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Ketamine in perioperative analgesia for knee surgeries: Review of evidence from randomized controlled trials
Successful perioperative analgesia for knee surgeries results in improved patient satisfaction and promotes successful rehabilitation. However, effective perioperative pain control is commonly a challenging task for knee surgeries. Such surgical procedures as total knee replacement or knee arthroscopy may be accompanied by severe postoperative pain. As opioids and nonsteroidal anti-inflammatory drugs are commonly used, the side effects of these types of medicines are quite common as well, especially in patients with chronic pain, as they are commonly dissatisfied with regular analgesia. (Source: Techniques in Regional Anes...
Source: Techniques in Regional Anesthesia and Pain Management - November 19, 2015 Category: Anesthesiology Authors: Dmitri Souzdalnitski, Glenn R. Rech, Aleksandr Naydinskiy, Daria Suzdalnitskaya, Roman V. Isakov, Maged Guirguis Source Type: research

Interventional techniques for the management of digital ischemia due to Raynaud’s phenomenon
Digital ischemia secondary to Raynaud’s phenomenon (RP) presents a significant challenge to clinicians because its symptoms are progressive, painful, and often unresponsive to medical management or conservative measures. The associated symptoms (pallor, cyanosis, and pain) can profoundly affect quality of life and are associated with significant morbidity, including ulceration, infection, and gangrene. Given the limitations of medical management and conservative therapies, a number of interventional and surgical techniques may be considered for treatment of pain and ischemic symptoms: peripheral nerve blockade of the bra...
Source: Techniques in Regional Anesthesia and Pain Management - November 18, 2015 Category: Anesthesiology Authors: José R. Soberón, Nathan J. Harrison Source Type: research

Interventional techniques for the management of digital ischemia due to Raynaud ’s phenomenon
Digital ischemia secondary to Raynaud ’s phenomenon (RP) presents a significant challenge to clinicians because its symptoms are progressive, painful, and often unresponsive to medical management or conservative measures. The associated symptoms (pallor, cyanosis, and pain) can profoundly affect quality of life and are associated with significant morbidity, including ulceration, infection, and gangrene. Given the limitations of medical management and conservative therapies, a number of interventional and surgical techniques may be considered for treatment of pain and ischemic symptoms: peripheral nerve blockade of the br...
Source: Techniques in Regional Anesthesia and Pain Management - November 17, 2015 Category: Anesthesiology Authors: Jos é R. Soberón, Nathan J. Harrison Source Type: research

Interventional techniques for the management of digital ischemia due to Raynaud ’s phenomenon
Digital ischemia secondary to Raynaud ’s phenomenon (RP) presents a significant challenge to clinicians because its symptoms are progressive, painful, and often unresponsive to medical management or conservative measures. The associated symptoms (pallor, cyanosis, and pain) can profoundly affect quality of life and are associated with significant morbidity, including ulceration, infection, and gangrene. Given the limitations of medical management and conservative therapies, a number of interventional and surgical techniques may be considered for treatment of pain and ischemic symptoms: peripheral nerve blockade of the b...
Source: Techniques in Regional Anesthesia and Pain Management - November 17, 2015 Category: Anesthesiology Authors: Jos é R. Soberón, Nathan J. Harrison Source Type: research

Application of cooled radiofrequency ablation in management of chronic joint pain
Radiofrequency ablation (RFA) is a minimally invasive neurotomy technique that can provide sensory ablation in patients with chronic pain. Cooled RFA, however, can create larger lesions compared with traditional RFA. Size of lesions plays a more important role in neurotomy of articular nerves where neural anatomy is not as predictable. We review the literature present about cooled radiofrequency neurotomy of articular branches of joints in patients with chronic pain of sacroiliac, hip, or knee joints. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 17, 2015 Category: Anesthesiology Authors: Vafi Salmasi, Gassan Chaiban, Hazem Eissa, Reda Tolba, Lesley Lirette, Maged N. Guirguis Source Type: research

An ancient treatment for present-day surgery: Percutaneously freezing sensory nerves for treatment of postsurgical knee pain
The analgesic properties of cold therapy have been well known for many centuries. Cryoneurolysis of sensory peripheral nerves, in which the epineurium and perineurium resist freeze damage, allowing the structural scaffold to remain intact for normal axonal regeneration and remyelination to occur, has been used to treat pain for many decades. Chronic knee pain due to osteoarthritis is a common condition associated with significant disability among the elderly. Because no single treatment modality has been shown to be effective for treatment of knee pain secondary to osteoarthritis, treatment usually involves a combination o...
Source: Techniques in Regional Anesthesia and Pain Management - November 17, 2015 Category: Anesthesiology Authors: Vinod Dasa, Gabe Lensing, Miles Parsons, Ryan Bliss, Jessica Preciado, Maged Guirguis, Jason Mussell Source Type: research

Analgesia for the parturient with chronic nonmalignant pain
The prevalence of chronic pain, including but not limited to back, leg, and pelvic pain, is substantial during the peripartum period. Such pain may affect maternal and fetal outcomes. Therefore, obstetric anesthesiologists should be familiar with the analgesia provided to patients with chronic pain as well as any history of opioid dependence or substance abuse. We systematically searched PubMed and the Cochrane databases for all reports published on perioperative management of parturients with chronic pain. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 17, 2015 Category: Anesthesiology Authors: Dmitri Souzdalnitski, Denis Snegovskikh Source Type: research

Application of cooled radiofrequency ablation in management of chronic joint pain
Radiofrequency ablation (RFA) is a minimally invasive neurotomy technique that can provide sensory ablation in patients with chronic pain. Cooled RFA, however, can create larger lesions compared with traditional RFA. Size of lesions plays a more important role in neurotomy of articular nerves where neural anatomy is not as predictable. We review the literature present about cooled radiofrequency neurotomy of articular branches of joints in patients with chronic pain of sacroiliac, hip, or knee joints. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Vafi Salmasi, Gassan Chaiban, Hazem Eissa, Reda Tolba, Lesley Lirette, Maged N. Guirguis Source Type: research

An ancient treatment for present-day surgery: Percutaneously freezing sensory nerves for treatment of postsurgical knee pain
The analgesic properties of cold therapy have been well known for many centuries. Cryoneurolysis of sensory peripheral nerves, in which the epineurium and perineurium resist freeze damage, allowing the structural scaffold to remain intact for normal axonal regeneration and remyelination to occur, has been used to treat pain for many decades. Chronic knee pain due to osteoarthritis is a common condition associated with significant disability among the elderly. Because no single treatment modality has been shown to be effective for treatment of knee pain secondary to osteoarthritis, treatment usually involves a combination o...
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Vinod Dasa, Gabe Lensing, Miles Parsons, Ryan Bliss, Jessica Preciado, Maged Guirguis, Jason Mussell Source Type: research

Analgesia for the parturient with chronic nonmalignant pain
The prevalence of chronic pain, including but not limited to back, leg, and pelvic pain, is substantial during the peripartum period. Such pain may affect maternal and fetal outcomes. Therefore, obstetric anesthesiologists should be familiar with the analgesia provided to patients with chronic pain as well as any history of opioid dependence or substance abuse. We systematically searched PubMed and the Cochrane databases for all reports published on perioperative management of parturients with chronic pain. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Dmitri Souzdalnitski, Denis Snegovskikh Source Type: research

Drugs able to prevent chronic pain
Using drugs that follow anatomical pathways and act on receptors to treat acute pain and prevent its transformation into chronic pain is an appealing idea. The challenge consists of providing personalized treatment based on risk factors, pain and surgery type, and the type of rehabilitation program to minimize complications and optimize the pain treatment to prevent chronic pain. Clinical practice has started to understand the pathophysiological mechanisms and various neurochemical receptors involved in the transformation of acute pain into chronic pain. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Grisell Vargas-Schaffer Source Type: research

Opioid-induced hyperalgesia: New insights into the chronicization of pain
The existence of opioid-induced hyperalgesia (OIH), ie, nociceptive sensitization, caused by exposure to opioids remains difficult to appraise in perioperative setting because objective assessment is rare, evidence mostly relying on subjective measures like pain scores and postoperative analgesics use. Basic diagnostic criteria of OIH are still needed. Experimental studies have highlighted the pronociceptive effects of intraoperative high doses of opioids in term of latent hypersensitivity and long-term vulnerability to pain. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Laurent Veevaete, Patricia Lavand׳homme Source Type: research

Ultrasound-guided quadratus lumborum and subcostal transversus abdominis plane blocks
Abdominal field blocks are commonly used for postoperative analgesia in major abdominal surgeries. The original transversus abdominis plane (TAP) block is limited in its dermatomal coverage to T10-L1. However, modifications made to the classic TAP block technique can enhance the spread of local anesthetic and provide more effective analgesia. In this article, we describe 2 of such modifications of the classic TAP block, namely quadratus lumborum and subcostal TAP blocks. (Source: Techniques in Regional Anesthesia and Pain Management)
Source: Techniques in Regional Anesthesia and Pain Management - November 16, 2015 Category: Anesthesiology Authors: Priya Agrawal, Ehab Farag Source Type: research