The Ochsner journal
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The Ochsner journal · Jan 2019
ReviewSphenopalatine Ganglion Block and Radiofrequency Ablation: Technical Notes and Efficacy.
Background: Sphenopalatine ganglion (SPG) blockade or lesioning can offer significant pain relief for cluster headaches (CHs) and a variety of other pain syndromes involving the head and face. Methods: We reviewed the literature on the efficacy of SPG block and radiofrequency ablation (RFA) using PubMed and Google Scholar. Results: The infrazygomatic technique can be used to directly access the SPG for injection of local anesthetic or lesioning using RFA. ⋯ SPG blockade efficacy is supported by randomized controlled studies but SPG RFA is not. Conclusion: Targeting the SPG is a promising treatment option for refractory CHs. RFA and neuromodulation have the potential to offer long-term significant pain relief, but more randomized studies are needed to demonstrate their efficacy.
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The Ochsner journal · Jan 2014
Analgesic efficacy and technique of ultrasound-guided suprascapular nerve catheters after shoulder arthroscopy.
Conventional approaches to brachial plexus blocks may not cover the suprascapular nerve. Accordingly, after shoulder arthroscopy, sensation from the posterior part of the shoulder is commonly spared. Most previous research involving suprascapular nerve blocks described single-injection techniques. However, with the widespread availability and fairly reasonable cost of disposable infusion pumps, continuous catheter techniques provide a more appealing method of prolonging postoperative analgesia. ⋯ Continuous suprascapular catheter techniques provide good pain relief and improve postoperative analgesia after shoulder arthroscopy.
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The Ochsner journal · Jan 2019
Case ReportsLaminoplasty for Cervical Spinal Cord Stimulator Implantation in Patients With Cervical Spondylosis and Fusion: A Technical Note.
Background: Epidural spinal cord stimulator (SCS) implantation is a commonly used strategy for treating refractory neuropathic pain, but the literature on the technical aspects of cervical SCS surgery remains scarce. Degenerative cervical stenosis and prior fusion surgery are relatively frequent conditions in this population, and the optimal method for cervical lead placement among such patients has not been established. Decompressive laminectomy may be required for cervical SCS placement in the presence of spinal stenosis. ⋯ Case Series: We present a surgical technique for cervical SCS implantation and the cases of 3 patients with significant spinal stenosis and/or prior fusion. In these patients, the paddle lead placement was safely achieved using cervical laminoplasty techniques. Conclusion: In addition to stabilizing the epidural paddle lead, laminoplasty offers several potential advantages compared to decompression alone.
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The flipped classroom is a student-centered approach to learning that increases active learning for the student compared to traditional classroom-based instruction. In the flipped classroom model, students are first exposed to the learning material through didactics outside of the classroom, usually in the form of written material, voice-over lectures, or videos. During the formal teaching time, an instructor facilitates student-driven discussion of the material via case scenarios, allowing for complex problem solving, peer interaction, and a deep understanding of the concepts. A successful flipped classroom should have three goals: (1) allow the students to become critical thinkers, (2) fully engage students and instructors, and (3) stimulate the development of a deep understanding of the material. The flipped classroom model includes teaching and learning methods that can appeal to all four generations in the academic environment. ⋯ The flipped classroom is a feasible and useful alternative to the traditional classroom. It is a method that embraces Generation Y's need for active learning in a group setting while maintaining a traditional classroom method for introducing the information. Active learning increases student engagement and can lead to improved retention of material as demonstrated on standard examinations.
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The Ochsner journal · Jan 2018
ReviewImmune Checkpoint Inhibitors in Pediatric Solid Tumors: Status in 2018.
Checkpoint inhibitors have transformed the treatment of cancer in adults. This class of drugs has demonstrated encouraging results in various malignancies such as metastatic melanoma, bladder cancer, renal cancer, and non-small cell lung carcinoma. However, researchers have only begun investigating the effectiveness and tolerability of checkpoint inhibitors in pediatric patients. ⋯ Immune checkpoint inhibitors have the potential to further therapeutic advances in pediatric oncology; however, we need more clinical trials and combination drug strategies targeted toward pediatric cancers.