologies and sponsoring practice advisories. Subspecialty societies such as European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine foster regional anesthesia education through their efforts to define curricula, produce guidelines, and promote international collaboration.