Best practices for interventional pain procedures in the setting of a local anesthetic shortage: A practice advisory from the Spine Intervention Society

Nagpal, Ameet S.; Zhao, Zirong; Miller, David C.; McCormick, Zachary L; Duszynski, Belinda; Benrud, Jacob; Chow, Robert M.; Travnicek, Katherine; Schuster, Nathaniel M.

doi:10.1016/j.inpm.2023.100177

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The high incidence of vascular injection and the rare but significant risk of adverse events have raised concerns regarding the safety of cervical procedures. 27 There was no report of vascular injection following ultrasound-guided injection. 2,21,22,28 Most studies on vascular injection report no evidence of entering the blood vessels based solely on the absence of aspiration or flask back.…”

Section: ) Comparative Advantage Of Ultrasound Guided Root Block To C...mentioning

confidence: 99%

Ultrasound-Guided Selective Cervical Root Block in Spondylotic Radiculopathy: Advantages and Safety

Lee

2023

Clinical Pain

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This review journal focuses on using ultrasound-guided root block in spondylotic radiculopathy, exploring its therapeutic potential, safety advantages, and validation challenges. C-arm guided transforaminal epidural steroid injection (C-TFESI) has constantly shown effective treatment outcomes for spondylotic radiculopathy. However, C-TFESI has been associated with rare significant adverse events, including cervical cord and brain infarction. Advancements in musculoskeletal ultrasonography have sparked efforts to apply this technique in spondylotic radiculopathy treatment. The distinct advantages of ultrasound, particularly in soft tissue discrimination and vascular visualization, have positioned it as a valuable tool in minimizing the risk of significant complications like spinal cord and brain infarction following cervical spinal injection procedures. Numerous studies have reported the potential and efficacy of ultrasound-guided cervical root block, establishing it as a safe and effective therapeutic approach. However, further validation is warranted to address the limitations and gaps in the current knowledge, particularly regarding the risk of vascular injection.

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Section: ) Comparative Advantage Of Ultrasound Guided Root Block To C...mentioning

confidence: 99%

Ultrasound-Guided Selective Cervical Root Block in Spondylotic Radiculopathy: Advantages and Safety

Lee

2023

Clinical Pain

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“…However, pain relief by systemic administration of analgesic drugs may lead to severe adverse effects on the central nervous system, gastrointestinal system, and other organs [3,4]. Thus, a safe medical procedure called interventional pain management is required to relieve the pain, in which, one or more pain management techniques such as tissue infiltration, nerve blocks, and neuraxial anesthesia are used with the aid of local anesthetic drugs [5]. Bupivacaine (BPV) is a commonly used long-acting local anesthetic drug used for perioperative pain management, which arrests nerve signal conduction by inhibiting sodium influx, which is essential for the generation and propagation of action potentials in nerve cells [6].…”

Section: Introductionmentioning

confidence: 99%

Depolymerized Chitosan-g-[Poly(MMA-co-HEMA-cl-EGDMA)] Based Nanogels for Controlled Local Release of Bupivacaine

Nagella,

Choi,

Park

et al. 2023

IJMS

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This study is designed to formulate and characterize chitosan-based nanogels that provide the controlled delivery of anesthetic drugs, such as bupivacaine (BPV), for effective postoperative pain management over prolonged periods of time. Drug carriers of chitosan/poly (MMA-co-HEMA-cl-EGDMA) (CsPMH) nanogels were prepared by varying the composition of comonomers such as MMA, HEMA, and redox initiator CAN. The nanogels were then characterized using FTIR, TGA, SEM, and TEM. The CsPMH nanogels showed greater encapsulation efficiencies from 43.20–91.77%. Computational studies were also conducted to evaluate the interaction between the drug and CsPMH nanoparticles. Finally, BPV-loaded nanoparticles were used to examine their in vitro release behavior. At pH 7.4, all the drug carriers displayed the “n” value around 0.7, thus the BPV release follows anomalous diffusion. Drug carrier 7 demonstrated a steady and sustained release of BPV for approximately 24 h and released about 91% of BPV, following the K-P mechanism of drug release. On the other hand, drug carrier 6 exhibited controlled release for approximately 12 h and released only 62% of BPV.

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An update on technical and safety practice patterns in transforaminal epidural steroid injections

Gureck,

Gebrekristos,

Turcu

et al. 2023

Interventional Pain Medicine

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Best practices for interventional pain procedures in the setting of a local anesthetic shortage: A practice advisory from the Spine Intervention Society

Cited by 3 publications

References 18 publications

Ultrasound-Guided Selective Cervical Root Block in Spondylotic Radiculopathy: Advantages and Safety

Ultrasound-Guided Selective Cervical Root Block in Spondylotic Radiculopathy: Advantages and Safety

Depolymerized Chitosan-g-[Poly(MMA-co-HEMA-cl-EGDMA)] Based Nanogels for Controlled Local Release of Bupivacaine

An update on technical and safety practice patterns in transforaminal epidural steroid injections

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