Pub Date : 2022-05-23DOI: 10.1136/rapm-2021-103115corr1
{"title":"Correction: Dose-dependent effects of high intensity focused ultrasound on compound action potentials in an ex vivo rodent peripheral nerve model: comparison to local anesthetics","authors":"","doi":"10.1136/rapm-2021-103115corr1","DOIUrl":"https://doi.org/10.1136/rapm-2021-103115corr1","url":null,"abstract":"","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"166 1","pages":"e3 - e3"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77858335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-23DOI: 10.1136/rapm-2021-103228corr1
Zheng J, Pan D, Zheng B, et al. Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebocontrolled trial. Reg Anesth Pain Med 2022;47:155–160. doi: 10.1136/rapm2021103228 The correct affiliation for the corresponding author, Xiangcai Ruan, is: Department of Anesthesiology and Pain Medicine, The Sixth Affiliated Hospital, Sun Yatsen University, Guangzhou, China.
{"title":"Correction: Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial","authors":"","doi":"10.1136/rapm-2021-103228corr1","DOIUrl":"https://doi.org/10.1136/rapm-2021-103228corr1","url":null,"abstract":"Zheng J, Pan D, Zheng B, et al. Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebocontrolled trial. Reg Anesth Pain Med 2022;47:155–160. doi: 10.1136/rapm2021103228 The correct affiliation for the corresponding author, Xiangcai Ruan, is: Department of Anesthesiology and Pain Medicine, The Sixth Affiliated Hospital, Sun Yatsen University, Guangzhou, China.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"33 1","pages":"e4 - e4"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80018703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-20DOI: 10.1136/rapm-2022-103688
K. Onoe, Hiroki Ogata, Takuma Okamoto, H. Okutani, R. Ueki, N. Kariya, T. Tatara, M. Hashimoto, S. Hasegawa, Y. Matsuki, Munetaka Hirose
Introduction A curative-intent surgical procedure, pleurectomy/decortication, for malignant pleural mesothelioma is accompanied by a high incidence of major postoperative complications. Although epidural block, which suppresses nociception during and after surgery, reportedly has both benefits and disadvantages in terms of outcomes after thoracic surgery for other diseases, the effects of epidural block on major complications after pleurectomy/decortication have not been evaluated. The aim of this study was to evaluate the association between epidural block and major postoperative complications following pleurectomy/decortication. Methods In a single-institutional observational study, consecutive adult patients undergoing pleurectomy/decortication under general anesthesia were enrolled from March 2019 to December 2021. Multivariable logistic regression analysis was performed to determine the association between perioperative variables and major complications. Next, patients were divided into two groups: general anesthesia with and without epidural block. Incidences of major postoperative complications, defined as Clavien-Dindo grades≥III, were compared between groups. Results In all patients enrolled with American Society of Anesthesiologists (ASA) physical status II or III (n=99), general anesthesia without epidural block was identified as a sole risk factor for major complications among perioperative variables. The incidence of major complications was 32.3% (95% CI 19.1% to 49.2%) in patients with epidural block (n=34), which was significantly lower than 63.1% (95% CI 50.9% to 73.8%) in patients without epidural block (n=65). In sensitivity analysis in patients with ASA physical status II alone, the same results were obtained. Conclusion Epidural block is likely associated with reduction of the incidence of major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia.
恶性胸膜间皮瘤的胸膜切除术/去皮术是一种治疗目的明确的外科手术，其术后主要并发症的发生率很高。据报道，硬膜外阻滞在手术期间和手术后抑制伤害感受，对其他疾病胸外科手术后的结果既有好处也有缺点，但硬膜外阻滞对胸膜切除/去皮术后主要并发症的影响尚未得到评估。本研究的目的是评估硬膜外阻滞与胸膜切除术/去皮术后主要并发症之间的关系。方法在一项单机构观察性研究中，于2019年3月至2021年12月连续招募在全身麻醉下接受胸膜切除术/去皮术的成年患者。采用多变量logistic回归分析确定围手术期变量与主要并发症的关系。接下来，将患者分为两组:全麻加硬膜外阻滞和不加硬膜外阻滞。比较两组术后主要并发症发生率，Clavien-Dindo分级≥III。结果在美国麻醉医师学会(ASA)身体状态II或III的所有患者(n=99)中，在围手术期变量中，无硬膜外阻滞的全身麻醉被确定为主要并发症的唯一危险因素。硬膜外阻滞患者(n=34)的主要并发症发生率为32.3% (95% CI 19.1% ~ 49.2%)，显著低于无硬膜外阻滞患者(n=65)的63.1% (95% CI 50.9% ~ 73.8%)。在单独对ASA身体状态为II的患者进行敏感性分析时，得到了相同的结果。结论硬膜外阻滞可降低全身麻醉下恶性胸膜间皮瘤切除/去皮术后主要并发症的发生率。
{"title":"Association between thoracic epidural block and major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia","authors":"K. Onoe, Hiroki Ogata, Takuma Okamoto, H. Okutani, R. Ueki, N. Kariya, T. Tatara, M. Hashimoto, S. Hasegawa, Y. Matsuki, Munetaka Hirose","doi":"10.1136/rapm-2022-103688","DOIUrl":"https://doi.org/10.1136/rapm-2022-103688","url":null,"abstract":"Introduction A curative-intent surgical procedure, pleurectomy/decortication, for malignant pleural mesothelioma is accompanied by a high incidence of major postoperative complications. Although epidural block, which suppresses nociception during and after surgery, reportedly has both benefits and disadvantages in terms of outcomes after thoracic surgery for other diseases, the effects of epidural block on major complications after pleurectomy/decortication have not been evaluated. The aim of this study was to evaluate the association between epidural block and major postoperative complications following pleurectomy/decortication. Methods In a single-institutional observational study, consecutive adult patients undergoing pleurectomy/decortication under general anesthesia were enrolled from March 2019 to December 2021. Multivariable logistic regression analysis was performed to determine the association between perioperative variables and major complications. Next, patients were divided into two groups: general anesthesia with and without epidural block. Incidences of major postoperative complications, defined as Clavien-Dindo grades≥III, were compared between groups. Results In all patients enrolled with American Society of Anesthesiologists (ASA) physical status II or III (n=99), general anesthesia without epidural block was identified as a sole risk factor for major complications among perioperative variables. The incidence of major complications was 32.3% (95% CI 19.1% to 49.2%) in patients with epidural block (n=34), which was significantly lower than 63.1% (95% CI 50.9% to 73.8%) in patients without epidural block (n=65). In sensitivity analysis in patients with ASA physical status II alone, the same results were obtained. Conclusion Epidural block is likely associated with reduction of the incidence of major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"33 1","pages":"494 - 499"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78118122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1136/rapm-2022-103554
Taras Grosh, James Kim, Veena Graff, E. Mariano, N. Elkassabany
To cite: Grosh T, Kim J, Graff V, et al. Reg Anesth Pain Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/rapm-2022103554 Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
引用:Grosh T, Kim J, Graff V等。Reg Anesth Pain Med Epub提前打印:[请包括年月日]。doi:10.1136/rapm-2022103554麻醉学和重症监护，宾夕法尼亚大学，费城，宾夕法尼亚州，美国麻醉和围手术期护理服务，VA帕洛阿尔托卫生保健系统，帕洛阿尔托，加利福尼亚州，美国，斯坦福大学医学院麻醉学，围手术期和疼痛医学系，斯坦福，加利福尼亚州，美国
{"title":"Is there a correlation between Altmetric Attention Scores and citation count in Regional Anesthesia and Pain Medicine journal articles?","authors":"Taras Grosh, James Kim, Veena Graff, E. Mariano, N. Elkassabany","doi":"10.1136/rapm-2022-103554","DOIUrl":"https://doi.org/10.1136/rapm-2022-103554","url":null,"abstract":"To cite: Grosh T, Kim J, Graff V, et al. Reg Anesth Pain Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/rapm-2022103554 Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"92 1","pages":"649 - 650"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80378371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1136/rapm-2022-103552
Jatin Joshi, M. Roytman, R. Aiyer, E. Mauer, J. L. Chazen
Background Cervical epidural steroid injections are commonly performed to manage pain from cervical spine disease. Cadaveric studies have demonstrated incomplete ligamentum flavum fusion in the central interlaminar region with resultant midline gaps. We performed an MR-based characterization of cervical ligamentum flavum midline gaps to improve understanding of their prevalence and guide interventionalists in procedural planning. Methods Fifty patients were retrospectively reviewed following institutional review board approval. Axial T2-weighted spinecho sequences were used to evaluate ligamentum flavum integrity at the interlaminar spaces of C5–C6, C6–C7 and C7–T1. Interlaminar spaces were further subdivided into superior, middle, and inferior portions, yielding 150 interlaminar regions characterized from C5 to T1. Subsequently, a novel categorization of gap morphology was performed, highlighting gap morphology (anterior, posterior, full, or no gap). Results Full gaps of the ligamentum flavum, with direct epidural space exposure, were observed with variable prevalence at all three levels evaluated. The highest incidence of full ligamentum flavum gaps were observed at C7–T1, occurring in 71.4% of patients at both its middle and inferior portions. The inferior aspect of C5–C6 demonstrated the lowest observed rates of full ligamentum flavum gap (2%). Conclusions Ligamentum flavum gaps occur in the lower cervical spine at high rates, with the highest prevalence of full thickness ligamentum flavum gaps at C7–T1. Interventionists must be aware of these important normal variants and evaluate preprocedural MRI to plan interventions.
{"title":"Cervical spine ligamentum flavum gaps: MR characterisation and implications for interlaminar epidural injection therapy","authors":"Jatin Joshi, M. Roytman, R. Aiyer, E. Mauer, J. L. Chazen","doi":"10.1136/rapm-2022-103552","DOIUrl":"https://doi.org/10.1136/rapm-2022-103552","url":null,"abstract":"Background Cervical epidural steroid injections are commonly performed to manage pain from cervical spine disease. Cadaveric studies have demonstrated incomplete ligamentum flavum fusion in the central interlaminar region with resultant midline gaps. We performed an MR-based characterization of cervical ligamentum flavum midline gaps to improve understanding of their prevalence and guide interventionalists in procedural planning. Methods Fifty patients were retrospectively reviewed following institutional review board approval. Axial T2-weighted spinecho sequences were used to evaluate ligamentum flavum integrity at the interlaminar spaces of C5–C6, C6–C7 and C7–T1. Interlaminar spaces were further subdivided into superior, middle, and inferior portions, yielding 150 interlaminar regions characterized from C5 to T1. Subsequently, a novel categorization of gap morphology was performed, highlighting gap morphology (anterior, posterior, full, or no gap). Results Full gaps of the ligamentum flavum, with direct epidural space exposure, were observed with variable prevalence at all three levels evaluated. The highest incidence of full ligamentum flavum gaps were observed at C7–T1, occurring in 71.4% of patients at both its middle and inferior portions. The inferior aspect of C5–C6 demonstrated the lowest observed rates of full ligamentum flavum gap (2%). Conclusions Ligamentum flavum gaps occur in the lower cervical spine at high rates, with the highest prevalence of full thickness ligamentum flavum gaps at C7–T1. Interventionists must be aware of these important normal variants and evaluate preprocedural MRI to plan interventions.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"50 1","pages":"459 - 463"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85850093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-06DOI: 10.1136/rapm-2021-103180
E. Schwenk, Aaron Walter, M. Torjman, Sarah Mukhtar, Harsh T Patel, Bryan Nardone, George Sun, Bhavana Thota, C. Lauritsen, S. Silberstein
Introduction Patients with refractory chronic migraine have poor quality of life. Intravenous infusions are indicated to rapidly ‘break the cycle’ of pain. Lidocaine infusions may be effective but evidence is limited. Methods The records of 832 hospital admissions involving continuous multiday lidocaine infusions for migraine were reviewed. All patients met criteria for refractory chronic migraine. During hospitalization, patients received additional migraine medications including ketorolac, magnesium, dihydroergotamine, methylprednisolone, and neuroleptics. The primary outcome was change in headache pain from baseline to hospital discharge. Secondary outcomes measured at the post-discharge office visit (25–65 days after treatment) included headache pain and the number of headache days, and percentage of sustained responders. Percentage of acute responders, plasma lidocaine levels, and adverse drug effects were also determined. Results In total, 609 patient admissions met criteria. The mean age was 46±14 years; 81.1% were female. Median pain rating decreased from baseline of 7.0 (5.0–8.0) to 1.0 (0.0–3.0) at end of hospitalization (p<0.001); 87.8% of patients were acute responders. Average pain (N=261) remained below baseline at office visit 1 (5.5 (4.0–7.0); p<0.001). Forty-three percent of patients were sustained responders at 1 month. Headache days (N=266) decreased from 26.8±3.9 at baseline to 22.5±8.3 at the post-discharge office visit (p<0.001). Nausea and vomiting were the most common adverse drug effects and all were mild. Conclusion Lidocaine infusions may be associated with short-term and medium-term pain relief in refractory chronic migraine. Prospective studies should confirm these results.
{"title":"Lidocaine infusions for refractory chronic migraine: a retrospective analysis","authors":"E. Schwenk, Aaron Walter, M. Torjman, Sarah Mukhtar, Harsh T Patel, Bryan Nardone, George Sun, Bhavana Thota, C. Lauritsen, S. Silberstein","doi":"10.1136/rapm-2021-103180","DOIUrl":"https://doi.org/10.1136/rapm-2021-103180","url":null,"abstract":"Introduction Patients with refractory chronic migraine have poor quality of life. Intravenous infusions are indicated to rapidly ‘break the cycle’ of pain. Lidocaine infusions may be effective but evidence is limited. Methods The records of 832 hospital admissions involving continuous multiday lidocaine infusions for migraine were reviewed. All patients met criteria for refractory chronic migraine. During hospitalization, patients received additional migraine medications including ketorolac, magnesium, dihydroergotamine, methylprednisolone, and neuroleptics. The primary outcome was change in headache pain from baseline to hospital discharge. Secondary outcomes measured at the post-discharge office visit (25–65 days after treatment) included headache pain and the number of headache days, and percentage of sustained responders. Percentage of acute responders, plasma lidocaine levels, and adverse drug effects were also determined. Results In total, 609 patient admissions met criteria. The mean age was 46±14 years; 81.1% were female. Median pain rating decreased from baseline of 7.0 (5.0–8.0) to 1.0 (0.0–3.0) at end of hospitalization (p<0.001); 87.8% of patients were acute responders. Average pain (N=261) remained below baseline at office visit 1 (5.5 (4.0–7.0); p<0.001). Forty-three percent of patients were sustained responders at 1 month. Headache days (N=266) decreased from 26.8±3.9 at baseline to 22.5±8.3 at the post-discharge office visit (p<0.001). Nausea and vomiting were the most common adverse drug effects and all were mild. Conclusion Lidocaine infusions may be associated with short-term and medium-term pain relief in refractory chronic migraine. Prospective studies should confirm these results.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"68 1","pages":"408 - 413"},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81696658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-21DOI: 10.1136/rapm-2022-103630
B. Songthamwat, P. Luangjarmekorn, Wirinaree Kampitak, R. Sivakumar, M. Karmakar
Background and objectives Recent reports suggest that a selective trunk block (SeTB) can produce sensorimotor blockade of the entire upper extremity, except for the T2 dermatome. There are no data demonstrating the anatomic mechanism of SeTB. This cadaver study aimed to evaluate the spread of an injectate after a simulated ultrasound-guided (USG) SeTB. Methods USG SeTB (n=7) was performed on both sides of the neck in four adult human cadavers with 25 mL of 0.1% methylene blue dye. Anatomic dissection was performed to document staining (deep, faint, and no stain) of the various elements of the brachial plexus from the level of the roots to the cords, including the phrenic, dorsal scapular, and long thoracic nerves. Only structures that were deeply stained were defined as being affected by the SeTB. Results All the trunks and divisions of the brachial plexus, as well as the ventral rami of C5–C7 and suprascapular nerve, were deeply stained in all (100%) the simulated injections. The ventral rami of C8 and T1 (86%), dorsal scapular and long thoracic nerve (71%), and the phrenic nerve (57%) were also deeply stained in a substantial number of the injections. Conclusion This cadaver study demonstrates that an USG SeTB consistently affects all the trunks and divisions of the brachial plexus, as well as the suprascapular nerve. This study also establishes that SeTB may not be phrenic nerve sparing. Future research to evaluate the safety and efficacy of SeTB as an all-purpose brachial plexus block technique for upper extremity surgery is warranted. Trial registration number Registered at https://www.thaiclinicaltrials.org on December 13, 2021 under the trial registration number TCTR20211213005.
{"title":"Ultrasound-guided selective trunk block (SeTB): a cadaver anatomic study to evaluate the spread of dye after a simulated injection","authors":"B. Songthamwat, P. Luangjarmekorn, Wirinaree Kampitak, R. Sivakumar, M. Karmakar","doi":"10.1136/rapm-2022-103630","DOIUrl":"https://doi.org/10.1136/rapm-2022-103630","url":null,"abstract":"Background and objectives Recent reports suggest that a selective trunk block (SeTB) can produce sensorimotor blockade of the entire upper extremity, except for the T2 dermatome. There are no data demonstrating the anatomic mechanism of SeTB. This cadaver study aimed to evaluate the spread of an injectate after a simulated ultrasound-guided (USG) SeTB. Methods USG SeTB (n=7) was performed on both sides of the neck in four adult human cadavers with 25 mL of 0.1% methylene blue dye. Anatomic dissection was performed to document staining (deep, faint, and no stain) of the various elements of the brachial plexus from the level of the roots to the cords, including the phrenic, dorsal scapular, and long thoracic nerves. Only structures that were deeply stained were defined as being affected by the SeTB. Results All the trunks and divisions of the brachial plexus, as well as the ventral rami of C5–C7 and suprascapular nerve, were deeply stained in all (100%) the simulated injections. The ventral rami of C8 and T1 (86%), dorsal scapular and long thoracic nerve (71%), and the phrenic nerve (57%) were also deeply stained in a substantial number of the injections. Conclusion This cadaver study demonstrates that an USG SeTB consistently affects all the trunks and divisions of the brachial plexus, as well as the suprascapular nerve. This study also establishes that SeTB may not be phrenic nerve sparing. Future research to evaluate the safety and efficacy of SeTB as an all-purpose brachial plexus block technique for upper extremity surgery is warranted. Trial registration number Registered at https://www.thaiclinicaltrials.org on December 13, 2021 under the trial registration number TCTR20211213005.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"22 1","pages":"414 - 419"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83725916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1136/rapm-2021-103274
J. R. Coleman, P. Hartmann, Matthew Kona, Robert Thiele, Reza Salajegheh, N. Hanson
Ensuring proper placement of epidural catheters is critical to improving their reliability for pain control and maintaining confidence in their continued use. This article will seek to address the role of objective confirmation of successful epidural placement via either single view or continuous epidural contrast studies, each creating an ‘epidurogram.’ Furthermore, the pertinent anatomical corollaries of continuous fluoroscopy used frequently in chronic pain medicine, from which these techniques emerged, will be addressed. Technical radiographic information needed to better understand and troubleshoot these studies is also included. Image examples which highlight the patterns key for successful interpretation of epidurograms will be provided. The aim of this paper was to provide an anesthesiologist unfamiliar with fluoroscopic evaluation of epidural catheters with the tools necessary to successfully conduct and interpret such an examination.
{"title":"Use of epidurography in the perioperative and acute pain setting","authors":"J. R. Coleman, P. Hartmann, Matthew Kona, Robert Thiele, Reza Salajegheh, N. Hanson","doi":"10.1136/rapm-2021-103274","DOIUrl":"https://doi.org/10.1136/rapm-2021-103274","url":null,"abstract":"Ensuring proper placement of epidural catheters is critical to improving their reliability for pain control and maintaining confidence in their continued use. This article will seek to address the role of objective confirmation of successful epidural placement via either single view or continuous epidural contrast studies, each creating an ‘epidurogram.’ Furthermore, the pertinent anatomical corollaries of continuous fluoroscopy used frequently in chronic pain medicine, from which these techniques emerged, will be addressed. Technical radiographic information needed to better understand and troubleshoot these studies is also included. Image examples which highlight the patterns key for successful interpretation of epidurograms will be provided. The aim of this paper was to provide an anesthesiologist unfamiliar with fluoroscopic evaluation of epidural catheters with the tools necessary to successfully conduct and interpret such an examination.","PeriodicalId":21046,"journal":{"name":"Regional Anesthesia & Pain Medicine","volume":"8 1","pages":"445 - 448"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80137899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1136/rapm-2022-103623
Raghuraman M. Sethuraman, V. Narayanan
To the Editor We read the article regarding the nomenclature for various regional anesthesia techniques and found it very useful. We greatly appreciate the efforts of the experts and respect their suggestions of nomenclatures for various regional anesthesia techniques. We strongly believe that nomenclatures suggested by the panel would certainly avoid confusion and wish to have clarifications on the nomenclature suggested for the PECS II block (pectoralis block II). To our knowledge, ‘PECS II’ is one of the commonly misinterpreted terms used in regional anesthesia parlance. Blanco et al described PECS II (modified PECS I) as a combination of two techniques which is inclusive of PECS I by default. Unfortunately, it is commonly misconstrued as a single technique, thereby erroneously describing it as ‘PECS I+PECS II’ by some authors as pointed out by Woodworth et al in their ‘thoughtprovoking’ review article on the anatomy and regional techniques of the breast. The experts (although 53% only) have agreed to the term ‘Pectoserratus plane block’ for PECS II. However, it requires clarification because the term ‘Interpectoral plane block’ suggested for PECS I has not been added to the proposed nomenclature for PECS II. We feel that it would have been better if the collective term ‘Interpectoral +Pectoserratus plane blocks’ was suggested for PECS II to make it more clear.
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