Journal of Clinical Anesthesia and Pain Management

Case Report Pages 129-130

The Value of Digital Subtraction Angiography in Interlaminar Cervical Epidural Steroid Injections

Authors: Anand Prem, MD, Suwarna Anand, MD and Arvind Chandrashekar, MD

Abstract: Neck and upper extremity radicular pain is a common indication for ambulatory clinic visits for Chronic pain. By the time a patient presents to a Pain specialist, they have often exhausted all conservative treatment modalities including rest, heat, Nonsteroidal anti-inflammatory drugs, muscle relaxants and Physical therapy. These patients have often failed a trial of opioids as well and deemed not a candidate for surgery by a Spine surgeon.

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Research Article Pages 178-185

A Consecutive Cohort with COVID-19 in Wuhan, China: Natural History, Clinical Features and Considerations

Authors: Bin Sun, MD, Hao Wang, MD, Hui-Xia Xu and Gui-Jun Zhang, MD

Abstract: A novel type of coronavirus pneumonia was first reported in Wuhan in December 2019. Clinical features and prognosis of elder patients were still unclear, therefore, this study was on a purpose to provide a better understand of this disease.

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Case Report Pages 173-177

Treatment of Post-Stroke Shoulder Pain of Multi-Factorial Etiology

Authors: Stephen Hannaford, Varun Channagiri, Mina Gaballa, James Guider, Robert Wayne, Timothy Calvert, Carolyn Kloepping and Andrew G Kaufman

Abstract: Chronic pain after stroke is a common, yet often overlooked sequela of cerebrovascular injury. Among the syndromes seen in post-stroke pain (PSP) are central post-stroke pain (CPSP) and complex regional pain syndrome (CRPS). Shoulder pain develops in a large subset of patients with residual upper-extremity weakness.

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Review Article Pages 165-172

Impact of Academic Detailing on Opioid Prescribing at the Veterans Health Administration

Authors: Mark Bounthavong, PharmD, PhD, Michael A Harvey, PharmD, BCPS, Daina L Wells, PharmD, MBA, BCPP, BCPS, Julianne E Himstreet, PharmD, BCPS, Marcos K Lau, PharmD, MS, BCPS, Chad L Kay, PharmD, BCPS, Sarah J Popish, PharmD, BCPP, Andrea G Grana JD, MPH, Blake A Freeman, MPH, MBA, Christina Morillo, BPA, Sophia Mullins-Cunningham, AA and Melissa LD Christopher, PharmD

Abstract: In 2014, the United States Veterans Health Administration (VHA) Pharmacy Benefits Management Academic Detailing Service (ADS) began national implementation of academic detailing (AD), a one-on-one educational outreach program delivered by specially trained clinical pharmacy specialists to address mental health disorders and pain management. Consequently, ADS adopted the mission of the VHA Opioid Safety Initiative (OSI) to align providers' opioid prescribing with evidence-based practice.

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Review Article Pages 156-164

Intravenous Iron to Treat Anemia becomes an Essential Service to Conserve Blood during the COVID-19 Pandemic

Authors: Obianuju Okocha, MD, Betty M Luan-Erfe, MD, Jack M Peace, MD and Bobbie Jean Sweitzer, MD, FACP

Abstract: With the outbreak of Coronavirus Disease 2019 (COVID-19), blood drives have been cancelled, resulting in significantly fewer donations. However, blood components are still being used to treat patients with acute and chronic hemorrhage, trauma, cancer, hematologic disorders and even COVID-19 with disseminated intravascular coagulation. Consequently, national and local blood supplies will dwindle and may become critically limited. The clinician's stewardship in anemia management and blood use has become ever more important during this pandemic.

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Review Article Pages 150-155

Obstructive Sleep Apnea Syndrome as an Important Risk Factor in Severe Covid-19 Disease

Authors: Calixto Machado, Phillip A DeFina, Yanín Machado, Mauricio Chinchilla, Elena Cuspineda and Yazmina Machado

Abstract: OSAS has been considered by some authors an important risk factor for severe Covid-19. Risk factors for mortality in COVID-19, such as cardiovascular and cerebrovascular complications or comorbidities, for example hypertension, heart failure, coronary artery disease, cerebrovascular diseases, diabetes mellitus, and obesity are commonly seen in OSAS patients. SARS-CoV-2 uses the ACE2 receptor for host cell entry, and augmented expression of ACE and dysregulation of the renin-angiotensin system in untreated OSAS patients, due to chronic intermittent hypoxia, has been shown.

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Retrospective Study Pages 143-149

Relationship among Preoperative, Pre and Postinduction Blood Pressure in Normotensive and Hypertensive Patients

Authors: Ricardo Caio Gracco De Bernardis, Helena Knebel Vieira De Souza, Jesse Abimael Infante Izquierdo, Mônica Maria Siaulys, Mauro Prado Da Silva, Marcel Veronez Vitoreli, Pedro Ferretti Pinheiro, Silvio Julio Bittencourt Yamamura and Ligia Andrade Da Silva Telles Mathias

Abstract: This study aimed to verify the relationship between blood pressure (BP) obtained during preoperative evaluation at preinduction and compared to BP at 20 min after induction for normotensive and hypertensive patients.

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Pilot Study Pages 136-142

Value of Rotation Thrombelastometry in Cardiac Surgical Patients with Normal Bleeding Risk-A Pilot Study

Authors: Stefan P Wirtz, MD, Florian R Fritzsche, MD, PHD, MPH, Christoph Schmidt, MD, PHD, Benno von Bormann, MD, PHD, Gehard Brodner, MD, PHD and Elmar Berendes, MD, PHD

Abstract: The ROTEM^® Whole Blood Haemostasis Analyser has been introduced for point-of-care monitoring using computerized rotation thrombelastometry, an enhancement of thrombelastography^®. This study aimed to investigate the clinical relevance of the ROTEM^® device in patients undergoing routine cardiac surgery.

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Editorial Pages 134-135

The Use of Cocaine and Derivatives and the Cancellation of Surgery

Authors: Luiz Eduardo Imbelloni, MD, PhD, André Augusto de Araujo, MD, Jaime Weslei Sakamoto, MD, and Eduardo Piccinini Viana, MD

Abstract: Cocaine or benzoylmethylecgonine is a central nervous stimulant and an anesthetic; it is extracted from the leaves of the Erthroxylon coca plant. This salt is freely soluble in water, which allows it to be injected, but its lipid solubility also enables it to be absorbed through the nasal mucosa

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Case Report Pages 131-133

Case Report: The Combined Spinal and Caudal (CSC) Anesthetic-Is this the New Ideal Anesthetic in a Formerly Preterm, High-Risk Infant with Chronic Lung Disease Undergoing Infraumbilical Surgery?

Authors: Kelly Tseng, MD and Chang Amber Liu, MD, MSc, FAAP

Abstract: Postoperative apnea is a well-recognized clinical entity commonly occurring in formerly preterm, high-risk infants. Spinal anesthesia has been demonstrated to be an attractive alternative to general anesthesia as it is associated with reduction of early risk of postoperative apnea in infants, hence it has become a valuable anesthetic technique in infraumbilical and lower extremity procedures, including inguinal herniorrhaphy.

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Research Article Pages 123-128

Reduced Opioid Use and Reduced Time in the Postanesthesia Care Unit Following Preoperative Administration of Sublingual Sufentanil in an Ambulatory Surgery Setting

Authors: Christian D Tvetenstrand, MD and Michael E Wolff, MD

Abstract: As the number of surgeries performed in an outpatient setting continues to rise, it is important to continually optimize perioperative pain management to enhance patient outcomes and optimize efficiency of the postanesthesia care unit (PACU). While intravenous (IV) fentanyl is commonly used to provide pain relief both intra- and postoperatively, IV bolus dosing can have negative hemodynamic effects during surgery and induce nausea and vomiting in the PACU.

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Case Report Pages 114-122

Anaesthetic Considerations for Patients with a Vagal Nerve Stimulator

Authors: Grellan Tuohy, Albi Jose Chalissery, Ciara Jean Murphy and Orsolya Solymos

Abstract: Vagal nerve stimulation is a neurosurgical treatment modality approved for the management of drug-resistant epilepsy. With its increased utilisation, anaesthesiologists will more frequently encounter patients with an indwelling vagal nerve stimulator (VNS), both in the elective and in the emergency surgical settings.

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Journal of Clinical Anesthesia and Pain Management

Table of Content: Volume 4, Issue 2

Authors: Anand Prem, MD, Suwarna Anand, MD and Arvind Chandrashekar, MD

Authors: Bin Sun, MD, Hao Wang, MD, Hui-Xia Xu and Gui-Jun Zhang, MD

Authors: Stephen Hannaford, Varun Channagiri, Mina Gaballa, James Guider, Robert Wayne, Timothy Calvert, Carolyn Kloepping and Andrew G Kaufman

Authors: Obianuju Okocha, MD, Betty M Luan-Erfe, MD, Jack M Peace, MD and Bobbie Jean Sweitzer, MD, FACP

Authors: Calixto Machado, Phillip A DeFina, Yanín Machado, Mauricio Chinchilla, Elena Cuspineda and Yazmina Machado

Authors: Ricardo Caio Gracco De Bernardis, Helena Knebel Vieira De Souza, Jesse Abimael Infante Izquierdo, Mônica Maria Siaulys, Mauro Prado Da Silva, Marcel Veronez Vitoreli, Pedro Ferretti Pinheiro, Silvio Julio Bittencourt Yamamura and Ligia Andrade Da Silva Telles Mathias

Authors: Stefan P Wirtz, MD, Florian R Fritzsche, MD, PHD, MPH, Christoph Schmidt, MD, PHD, Benno von Bormann, MD, PHD, Gehard Brodner, MD, PHD and Elmar Berendes, MD, PHD

Authors: Luiz Eduardo Imbelloni, MD, PhD, André Augusto de Araujo, MD, Jaime Weslei Sakamoto, MD, and Eduardo Piccinini Viana, MD

Authors: Kelly Tseng, MD and Chang Amber Liu, MD, MSc, FAAP

Authors: Christian D Tvetenstrand, MD and Michael E Wolff, MD

Authors: Grellan Tuohy, Albi Jose Chalissery, Ciara Jean Murphy and Orsolya Solymos