Regional analgesia and acute pain management

Cover......Page 1
 Authors......Page 2
 Economics and Practice Management Issues Associated With Acute Pain Management213......Page 5
 Unintentional Subdural Injection: A Complication of Neuraxial Anesthesia/Analgesia279......Page 6
 Index343......Page 7
 Foreword......Page 8
 Regional Analgesia and Acute Pain Management: Major Leaps in Small Steps?......Page 10
 New Concepts in Acute Pain Management: Strategies to Prevent Chronic Postsurgical Pain, Opioid-Induced Hyperalgesia, and Ou .........Page 12
 Abdominal surgery......Page 159
 Performance time......Page 13
 Quality......Page 14
 Patient safety......Page 15
 Limitations of the current RCTs......Page 17
 Infectious complications......Page 98
 Summary......Page 20
 References......Page 21
 Indications and selection criteria......Page 25
 Stimulating versus Nonstimulating Catheters......Page 26
 Needle in-plane, nerve in short-axis approach......Page 27
 Infusates......Page 28
 Infusion Pump Selection......Page 29
 Home Care......Page 30
 Inaccurate Catheter Placement......Page 31
 Vascular Puncture/Hematoma......Page 32
 Delayed Local Anesthetic Toxicity......Page 33
 Catheter Migration......Page 34
 References......Page 35
 Economics and practice management issues associated with acute pain management......Page 44
 Anesthesiologists’ impact on cost......Page 45
 Risk Factors......Page 146
 Overview of RA Cost Benefits......Page 46
 PACU bypass, reduced length of stay, same-day discharge......Page 47
 Standardization and safety of PACU bypass protocols......Page 48
 Logistics of delivery......Page 49
 Neuraxial blocks......Page 50
 Inpatient acute pain management......Page 51
 Postoperative Infections and Potential Beneficial Role of RA......Page 52
 Reduced blood transfusions......Page 53
 Societal Cost of Poor Pain Management......Page 54
 References......Page 55
 Mechanisms and Clinical Presentation......Page 65
 Prevention......Page 66
 Treatment......Page 67
 Adverse Effects of LE......Page 68
 Mechanisms underlying the development of CPSP......Page 143
 References......Page 70
 Physical examination......Page 74
 Electroneuromyography......Page 75
 The Action Potential......Page 76
 H-reflex......Page 77
 EMG......Page 78
 Insertional activity......Page 79
 Amplitude......Page 80
 Recruitment......Page 81
 Intraoperative nerve monitoring......Page 82
 Treatment......Page 85
 References......Page 86
 Incidence of neurologic complications......Page 88
 Breast and plastic reconstructive surgery......Page 160
 Nerve injury from plexus-peripheral needle and catheter placement......Page 91
 Local anesthetic toxicity......Page 93
 Transient Neurologic Symptoms......Page 94
 Neural ischemia......Page 95
 Hemorrhagic complications......Page 96
 Plexus and Peripheral Blockade in the Anticoagulated Patient......Page 97
 What does potent analgesic techniques mean......Page 150
 Regional block in patients with preexisting neurologic disorders......Page 101
 Multiple Sclerosis......Page 102
 Spinal Stenosis and Lumbar Root Disease......Page 103
 Regional anesthesia in anesthetized adults......Page 104
 References......Page 105
 Unintentional Subdural Injection: A Complication of Neuraxial Anesthesia/Analgesia......Page 110
 Clinical presentation......Page 111
 Diagnosis and treatment......Page 112
 Case discussion......Page 116
 Total Hip Arthroplasty......Page 162
 Case discussion......Page 117
 Case 3......Page 118
 Case discussion......Page 119
 References......Page 120
 Challenges in Acute Pain Management......Page 122
 Acute pain processing pathways......Page 123
 Opioid-Induced Hyperalgesia......Page 124
 Opioid Tolerance in Chronic Pain Patients......Page 125
 Substance Abuse and Addiction......Page 127
 Elderly and Cognitively Impaired Patients......Page 128
 Sleep Apnea......Page 129
 Neurologic Disease......Page 132
 Renal Disease......Page 133
 Hepatic Disease......Page 134
 Orthopedic surgery......Page 161
 References......Page 135
 What is the incidence of CPSP......Page 142
 Strategies for prevention......Page 147
 How to Improve the Treatment of Acute Postoperative Pain to Prevent CPSP......Page 148
 Protective anesthesia and analgesia......Page 149
 Antihyperalgesics, drugs acting on secondary hyperalgesia......Page 151
 References......Page 153
 Local Infiltration Analgesia......Page 158
 Total Knee Joint Replacement......Page 163
 Drugs Used......Page 164
 Infusion......Page 165
 References......Page 166