Postoperative Rebound Pain: Our Current Understanding About the Role of Regional Anesthesia and Multimodal Approaches in Prevention and Treatment.

Purpose Of Review: Rebound pain (RP) is a common occurrence after peripheral nerve block placement, especially when blocks are used for orthopedic surgery. This literature review focuses on the incidence and risk factors for RP as well as preventative and treatment strategies.

Recent Findings: The addition of adjuvants to a block, when appropriate, and starting patients on oral analgesics prior to sensory resolution are reasonable approaches.

A Cross-sectional Study of the Social Media Presence of ACGME-Accredited Pain Medicine Fellowship Programs: Time to Get Online?

Background: Approximately 70% of Americans use social media platforms, and use of specific platforms, such as Instagram, Twitter, Snapchat, and TikTok, is especially common among adults under 30. The presence of social media accounts among residency and fellowship programs in academic medicine has been used to connect with other specialties, highlight achievements and research, disseminate information to the general public, and as a recruiting tool for applicants.

Objectives: The objective of this cross-sectional study was to evaluate the social media presence, specifically on Twitter and Instagram, of the Accreditation Council for Graduate Medical Education (ACGME)-accredited Pain Medicine fellowship programs.

The practice of regional anesthesia during the COVID-19 pandemic: an international survey of members of three regional anesthesia societies.

Purpose: To determine the preferences and attitudes of members of regional anesthesia societies during the COVID-19 pandemic.

Methods: We distributed an electronic survey to members of the American Society of Regional Anesthesia and Pain Medicine, Regional Anaesthesia-UK, and the European Society of Regional Anaesthesia & Pain Therapy. A questionnaire consisting of 19 questions was developed by a panel of experienced regional anesthesiologists and distributed by email to the participants.

Postoperative Hyperthermia and Hemodynamic Instability in a Suspected Malignant Hyperthermia-Susceptible Patient: A Case Report.

Malignant hyperthermia (MH) is a rare but potentially fatal complication of exposure to certain anesthetic drugs. However, stress-induced MH, initially observed in pigs undergoing intense physical or emotional strain, has been reported in the absence of anesthetic exposure. In this case report, we describe a case of postoperative hyperthermia and cardiac dysfunction suspicious for stress-induced MH occurring after an endobronchial biopsy in a patient with recurrent undiagnosed fevers.

Ultrasound-Guided Midpoint Transverse Process to Pleura Nerve Block for Medical Thoracoscopy: A Case Report.

We performed the midpoint transverse process to pleura (MTP) block in a patient with a recurrent pleural effusion requiring medical thoracoscopy, drainage of pleural effusion, talc poudrage, and placement of tunneled pleural catheter under sedation while in the left lateral decubitus position. Forty milliliters of a combination of bupivacaine hydrochloride and lidocaine, with dexamethasone and clonidine as adjuvants, was injected at the T6 level under ultrasound guidance with satisfactory intra- and postoperative analgesia.

Provider preferences for postoperative analgesia in obese and non-obese patients undergoing ambulatory surgery.

Background: Few guidelines exist on safe prescription of postoperative analgesia to obese patients undergoing ambulatory surgery. This study examines the preferences of providers in the standard treatment of postoperative pain in the ambulatory setting.

Methods: Providers from five academic medical centers within a single US city were surveyed from May-September 2015.

Regional Nerve Blocks Improve Pain and Functional Outcomes in Hip Fracture: A Randomized Controlled Trial.

Objectives: To compared outcomes of regional nerve blocks with those of standard analgesics after hip fracture.

Design: Multisite randomized controlled trial from April 2009 to March 2013.

Setting: Three New York hospitals.

Positive perceptions on safety and satisfaction during a patient-centered timeout before peripheral nerve blockade.

Objectives: To determine the psychometric outcomes of patients participating in an extensive patient-centered verification process before receiving sedation for regional anesthesia.

Design: Survey.

Setting: Perioperative areas of university-affiliated hospital.

Preoperative evaluation and preparation of patients for orthopedic surgery.

Orthopedic patients frequently have multiple comorbidities when they present for surgery. This article discusses risk stratification of this population and the preoperative work-up for patients with specific underlying conditions who often require orthopedic procedures. Preoperative strategies to decrease exposure to allogeneic blood and advantages of the Perioperative Surgical Home model in this unique population are discussed.

Types of office-based anesthetics.

Over the past several decades, there have been evolutionary changes in both surgery and anesthesia. Newer anesthetics have excellent safety profiles and are associated with fewer hemodynamic side effects and rapid elimination from the body. Innovative surgical techniques are less invasive and cause less perioperative patient pain.

Neuraxial anesthesia and timing of heparin administration in patients undergoing surgery for congenital heart disease using cardiopulmonary bypass.

Objective: The goal of this review was to add to the existing literature documenting the safety of performing neuraxial techniques in patients who are subsequently fully heparinized, with particular emphasis on the timing of heparin administration. This will help improve risk estimation and possibly lead to a more widespread use of neuraxial anesthesia in patients undergoing cardiac surgery.

Design: Retrospective chart review.

Development of a mobile ultrasound-guided peripheral nerve block and catheter service.

Ultrasound guidance is associated with improved efficiency and success of peripheral nerve blockade and a decreased incidence of vascular puncture, making these interventions safer. Patients with peripheral nerve blocks report decreased pain and increased satisfaction scores. We present the development of a mobile ultrasound-guided block service that allows for the safe and efficient placement of nerve blocks and perineural catheters at the nontraditional location of the patient's bedside and in the emergency department.

Anesthesia for patients undergoing orthopedic oncologic surgeries.

When planning an anesthetic for patients undergoing orthopedic oncologic surgeries, numerous factors must be considered. Preoperative evaluation may elucidate significant co-morbidities or side effects secondary to chemotherapy or radiation, which can affect anesthetic choices. Procedures vary in length and complexity and pose challenges in both positioning and in planning to minimize blood loss.

Treating stridor with opioids: a challenging case of paradoxical vocal cord movement.

A 61 year-old patient with a history of anxiety disorder presented with stridor after an uneventful laparotomy with a general anesthetic. Postoperative analgesia was withheld secondary to intermittent oxygen desaturation. She was unresponsive to standard therapies, including racemic epinephrine and albuterol nebulizers.