Pediatric transport medicine and the dawn of the pediatric anesthesiology and critical care medicine subspecialty: an interview with pioneer Dr. Alvin Hackel
Summary Dr. Alvin ‘Al’ Hackel (1932‐) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology (‘who is a pediatric anesthesiologist?’) and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. His enduring impact on pediatric anesthesia and critical care practice was recognized in 2006 by the American Academy of Pediatrics when it bestowed upon him the profession's highest lifetime achievement award, the Robert M. Smith Award. Of his many contributions, Dr. Hackel identifies his early involvement in the development of pediatric transport medicine as well as the subspecialty of pediatric anesthesiology as his defining contribution. Based on a series of interviews held with Dr. Hackel between 2009 and 2014, this article reviews the early development of transportation medicine and the remarkable career of a pioneering pediatric anesthesiologist.
ConclusionAdministration of articaine as a supplemental intraseptal and BI following IANB can be considered a more successful anesthetic technique in mandibular molars with symptomatic irreversible pulpitis compared with the conventional IANB and supplemental BI.Clinical relevanceThe addition of an articaine intraseptal injection to IANB+BI technique may result in a significantly higher success rate of pulpal anesthesia in mandibular molars with symptomatic irreversible pulpitis.
Authors: Lespasio MJ, Guarino AJ Abstract Heterotopic ossification (HO) is the presence of normal bone in soft tissue where bone should not exist. After direct musculoskeletal trauma of the surrounding soft tissue, HO is hypothesized to develop from a dysfunction of normal lamellar bone formation and remodeling that appears in nonskeletal areas of the body. Acquired HO related to total joint arthroplasty (TJA) of the hip and knee forms outside the joint capsule and can be a challenging condition when it impairs the essential healing process after elective surgery. Although HO is rare after elective TJA and thus cli...
Authors: Zakir HM, Masuda Y, Kitagawa J Abstract Transient receptor potential vanilloid 1 (TRPV1) is a polymodal receptor channel, which plays an important role in pain transduction. It is important to understand the functional expression of this channel under neuropathic pain (NP) conditions. A novel method was used to investigate the dynamics of functional expression of this channel on regenerated neurons under NP conditions following trigeminal nerve injury using a combination of a permanently charged sodium channel blocker (QX-314) and a TRPV1 agonist (capsaicin; QX-CAP). The combination was originally introduc...
Local anesthesia (LA) administration provokes pain responses that can be the worst part of a patient ’s experience in interventional radiology (IR). This pain is often overlooked by IRs due to its temporary nature but is easily prevented. As the specialty of IR grows along with increasing case complexity, so does the chance for more pain and therefore the necessity to master techniques to minimiz e the pain of LA.
Uterine artery embolization (UAE) is effective in treating symptomatic uterine fibroids. Superior hypogastric nerve block (SHNB) using local anesthetic has been shown to decrease pain and narcotic pain medication use following UAE; however, its duration is limited to approximately 8-12 hours. Recent studies have demonstrated that the addition of steroid to nerve blocks used for other indications significantly prolonged the duration of analgesia (in one study, from 17.3 hours to 27.8 hours). The purpose of this retrospective study is to determine the safety of the addition of steroid to SHNB in patients undergoing UAE, and ...
ConclusionsPatients with high ASA score, low ALB level or age>70 years were at high risk of ERAS failure in pancreaticoduodenectomy. These preoperative demographic and clinical characteristics are important determinants to obtain successful postoperative recovery in ERAS program.
PMID: 32068583 [PubMed - in process]
PMID: 32068588 [PubMed - in process]
In patients with chronic musculoskeletal pain, an increase in opioid dosage appears to be of no clear benefit, according to a two-year study.Reuters Health Information
https://www.painmedicinenews.com/Online-First/Article/01-20/Successful-Management-of-High-Spinal-Anesthesia-Following-C2-C3-Facet-Joint-Injection/57168?sub=FB91EF6AF8C99D4BDA1617412032C789116450929F4665EAF77A779E586D57&enl=true&dgid=U080859650&utm_source=enl&utm_content=2&utm_campaign=2020217&utm_medium=title Why are people still going IA?