Developing epilepsy training capacity for primary care providers using the project ECHO telementoring model.

Background: Primary care providers (PCPs) provide a large proportion of care for people with epilepsy (PWE) and need regular training for updates. However, PCPs treat patients in so many therapeutic areas that epilepsy often becomes a less important concern. We used an established telementoring program, Project ECHO (Extension for Community Healthcare Outcomes), and combined epilepsy education with general neurology topics to generate more interest among PCPs.

Impact of a University-Wide Interdisciplinary Mind-Body Skills Program on Student Mental and Emotional Well-Being.

Background: Positive effects of mind-body skills programs on participant well-being have been reported in health professions students. The success seen with medical students at this university led to great interest in expanding the mind-body skills program so students in other disciplines could benefit from the program.

Objective: The purpose of this study was to assess the effects of a 9-week mind-body skills program on the mental and emotional well-being of multidisciplinary students compared to controls.

Feasibility and Acceptability of a Community-Based Modified Mindfulness-Based Stress Reduction Program for the Under- and Unemployed.

Background: Mindfulness-Based Stress Reduction (MBSR) often improves health outcomes, though literature primarily focuses on middle-class, employed individuals. With an estimated average of six million unemployed over the past year, and the recent uptick in unemployment due to the COVID-19 pandemic, it is important to identify methods to mitigate and reduce the negative health outcomes often associated with under- and unemployment.

Objectives: We aimed to 1) outline the process of partnering with a community organization to implement a modified MBSR program for under- and unemployed individuals, and 2) present pilot data on preliminary results.

Lidocaine pretreatment with tourniquet versus lidocaine-propofol admixture for attenuating propofol injection pain: a randomized controlled trial.

Objective: Findings from studies investigating optimal techniques for attenuating propofol-related injection pain are inconsistent. In previous studies, lidocaine pretreatment using a tourniquet has been reported to be superior, inferior, or equivalent to a lidocaine-propofol admixture for reducing pain. This discordance could represent either no meaningful difference in the treatments or underlying methodological differences in the previous studies.

Respiratory and sleep effects of remifentanil in volunteers with moderate obstructive sleep apnea.

Background: There is concern that opioid-based analgesia will worsen sleep-related respiratory insufficiency in patients with obstructive sleep apnea (OSA), resulting in serious morbidity or mortality. However, there are no studies that directly address the merit of this concern. Consequently, the authors designed this study as the first prospective, double-blind, placebo-controlled investigation of opioid pharmacology in patients with documented OSA.

Concurrent expansion of plasma volume and left ventricular end-diastolic volume in patients after rapid infusion of 5% albumin and lactated Ringer's solution.

Study Objective: To examine the effects of plasma volume expansion on plasma volume, left ventricular end-diastolic volume (LVEDV), and cardiac index (CI) after rapid fluid infusion, as knowledge of the degree of concordance between plasma and cardiac preload expansion could optimize LVEDV expansion without administering excessive fluid.

Design: Randomized, double-blinded study.

Setting: Academic community hospital.

Preoperative use of enoxaparin increases the risk of postoperative bleeding and re-exploration in cardiac surgery patients.

Objective: The purpose of this study was to investigate if the preoperative use of new platelet inhibitors and low-molecular-weight heparins may contribute to bleeding after cardiac surgery.

Design: Retrospective data review.

Setting: University teaching hospital.

Parasternal block and local anesthetic infiltration with levobupivacaine after cardiac surgery with desflurane: the effect on postoperative pain, pulmonary function, and tracheal extubation times.

Early tracheal extubation has become common after cardiac surgery. Anesthetic techniques designed to achieve this goal can make immediate postoperative analgesia challenging. We conducted this randomized, placebo-controlled, double-blind study to investigate the effect of a parasternal block on postoperative analgesia, respiratory function, and extubation times.

Spinal 2-chloroprocaine: a dose-ranging study and the effect of added epinephrine.

Unlabelled: With the availability of preservative- and antioxidant-free 2-chloroprocaine (2-CP), there may be an acceptable short-acting alternative to lidocaine for spinal anesthesia. We examined the safety, dose-response characteristics, and effects of epinephrine with spinal 2-CP. Six volunteers per group were randomized to receive 30, 45, or 60 mg of spinal 2-CP with and without epinephrine.

Regional anesthesia for outpatient surgery.

In summary, regional techniques offer significant advantages in the outpatient setting. They can avoid the side effects of nausea, vomiting, and pain that frequently delay discharge or cause admission. They can also provide prolonged analgesia as well as offer, with the use of continuous catheters, the promise of a pain-free perioperative period.

Suprascapular nerve block prolongs analgesia after nonarthroscopic shoulder surgery but does not improve outcome.

Unlabelled: Suprascapular nerve block (SSNB) reportedly improves analgesia and 24-h outcomes after arthroscopic shoulder surgery performed under general anesthesia. In this study, we assessed the analgesic and clinical outcome efficacy of SSNB as an adjunct to interscalene brachial plexus block (ISB) for ambulatory nonarthroscopic shoulder surgery. Fifty patients were randomized to receive either a SSNB or sham injection as part of a standardized ISB-general anesthesia regimen.

"See one, do one, teach one, have one": a novel variation on regional anesthesia training.

Introduction: Is it possible to determine the number of nerve blocks needed for residents to become competent in regional anesthesia? Several studies have focused on this question, and the Residency Review Committee (RRC) for Anesthesiology has now defined a "minimum clinical experience" for some aspects of regional anesthesia training. In our experience, personally being a regional block recipient can also serve to enhance training.

Methods: Many residents at Virginia Mason Medical Center have received regional anesthetics as volunteers in research projects.

Hyperbaric spinal levobupivacaine: a comparison to racemic bupivacaine in volunteers.

Unlabelled: Levobupivacaine is the isolated S-enantiomer of bupivacaine and may be a favorable alternative to spinal bupivacaine. However, its clinical efficacy relative to bupivacaine and its dose-response characteristics, in spinal anesthesia, must first be known. This double-blinded, randomized, cross-over study was designed to compare the clinical efficacy of hyperbaric levobupivacaine and bupivacaine for spinal anesthesia.