Impact of Erector Spinae Plane Blocks on Pain Management and Postoperative Outcomes in Patients with Chronic Pain Undergoing Spine Fusion Surgery: A Retrospective Cohort Study.

Purpose: To evaluate the impact of bilateral ultrasound-guided erector spinae plane blocks (ESPBs) on pain and opioid-related outcomes in a surgical population with chronic pain.

Methods: A retrospective, observational cohort study. Clinical data were extracted from the electronic medical records of patients who underwent lumbar fusion (February 2018 - July 2020).

Intravenous Ketorolac Substantially Reduces Opioid Use and Length of Stay After Lumbar Fusion: A Randomized Controlled Trial.

Study Design: A randomized, double-blinded, placebo-controlled trial.

Objective: To examine the effect of intravenous ketorolac (IV-K) on hospital opioid use compared with IV-placebo (IV-P) and IV acetaminophen (IV-A).

Summary Of Background Data: Controlling postoperative pain while minimizing opioid use after lumbar spinal fusion is an important area of study.

Comparative review of airway anesthesia and sedation methods for awake intubation.

Purpose Of Review: Successful awake intubation hinges upon adequate airway anesthesia and sedation for patient comfort. This review will summarize relevant anatomy and regional anesthesia techniques to achieve airway anesthesia, and compare various airway anesthesia and sedation regimens.

Recent Findings: Overall, nerve blocks consistently provided superior airway anesthesia, shorter time to intubation, higher patient comfort, and higher postintubation patient satisfaction.

Erector Spinae Plane Block Reduces Immediate Postoperative Pain and Opioid Demand After Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Study Design: Matched cohort comparison.

Objective: To determine perioperative outcomes of erector spinae plane (ESP) block for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

Summary Of Background Data: There is a paucity of data on the impact of lumbar ESP block on perioperative outcomes and its safety in MI-TLIF.

Hemodynamically significant cardiac arrhythmias during general anesthesia for spine surgery: A case series and literature review.

Background Context: Hemodynamically significant bradycardia and cardiac arrest (CA) are rare under general anesthesia (GA) for spine surgery. Although patient risks are well defined, emerging data implicate surgical, anesthetic and neurologic factors which should be considered in the immediate management and decision to continue or terminate surgery.

Purpose: To characterize causes and contributors to significant arrhythmias during spine surgery.

Enhanced Recovery after Lumbar Spine Fusion: A Randomized Controlled Trial to Assess the Quality of Patient Recovery.

Background: Prospective trials of enhanced recovery after spine surgery are lacking. We tested the hypothesis that an enhanced recovery pathway improves quality of recovery after one- to two-level lumbar fusion.

Methods: A patient- and assessor-blinded trial of 56 patients randomized to enhanced recovery (17 evidence-based pre-, intra-, and postoperative care elements) or usual care was performed.

Trends in Ambulatory Laminectomy in the USA and Key Factors Associated with Successful Same-Day Discharge: A Retrospective Cohort Study.

Background: Laminectomy is commonly used in the treatment of lumbar spine pathology. Laminectomies are increasingly being performed in outpatient settings, but patient safety concerns remain.

Questions/purposes: We aimed to describe trends in outpatient lumbar laminectomy between 2008 and 2016 and to identify factors associated with successful same-day discharge.

Effects of a multimodal analgesic pathway with transversus abdominis plane block for lumbar spine fusion: a prospective feasibility trial.

Purpose: Lumbar spine fusion with anterior (ALIF) or lateral (LLIF) approach is a moderately painful procedure associated with significant length of hospital stay (LoS) and opioid requirements. We developed an opioid-sparing analgesic pathway of care for ALIF and LLIF, featuring transversus abdominis plane (TAP) block. In this study, we assessed the feasibility of performing the TAP block as an analgesic adjunct for ALIF or LLIF.

An enhanced recovery after surgery pathway: association with rapid discharge and minimal complications after anterior cervical spine surgery.

OBJECTIVEEnhanced recovery after surgery (ERAS) pathways are associated with improved outcomes, lower morbidity and complications, and higher patient satisfaction in multiple surgical subspecialties. Despite these gains, there are few data to guide the application of ERAS concepts to spine surgery. The authors report the development and implementation of the first ERAS pathway for patients undergoing anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA).

Opioid-free anesthesia within an enhanced recovery after surgery pathway for minimally invasive lumbar spine surgery: a retrospective matched cohort study.

OBJECTIVEEnhanced recovery after surgery (ERAS) and multimodal analgesia are established care models that minimize perioperative opioid consumption and promote positive outcomes after spine surgery. Opioid-free anesthesia (OFA) is an emerging technique that may achieve similar goals. The purpose of this study was to evaluate an OFA regimen within an ERAS pathway for lumbar decompressive surgery and to compare perioperative opioid requirements in a matched cohort of patients managed with traditional opioid-containing anesthesia (OCA).

An Observational Study of Cerebral Blood Flow Velocity Evaluation in the Prone Position During Posterior Lumbar Surgery.

Background: Prone positioning (PP) is necessary for surgical access during posterior spine procedure. However, physiological changes occur in the PP. Typical findings are a decrease in arterial blood pressure and in cardiac output that could potentially lead to an alteration in cerebral perfusion.

Design and Implementation of an Enhanced Recovery After Surgery (ERAS) Program for Minimally Invasive Lumbar Decompression Spine Surgery: Initial Experience.

Study Design: A retrospective cohort study of prospectively collected data.

Objective: The aim of this study was to describe the development of and early experience with an evidence-based enhanced recovery after surgery (ERAS) pathway for lumbar decompression.

Summary Of Background Data: ERAS protocols have been consistently associated with improved patient experience and outcomes, and reduced cost and length of hospital stay (LoS).

Evaluation of Postgraduates Following Implementation of a Focus Assessed Transthoracic Echocardiography (FATE) Training Course-A Pilot Study.

At our institution, implementation of a formal training course in Basic Focus Assessed Transthoracic Echocardiography (FATE) was associated with an improvement in anesthesia trainees' ability to obtain transthoracic echocardiography (TTE) images. Total image acquisition scores improved by a median (Q1, Q3) 9.1 (2.

Emergent reintubation following elective cervical surgery: A case series.

Aim: To review cases of emergent reintubation after cervical surgery.

Methods: Patients who were emergently intubated in the post-operative period following cervical surgery were identified. The patients' prospectively documented demographic parameters, medical history and clinical symptoms were ascertained.

Aortic perforation during lateral lumbar interbody fusion.

Study Design: A case report.

Objective: To report a unique case of aortic perforation during lateral lumbar interbody fusion (LLIF).

Summary Of Background Data: Among the reported advantages of this minimally invasive transpsoas procedure is the avoidance of an anterior intraperitoneal approach to the lumbar spine, thus avoiding visceral and vascular injuries typically associated with the latter.

Cervical spine disease is a risk factor for persistent phrenic nerve paresis following interscalene nerve block.

The use of interscalene blocks (ISBs) for shoulder surgery improves postoperative pain control, reduces recovery room times, and reduces overall hospital stays. The most common and potentially disabling adverse effect associated with ISBs is phrenic nerve paresis. Fortunately, persistent phrenic nerve paresis (PPNP) is rare.

Comparative utility of centrally versus peripherally transduced venous pressure monitoring in the perioperative period in spine surgery patients.

Study Objective: To compare central venous pressure (CVP) with peripheral venous pressure (PVP) monitoring during the intraoperative and postoperative periods in patients undergoing spine surgery.

Design: Prospective observational study.

Setting: University-affiliated teaching hospital.

The training and careers of regional anesthesia fellows--1983-2002.

Background And Objectives: The education and subsequent careers of regional anesthesia fellows have not been examined but may provide insight into improving future fellowship training and/or the future of the subspecialty.

Methods: Regional anesthesia fellows educated during a 20-year period (1983-2002) were asked to complete a comprehensive survey that detailed their training, current professional setting, and use of regional anesthesia, and how they foresee the future of regional anesthesia. A separate survey of academic anesthesiology chairs assessed the role of and need for regional anesthesiologists in teaching departments.

Guidelines for regional anesthesia fellowship training.

Background: The number of regional anesthesia fellowships has grown over the past 2 decades. There currently exist no guidelines for what constitutes ideal regional anesthesia fellowship training.

Methods: Regional anesthesia fellowship program directors and other advocates of regional anesthesia were invited to participate in a collaborative project to establish a standardized curriculum for regional anesthesia fellowships.

Pulmonary injury in patients undergoing complex spine surgery.

Background Context: Previous reports have shown that 15% of patients who undergo sequential anterior, then posterior, surgical corrections for spinal deformities demonstrate evidence of acute lung injury. By analyzing the bronchoalveolar lavage (BAL) fluid from these patients for evidence of acute inflammation, we might gain some insight into the etiology of this acute lung injury.

Purpose: To elucidate the etiology of acute lung injury after corrective surgery for adult spinal deformities.