The USMLE is a significant predictor of residency ABA/ASA In-Training Examination and ABA written examination performance in anesthesiology. Our program has significantly increased its average written board examination performance while increasing the relative importance of USMLE in resident selection.

Initial attempts at surgical anesthesia began many centuries ago, with the plants of antiquity. The mandragora, or mandrake, was used as a sedative and to induce pain relief for surgical procedures. It has been depicted in tablets and friezes since the 16th century before the common era (BCE) and used for its sedative effects by Hannibal (second century BCE) against his enemies. The Romans used the mandrake for surgery. The Arabs translated the scientific work of the Ancients and expanded on their knowledge. They developed the Spongia Somnifera, which contained the juice of the mandrake plant. After the fall of the Islamic cities of Europe to the Christians, scientific work was translated into Latin and the Spongia Somnifera was used in Europe until the discovery of the use of ether for surgical anesthesia.

Summary An 18-year-old man with metastatic femoral osteosarcoma had inadequate pain control with gabapentin, naproxen, and intravenous fentanyl. A tunneled femoral nerve catheter was used to administer a continuous infusion of 0.2% ropivacaine and 4 μg/mL clonidine (10 mL/h) until his death 88 days later. During discharge from hospital, catheter disconnection resulted in severe pain and readmission. Tunneling, aseptic insertion technique, antibiotics, and sterile infusate prepared by pharmacy may have reduced the chance of infection. We propose that this is a suitable and effective technique in the long-term management of patients with terminal cancer and should be considered on a case-by-case basis.

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Stellate-ganglion block (SGB) is a commonly performed procedure for the treatment of numerous conditions, including upper-extremity complex regional pain syndromes and arterial insufficiency. The appropriate response to SGB includes ipsilateral Horner’s syndrome and temperature elevation of affected extremity. Contralateral and bilateral Horner’s syndrome following SGB are rarely seen, with only six prior cases reported. We describe a case of a 47-year-old female with right-hand pain secondary to Raynaud’s phenomenon who underwent SGB with subsequent contralateral Horner’s syndrome and review the literature of this rare phenomenon.

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