RAEducation » BJA http://www.raeducation.com Regional Anesthesia Education...and Discussion Tue, 06 Apr 2010 12:21:26 +0000 http://wordpress.org/?v=2.9.2 en hourly 1 We give fluids in regional anesthesia? http://www.raeducation.com/2009/07/we-give-fluids-in-regional-anesthesia/ http://www.raeducation.com/2009/07/we-give-fluids-in-regional-anesthesia/#comments Mon, 13 Jul 2009 07:11:54 +0000 admin http://www.anest.ufl.edu/gator-rap/?p=860 Yet Another Related Posts Plugin.]]> Well, yes, we do care, especially as it pertains to epidurals (more on this later!). Here is a nice, quick BJA review on volume therapy. Seven misconceptions regarding volume therapy strategies–and their correction — Boldt 103 2: 147 — British Journal of Anaesthesia.

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]]> http://www.raeducation.com/2009/07/we-give-fluids-in-regional-anesthesia/feed/ 0 The Failing Spinal: Review from BJA http://www.raeducation.com/2009/05/the-failing-spinal-review-from-bja/ http://www.raeducation.com/2009/05/the-failing-spinal-review-from-bja/#comments Tue, 19 May 2009 17:05:27 +0000 admin https://www.anest.ufl.edu/gator-rap/?p=601 Yet Another Related Posts Plugin.]]> Failed spinal anaesthesia: mechanisms, management, and prevention

P. D. W. Fettes1,*, J.-R. Jansson2 and J. A. W. Wildsmith1

British Journal of Anaesthesia 2009 102(6):739-748; doi:10.1093/bja/aep096

Although spinal (subarachnoid or intrathecal) anaesthesia is generally regarded as one of the most reliable types of regional block methods, the possibility of failure has long been recognized. Dealing with a spinal anaesthetic which is in some way inadequate can be very difficult; so, the technique must be performed in a way which minimizes the risk of regional block. Thus, practitioners must be aware of all the possible mechanisms of failure so that, where possible, these mechanisms can be avoided. This review has considered the mechanisms in a sequential way: problems with lumbar puncture; errors in the preparation and injection of solutions; inadequate spreading of drugs through cerebrospinal fluid; failure of drug action on nervous tissue; and difficulties more related to patient management than the actual block. Techniques for minimizing the possibility of failure are discussed, all of them requiring, in essence, close attention to detail. Options for managing an inadequate block include repeating the injection, manipulation of the patient’s posture to encourage wider spread of the injected solution, supplementation with local anaesthetic infiltration by the surgeon, use of systemic sedation or analgesic drugs, and recourse to general anaesthesia. Follow-up procedures must include full documentation of what happened, the provision of an explanation to the patient and, if indicated by events, detailed investigation.

http://bja.oxfordjournals.org/cgi/content/full/102/6/739

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]]> http://www.raeducation.com/2009/05/the-failing-spinal-review-from-bja/feed/ 0 Acute compartment syndrome of the lower limb and the effect of postoperative analgesia on diagnosis http://www.raeducation.com/2009/04/acute-compartment-syndrome-of-the-lower-limb-and-the-effect-of-postoperative-analgesia-on-diagnosis/ http://www.raeducation.com/2009/04/acute-compartment-syndrome-of-the-lower-limb-and-the-effect-of-postoperative-analgesia-on-diagnosis/#comments Thu, 09 Apr 2009 13:00:39 +0000 admin https://www.anest.ufl.edu/gator-rap/?p=226 Yet Another Related Posts Plugin.]]> Wow. A phenomenal review of analgesia in orthopedic trauma for any acute pain medicine consultant. Not only a quick review of the pathophysiology, but great review of cases in the literature.

Acute compartment syndrome of the lower limb and the effect of postoperative analgesia on diagnosis — Mar et al. 102 (1): 3 — British Journal of Anaesthesia.

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]]> http://www.raeducation.com/2009/04/acute-compartment-syndrome-of-the-lower-limb-and-the-effect-of-postoperative-analgesia-on-diagnosis/feed/ 0 Intra-articular bupivacaine: potentially chrondotoxic? http://www.raeducation.com/2009/03/intra-articular-bupivacaine-potentially-chrondotoxic/ http://www.raeducation.com/2009/03/intra-articular-bupivacaine-potentially-chrondotoxic/#comments Sat, 14 Mar 2009 13:00:28 +0000 admin https://www.anest.ufl.edu/gator-rap/?p=353 Yet Another Related Posts Plugin.]]> A very nice editorial summarizing the state of the evidence for single-injection and continuous intra-articular infusions of local anesthetics. This has the potential to significantly change pain management strategies following joint surgery.

Intra-articular bupivacaine: potentially chrondotoxic?
S. T. Webb and S. Ghosh
British Journal of Anaesthesia 2009 102(4):439-441; doi:10.1093/bja/aep036

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]]> http://www.raeducation.com/2009/03/intra-articular-bupivacaine-potentially-chrondotoxic/feed/ 0 Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study http://www.raeducation.com/2008/12/determination-of-spread-of-injectate-after-ultrasound-guided-transversus-abdominis-plane-block-a-cadaveric-study/ http://www.raeducation.com/2008/12/determination-of-spread-of-injectate-after-ultrasound-guided-transversus-abdominis-plane-block-a-cadaveric-study/#comments Mon, 08 Dec 2008 17:50:24 +0000 admin https://www.anest.ufl.edu/gator-rap/?p=224
  • TAP Block Review by NYSORA A very nice review of the TAP block from NYSORA....
    • Related posts brought to you by Yet Another Related Posts Plugin.]]>     A very nice cadaveric study examining the spread of injectate following the TAP block. Includes some excellent diagrams of the TAP block anatomy and ultrasound imaging.

    Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study — Tran et al. 102 (1): 123 — British Journal of Anaesthesia.

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    1. TAP Block Review by NYSORA A very nice review of the TAP block from NYSORA....

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