Spinal anesthesia: the Holy Grail?
Published in Local and regional anesthesia
Managing anesthesia for cesarean section in obese patients: current perspectives.
Published in Local and regional anesthesia
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to a...
Ophthalmic regional blocks: management, challenges, and solutions.
Published in Local and regional anesthesia
In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The i...
Blockade of the mental nerve for lower lip surgery as a safe alternative to general anesthesia in two very old patients....
Published in Local and regional anesthesia
A mental nerve block is an easy-to-perform regional anesthetic technique for lower lip surgery. This technique might be especially advantageous in the very old, frail patient.
Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesar...
Published in Local and regional anesthesia
Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal syste...
Simulation in teaching regional anesthesia: current perspectives.
Published in Local and regional anesthesia
The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed....
Neuraxial and peripheral nerve blocks in patients taking anticoagulant or thromboprophylactic drugs: challenges and solu...
Published in Local and regional anesthesia
Incidence of hemorrhagic complications from neuraxial blockade is unknown, but classically cited as 1 in 150,000 epidurals and 1 in 220,000 spinals. However, recent literature and epidemiologic data suggest that for certain patient populations the frequency is higher (1 in 3,000). Due to safety concerns of bleeding risk, guidelines and recommendati...
Pain relief after transversus abdominis plane block for abdominal surgery in children: a service evaluation.
Published in Local and regional anesthesia
We carried out a prospective service evaluation of the quality of pain control after preoperative transverse abdominis plane (TAP) block in 100 children undergoing abdominal surgery. Data were collected on type of procedure, age, weight, level of the block, local anesthetic used, additional analgesia, and hourly pain scores. Of the 100 patients, 87...
Separation of stimulating catheters for continuous peripheral regional anesthesia during their removal - two case report...
Published in Local and regional anesthesia
Catheter separation and problems with residual metal wire components of stimulating catheters seem to be a rare but specific problem during removal. Anesthesiologists should strictly avoid catheter shearing during insertion, adhere to the manufacturer's instructions, and take care during catheter removal. Manufacturers should focus on technical sol...
Regional anesthesia for the trauma patient: improving patient outcomes.
Published in Local and regional anesthesia
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory im...
