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Published in N Engl J Med. 2014 Jul 3;371(1):11-21 Authors: Friedly JL1 et al BACKGROUND: Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis, a common cause of pain and disability in older adults. However, rigorous data are lacking regarding the effectiveness and safety of these injections. METHODS: In a double-blind, […]
Read MorePublished in Pain. 2014 Jun 28. pii: S0304-3959(14)00308-X. doi: 10.1016/j.pain.2014.06.019 Authors: Crosby ND et al Abstract Cervical facet joint injury induces persistent pain and central sensitization. Preventing the peripheral neuronal signals that initiate sensitization attenuates neuropathic pain. Yet, there is no clear relationship among facet joint afferent activity, development of central sensitization, and pain, which […]
Read MoreTalking to employees about performance problems, attendance issues or an upcoming layoff can be awkward and difficult. But there are steps you can take to make those types of conversations easier for you—and your employees. Leaders are often placed in situations that require difficult conversations. It’s quite common to put off these painful encounters because […]
Read MorePublished in Anesthesiology. 2014 Jul;121(1):52-8 Authors: Savilampi J et al BACKGROUND: Remifentanil is widely used for monitored anesthesia care in spontaneously breathing patients. However, the authors’ previous studies have shown that remifentanil induces subjective swallowing difficulties, which may increase the risk of aspiration. METHODS: Twenty-five healthy volunteers participated in a double-blind, randomized, crossover trial at […]
Read MorePublished in Anesth Analg. 2014 Jul;119(1):170-8 Authors: Sawynok J. et al Abstract Ketamine, in subanesthetic doses, produces systemic analgesia in chronic pain settings, an action largely attributed to block of N-methyl-D-aspartate receptors in the spinal cord and inhibition of central sensitization processes. N-methyl-D-aspartate receptors also are located peripherally on sensory afferent nerve endings, and this […]
Read MoreThe multifaceted problem of sharply rising opioid prescribing and related overdose deaths, which peaked in 2009, has been further analyzed by a research group in a recently published paper PM R 2014 Jan 9. The Stanford University team used 1997-2009 data from the large National Ambulatory and National Health Ambulatory Medical Care Surveys from the […]
Read MorePublished in Anesth Analg. 2014 Jul;119(1):137-40. Authors: Buck D et al Abstract An otherwise healthy 11-month-old, 8-kg infant presented for an elective circumcision. After a penile block with an excessive dose of 0.5% bupivacaine, the patient progressed to ventricular tachycardia. He was resuscitated with intralipid and had an uneventful recovery. The case was classified as […]
Read MoreLocal infiltration analgesia (LIA) provides effective analgesia early after total knee arthroplasty but has limited efficacy after total hip arthroplasty, according to results of a systematic review. “LIA should preferably be used in combination with evidence-based multimodal systemic analgesia,” Dr. Lasse O. Andersen from Bispebjerg Hospital in Copenhagen, Denmark told Reuters Health by email. “For […]
Read MoreBy implementing protocols that restrict the use of erythropoietin-stimulating agents (ESAs), hospitals can successfully cut costs while maintaining an equivalent level of patient care, according to two recent studies. At St. John Hospital and Medical Center in Detroit, a policy that delayed ESA administration to certain patients decreased ESA purchases by more than $16,000 per […]
Read MorePublished in Br J Anaesth. 2014;112(5):784-787. Authors: S. Kozek-Langenecker, D. Fries, D. R. Spahn, K. Zacharowski A recent systematic review, ‘Fibrinogen concentrate in bleeding patients’, published by The Cochrane Collaboration, aimed to assess the benefits and harms of fibrinogen concentrate compared with placebo or other treatments in bleeding patients. We agree with the authors finding […]
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