Faculty Opinions recommendation of Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition).

Author(s):  
Charles Marc Samama
2016 ◽  
Vol 41 (2) ◽  
pp. 181-194 ◽  
Author(s):  
Joseph M. Neal ◽  
Richard Brull ◽  
Jean-Louis Horn ◽  
Spencer S. Liu ◽  
Colin J. L. McCartney ◽  
...  

2017 ◽  
Vol 132 (1) ◽  
pp. 46-52 ◽  
Author(s):  
S Morris ◽  
E Hassin ◽  
M Borschmann

AbstractObjective:The safety of day-case tonsillectomy is widely documented in the literature; however, there are no evidence-based guidelines recommending patient characteristics that are incompatible with day-case tonsillectomy. This study aimed to identify which patients should be considered unsafe for day-case tonsillectomy based on the likelihood of needing critical intervention.Method:Retrospective review of 2863 tonsillectomy procedures performed at University Hospital Geelong from 1998 to 2014.Results:Of the patients, 7.81 per cent suffered a post-tonsillectomy complication and 4.15 per cent required intervention. The most serious complications, haemorrhage requiring a return to the operating theatre and airway compromise, occurred in 0.56 per cent and 0.11 per cent of patients respectively. The following patient characteristics were significantly associated with poorer outcomes: age of two years or less (p < 0.01), tonsillectomy indicated for neoplasm (p < 0.01) and quinsy (p < 0.05).Conclusion:The authors believe that all elective tonsillectomy patients should be considered for day-case surgery, with the following criteria necessitating overnight observation: age of two years or less; an indication for tonsillectomy of neoplasm or quinsy; and an American Society of Anesthesia score of more than 2.


2016 ◽  
Vol 124 (3) ◽  
pp. 535-552 ◽  

Abstract The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine present an updated report of the Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. Supplemental Digital Content is available in the text.


2021 ◽  
pp. rapm-2020-102002
Author(s):  
David Anthony Provenzano ◽  
Samuel Ambrose Florentino ◽  
Jason S Kilgore ◽  
Jose De Andres ◽  
B Todd Sitzman ◽  
...  

IntroductionInterventional pain procedures have increased in complexity, often requiring longer radiation exposure times and subsequently higher doses. The practicing physician requires an in-depth knowledge and evidence-based knowledge of radiation safety to limit the health risks to themselves, patients and healthcare staff. The objective of this study was to examine current radiation safety practices and knowledge among interventional pain physicians and compare them to evidence-based recommendations.Materials and methodsA 49-question survey was developed based on an extensive review of national and international guidelines on radiation safety. The survey was web-based and distributed through the following professional organizations: Association of Pain Program Directors, American Academy of Pain Medicine, American Society of Regional Anesthesia and Pain Medicine, European Society of Regional Anesthesia and Pain Therapy, International Neuromodulation Society, and North American Neuromodulation Society. Responses to radiation safety practices and knowledge questions were evaluated and compared with evidence-based recommendations. An exploratory data analysis examined associations with radiation safety training/education, geographical location, practice type, self-perceived understanding, and fellowship experience.ResultsOf 708 responding physicians, 93% reported concern over the health effects of radiation, while only 63% had ever received radiation safety training/education. Overall, ≥80% physician compliance with evidence-based radiation safety practice recommendations was demonstrated for only 2/15 survey questions. Physician knowledge of radiation safety principles was low, with 0/10 survey questions having correct response rates ≥80%.ConclusionWe have identified deficiencies in the implementation of evidence-based practices and knowledge gaps in radiation safety. Further education and training are warranted for both fellowship training and postgraduate medical practice. The substantial gaps identified should be addressed to better protect physicians, staff and patients from unnecessary exposure to ionizing radiation during interventional pain procedures.


2021 ◽  
pp. 471-477
Author(s):  
Noah Samuels ◽  
Eran Ben-Arye

Pain is a common and often debilitating symptom in both oncology and non-cancer settings, with conventional medical treatments often limited by adverse effects. Integrative medicine provides non-conventional therapies in a conventional setting, offering an additional option for the treatment of symptoms, including pain. Clinical research supports modalities such as acupuncture, touch therapies, and mind–body medicine (yoga, meditation, music therapy, hypnosis, etc.) in the treatment of pain, most significantly when provided as an ‘add-on’ to conventional palliative and supportive care. The Society for Integrative Oncology’s evidence-based guidelines on the use of integrative medicine in patients with breast cancer include the treatment of pain and exacerbating factors such as anxiety and stress. These guidelines have been endorsed by the American Society for Clinical Oncology and are in keeping with those recommended by the National Comprehensive Cancer Network. This chapter examines the effectiveness of integrative medicine in the treatment of pain in both oncology and non-cancer settings. An open and effective collaboration is needed among integrative physicians, who understand both paradigms of care, and palliative care professionals. Ways in which this collaboration can be advanced and future directions for research in the treatment of pain in palliative care are discussed.


Author(s):  
Issam A. Mardini ◽  
Jiabin Liu ◽  
Nabil Elkassabany

Regional anesthesia and analgesia provide attractive options for patients undergoing major orthopedic procedures. The use of anticoagulation medications in the elderly patient population and in patients with cardiovascular risks is very common. The guidelines from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and other societies have been adopted widely over many years. The guidelines provide a basis for adequate delay intervals between dosing of medications and performing neuraxial or peripheral nerve blocks (PNBs), thus allowing for safer practice of regional anesthesia. Following guidelines never eliminates risk, but it allows balanced clinical practice by physicians in regard to the risks and benefits for individual patients.


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