Spinal anesthesia is a common intervention for lower-body orthopedic procedures. A potential side effect is post-dural puncture headache (PDPH). Clinicians often use larger needles when performing this technique on older patients. This study found that the incidence of PDPH was not related to needle size.
Patients undergoing lower body amputations who received PNS implants were able to be discharged home or to rehab earlier with better pain control, required fewer opioids overtime, and were less likely to be readmitted to the hospital in 30 days.
Erector spinae plane (ESP) blocks enable injection of local anesthetics and steroids along a protective layer surrounding the muscles that support the spine to achieve numbing effects. In this study, patients with acute pancreatitis who received ESP blocks had superior pain control and decreased opioid intake.
The award honors Gaston P. Labat, MD (1843-1908), a pioneer in regional anesthesia and the first president of the American Society of Regional Anesthesia founded in 1923 (later abandoned and then “re-founded” in 1975).
Dr. Mukhdomi is a resident in anesthesiology at Brown University, Rhode Island Hospital where he has been chief resident since 2020. ASRA’s Resident/Fellow of the Year Award is given annually to a resident or fellow member of ASRA who has demonstrated outstanding contributions to regional anesthesia or pain medicine; has contributed to the advancement of the profession, welfare of residents, or quality of residency education; serves as a role model and mentor to his or her peers; and embodies the values of ASRA.
The American Society of Regional Anesthesia and Pain Medicine has joined 10 other pain societies in issuing a practice advisory on the use of gadolinium-based contrast agents. This off-label use is an alternative option for patients with hypersensitivity to the traditional contrast medium.
A recent study conducted by physicians across the country shows promise for a new treatment option for patients suffering chronic pain from diabetic neuropathy. The treatment entails spinal cord stimulator implantation, a technique commonly associated with chronic back and leg pain treatment.
In a study of cancer patients treated with methylnaltrexone, about 50%–70% experienced relief from opioid-induced constipation within 4 hours without the use of additional treatments, compared with 15% of placebo-treated patients. In addition, more patients treated with methylnaltrexone maintained a response at 24 hours after dosing compared with patients treated with placebo.
Neuromonitoring has been used in the fields of neurological and orthopedic surgery for years but has just recently made its debut in SCS implantation. There are limited studies observing neuromonitoring in this application, so doctors have shared the case study of a patient who successfully underwent the procedure and reported 90% pain reduction one week later.
Patients who receive hip replacement surgery at safety net hospitals – those that provide care regardless of ability to pay – were 38% more likely to die in the hospital than those receiving the surgery at other hospitals, according to a study published in the journal Regional Anesthesia & Pain Medicine.
Interscalene blocks are a type of regional anesthesia used to relieve pain during and after shoulder surgery. This procedure can lead to numbing of the phrenic nerve as well, however, which can lead to pulmonary complications. Researchers at Stanford University are experimenting with different amounts of saline that can help reverse the phrenic nerve blockade while still maintaining analgesic effect.
Researchers from the University of British Columbia studied three lidocaine derivatives for use as motor blockade with promising results. This study provides insight into developing more effective, longer-lasting non-opioid local anesthetics, which could improve postoperative pain control. ASRA presented researchers with "Best of Meeting Abstract" and "Resident/Fellow Travel Award" for their work.
Hemidiaphragmatic paresis, or HDP, is a condition in which one side of the diaphragm is weakened, resulting in shortness of breath and reduced respiratory function. It can occur when a patient is given regional anesthesia for shoulder surgery, using the supraclavicular nerve block. Researchers are trying to determine the right amount of anesthesia to use in the supraclavicular block so that the block still works but the chances of developing HDP are low.
The sooner hip replacement patients can walk after surgery, the faster they can be discharged, allowing for more comfortable recovery at home, lower overall cost of care, and increased availability of critical hospital resources. Results of a recent study found that patients who received mepivacaine spinal anesthesia were more likely to ambulate early and be discharged on the day of surgery.
Using an erector spinae plane block (ESPB) for postoperative analgesia from total shoulder replacement offers advantages over the more commonly used interscalene brachial plexus nerve block, including avoiding phrenic nerve complications and upper-extremity mobility issues, researchers from Stanford University in Stanford, CA, reported in findings from a new study.
ASRA award recipients are being recognized for their accomplishments despite the cancellation of the group's annual spring meeting. Included in recipients is the anesthesia pioneer who identified a treatment for local anesthetic systemic toxicity (LAST), a serious potential complication associated with procedures involving local anesthetics.
If you don’t have COVID-19, you probably want to stay as far away from a hospital as possible right now. However, the fact is that some people still need emergency surgery. If you or a loved one are in this situation – for any reason – you should know that experts say regional anesthesia may be better than general anesthesia to keep everyone in the operating room safe.asr
Eight trailblazing women in regional anesthesia and pain medicine are being honored for their achievements and contributions to the field as part of the ASRA Trailblazer Awards. Created to acknowledge potential for bias in the past, the program is part of the “Year of Women in ASRA,” so named by ASRA President Dr. Eugene Viscusi. Other components of the campaign include year-round highlights of prominent women in the field on the ASRA website and social media channels, greater recognition of gender disparities at meetings, improved data collection to continue to assess our progress representing the field, and, most importantly, development of an organizational plan to identify and correct disparities across all minority groups.
Nagy Mekhail, MD, PhD, professor at the Cleveland Clinic Lerner College of Medicine, has been selected to receive the American Society of Regional Anesthesia and Pain Medicine (ASRA) 2019 John J. Bonica Award.
Dr. Mark J. Lema, State University of New York (SUNY) Distinguished Service Professor and Chair of Anesthesiology at SUNY at Buffalo Jacobs School of Medicine and Biomedical Sciences, has been selected to receive ASRA’s 2019 Distinguished Service Award.
Colleagues at the University of California at Irvine have developed an electronic prescription drug accountability program to keep track of prescribing among hospitalists, primary care physicians, and emergency department physicians within an institution.
Researchers at Thomas Jefferson University and the University of Virginia retrospectively analyzed patient records see if side effects increased after repeated infusions. They actually found a couple of benefits.
Patients who have chosen to treat chronic pain with implanted peripheral nerve stimulation no longer need to be tethered permanently to the device. According to findings from a study in amputees, placing the device for just 60 days resulted in sustained pain relief and functional improvements.
Dr. Brian Sites, medical director of the acute pain medicine service at Dartmouth-Hitchcock Medical Center, has accepted the position of editor-in-chief for the Regional Anesthesia and Pain Medicine journal.
In honor of Women in Medicine month, we present a sample listing of women leaders in regional anesthesia. This article originally appeared in the February 2016 edition of ASRA News and again in the ASRA Blog three years ago.
Mastoora Nasiri, MD, and Adlai Pappy are the latest to receive grant funding for research in regional anesthesia and acute and chronic pain. Their studies will address enhanced recovery after cardiac surgery and cancer survival.
Ultrasound-guided bilateral rectus sheath block (RSB) is associated with fewer side effects and a reduced dependence on opioids, according to the results of a study from the Institute of Medical Sciences in New Delhi, India.
In patients undergoing primary hip arthroplasty, regional anesthesia with lidocaine infusion reduces postoperative pain and opioid consumption, possibly because of decreased immune cell signaling, according to research at Stanford University.
Although acetaminophen is frequently given prior to spine surgery to help reduce the need for opioids, this study found no benefit. Given the drug's high cost and low availability, researchers suggest it not be routinely given to this group of patients.
Researchers from the Netherlands have found that patients undergoing knee arthroscopy who received chloroprocaine recovered more quickly than those receiving prilocaine. The study has implications for both patient recovery and shorter hospital stays.
30-80% of amputee patients develop chronic pain after their surgery, and there is not yet a clear strategy for relieving that pain. Researchers found that adding liposomal bupivacaine to the nerve block in patients undergoing major lower extremity amputation helped reduce pain and opioid use.
Dr. Chad Brummett will accept the 2019 ASRA Presidential Scholar at the 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting, April 11-13, in Las Vegas. The award is given to those who have demonstrated great potential to in their research careers.
Dr. Joseph M. Neal will receive ASRA’s 2019 Gaston Labat Award at the 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting in Las Vegas, NV. The Gaston Labat Award is given annually to an individual who has demonstrated outstanding contributions to the development, teaching, and practice of regional anesthesia in the tradition of Gaston P. Labat, MD (1843-1908).
The American Society of Regional Anesthesia and Pain Medicine (ASRA) has named Jason Ochroch, MD, a fellow at the University of Pennsylvania, the 2019 Resident/Fellow of the Year.
The award is given annually to a resident or fellow member of ASRA who has demonstrated outstanding contributions to regional anesthesia or pain medicine; has contributed to the advancement of the profession, welfare of residents, or quality of residency education; serves as a role model and mentor to his or her peers; and embodies the values of ASRA.
Outgoing President Asokumar Buvanendran, MD, and his wife Jenn Asokumar have established a new grant that will provide access to the latest research in the field for physicians from low-resource countries.
ASRA has awarded the 2018 Chronic Pain Medicine Research Grant to Eellan Sivanesan, MD, for a project looking at the effectiveness of spinal cord stimulation (SCS) for the treatment of chemotherapy-induced painful neuropathy (CIPN). Sivanesan is an assistant professor in the department of anesthesiology and critical care medicine at Johns Hopkins University School of Medicine in Baltimore, MD.
Patients with fibromyalgia who use tobacco products are at greater risk for cognitive impairment and other symptoms that affect quality of life, according to the results of a study from the Mayo Clinic in Rochester, MI.
A minimal opiate supply, just a two-day course compared to a traditional two-week prescription, along with a scheduled-dose multimodal pain regimen after surgery limits the use of opiate medication by patients and, subsequently, opiate-related adverse effects while still providing effective pain control and high patient satisfaction.
A higher polygenic risk score—a genetic analysis computed from a combination of several of a person’s genes—is associated with more frequent and severe headaches. The findings support the idea that a propensity for headaches has a genetic basis.
Patients with centralized pain (fibromyalgia-like phenotype) are less likely to respond to a type of facet joint pain treatment called radiofrequency ablation (RFA), according to the results of a study from researchers at the University of Michigan in Ann Arbor, MI.