Management of an Entrapped Epidural Catheter.

Epidural catheters are seldom challenging to remove from patients. The occurrence of knotting in an epidural catheter, resulting in entrapment, is an uncommon complication of epidural catheterization. There is the risk of significant morbidity with a retained catheter, with the potential for infection or nerve injury.

Coring Revisited: A Case Report and Literature Review.

Coring is the retention of material from a medication vial into the needle and syringe, which can ultimately be transfused into a patient, causing adverse outcomes. The purpose of this article is to increase awareness of this underreported finding and to propose solutions to improve the quality of care and decrease fatalities. A 65-year-old male with a significant cardiovascular history was admitted and required an emergent bedside esophagogastroduodenoscopy, for which propofol was being aspirated for IV induction.

Opioid-Related Genetic Polymorphisms of Cytochrome P450 Enzymes after Total Joint Arthroplasty: A Focus on Drug-Drug-Gene Interaction with Commonly Coprescribed Medications.

Pharmacogenomic testing, together with the early detection of drug-drug-gene interactions (DDGI) before initiating opioids, can improve the selection of dosage and reduce the risk of adverse drug interactions and therapeutic failures following Total Joint Arthroplasty. The variants of CYP genes can mediate DDGI. Orthopedic surgeons should become familiar with the genetic aspect of opioid use and abuse, as well as the influence of the patient genetic makeup in opioid selection and response, and polymorphic variants in pain modulation.