2025
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia.
Gonzalez Fiol A, Pawan F, Alian A. Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia. Journal Of Visualized Experiments 2025 PMID: 39960192, DOI: 10.3791/66901.Peer-Reviewed Original ResearchConceptsSpine anatomyNeuraxial anesthesiaEpidural spaceCases of difficult anatomyLumbar spine anatomyNeuraxial ultrasonographyPreprocedural ultrasonographyNeuraxial techniquesSpinal sonographyDifficult anatomyRegular practiceAbnormal anatomyPalpation techniqueTraumatic procedureRegional anesthesiaUltrasonographyNeedle puncturePatientsSuccess rateAnesthesiaUltrasound techniqueAnatomyPractical tipsPalpationSeries of videosChapter 27 Anesthetic considerations for patients with neurologic disorders in pregnancy
Rubin P, Leffert L. Chapter 27 Anesthetic considerations for patients with neurologic disorders in pregnancy. 2025, 289-295. DOI: 10.1016/b978-0-443-21707-4.00027-6.Peer-Reviewed Original ResearchNeuraxial anesthesiaNeurological disordersReports of adverse outcomesPregnant patientsLaboring patientsLabor floorNeuraxial proceduresCase reportAnesthetic alternativeAnesthetic considerationsAdverse outcomesEvidence-based literaturePatientsIncrease patient satisfactionPatient satisfactionPregnancyNeurological conditionsAnesthesiaDisordersFetusesPathophysiology
2024
The Impact of Race/Ethnicity on Disparities in Utilization and Outcomes of Neuraxial Anesthesia for Hip and Femoral Shaft Fractures
Qian D, Olumuyide E, Keswani A, Lin H, Ouyang Y, DeMaria S, Poeran J, Park C, Burnett G. The Impact of Race/Ethnicity on Disparities in Utilization and Outcomes of Neuraxial Anesthesia for Hip and Femoral Shaft Fractures. Journal Of Clinical Medicine 2024, 13: 3999. PMID: 39064039, PMCID: PMC11277043, DOI: 10.3390/jcm13143999.Peer-Reviewed Original ResearchAdministration of neuraxial anesthesiaFemoral shaft fracture patientsSevere adverse eventsNeuraxial anesthesiaLength of stayIsolated hipNeuraxial anesthesia useFemoral shaft fracturesGeneral anesthesiaFracture patientsLogistic regressionAnesthesia useAdverse eventsShaft fracturesProvision of neuraxial anesthesiaWhite patientsHispanic patientsAmerican College of Surgeons National Quality Improvement Program databaseQuality Improvement Program databaseAssociated with decreased length of stayAssociated with decreased lengthBenefits of neuraxial anesthesiaAssociation of race/ethnicityHip fracture surgeryEffects of neuraxial anesthesia
2022
Duration of Exposure to General Endotracheal Anesthesia During Cesarean Deliveries at Term and Perinatal Complications
Swanson K, Liang L, Grobman W, Higgins N, Roy A, Son M. Duration of Exposure to General Endotracheal Anesthesia During Cesarean Deliveries at Term and Perinatal Complications. Obstetrical & Gynecological Survey 2022, 77: 453-455. DOI: 10.1097/01.ogx.0000852896.18085.ad.Peer-Reviewed Original ResearchPharmacokinetics and Tolerability of Intraperitoneal Chloroprocaine After Fetal Extraction in Women Undergoing Cesarean Delivery
Togioka BM, Zarnegarnia Y, Bleyle LA, Koop D, Brookfield K, Yanez ND, Treggiari MM. Pharmacokinetics and Tolerability of Intraperitoneal Chloroprocaine After Fetal Extraction in Women Undergoing Cesarean Delivery. Anesthesia & Analgesia 2022, 135: 777-786. PMID: 35544759, DOI: 10.1213/ane.0000000000006064.Peer-Reviewed Original ResearchConceptsLocal anesthetic systemic toxicityPeak plasma concentrationCesarean deliveryPlasma concentrationsSystemic toxicityIntraperitoneal administrationFetal extractionMultiple-dose escalation studyPatient drug exposureMaternal blood samplesMaximum plasma concentrationRoute of administrationYears of ageClinical tolerabilityEscalation studySpinal anesthesiaUterine closureNeuraxial anesthesiaClinical symptomsDrug exposureClinical signsWomen 18Prospective assessmentBlood samplesPharmacokinetic profilePerioperative Management of Patients with Idiopathic Pulmonary Fibrosis Undergoing Noncardiac Surgery: A Narrative Review
Carr ZJ, Yan L, Chavez-Duarte J, Zafar J, Oprea A. Perioperative Management of Patients with Idiopathic Pulmonary Fibrosis Undergoing Noncardiac Surgery: A Narrative Review. International Journal Of General Medicine 2022, 15: 2087-2100. PMID: 35237071, PMCID: PMC8882471, DOI: 10.2147/ijgm.s266217.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsIdiopathic pulmonary fibrosisInterstitial lung diseaseIdiopathic interstitial pneumoniaIPF patientsNarrative reviewPerioperative managementHome oxygen useSafe perioperative carePostoperative pulmonary complicationsRetrospective cohort studyCardiopulmonary exercise testingOptimal perioperative managementPreoperative risk stratificationPulmonary function studiesWeb of ScienceAcute exacerbationARISCAT scorePostoperative pneumoniaPulmonary complicationsNoncardiac surgerySurgical populationCohort studyExercise testingInterstitial pneumoniaNeuraxial anesthesiaLow Molecular Weight Heparin, Unfractionated Heparin and Neuraxial Anaesthesia
Combs D, Leffert L. Low Molecular Weight Heparin, Unfractionated Heparin and Neuraxial Anaesthesia. 2022, 329-335. DOI: 10.1007/978-3-030-72487-0_49.Peer-Reviewed Original ResearchGeneral Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection
Serino J, Galivanche AR, Grauer JN, Haynes M, Karas V, Della Valle CJ. General Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection. The Journal Of Arthroplasty 2022, 37: s971-s976. PMID: 35017049, DOI: 10.1016/j.arth.2022.01.002.Peer-Reviewed Original ResearchConceptsPeriprosthetic joint infectionNeuraxial anesthesiaAdverse eventsGeneral anesthesiaRevision surgeryJoint infectionLower riskNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsSerious adverse eventsThirty-day outcomesImprovement Program databasePropensity-score matchingIntraspinal abscessProgram databaseRevision arthroplastyAmerican CollegeAnesthesiaMultivariate analysisProcedural variablesSurgeryPatientsInfection24 Skin and collagen disorders
Charchaflieh J. 24 Skin and collagen disorders. 2022, 497-532. DOI: 10.1016/b978-0-323-71860-8.00033-1.Peer-Reviewed Original ResearchNonsteroidal anti-inflammatory drugsMH crisisMalignant hyperthermiaPotential deleterious effectsSkin disordersAnesthetic interventionsMalignant hyperthermia crisisSkeletal disordersTreatment of MHDisorders of muscleAnti-inflammatory drugsEffect of comorbiditiesEffects of drugsSystemic physiological effectsOpioid analgesicsAirway patencyNeuraxial anesthesiaPerformance of neuraxial anesthesiaAutoimmune disordersAirway managementDrug interactionsDermatological disordersDecreased mortalityMuscular weakness
2021
Pragmatic Approach to Neuraxial Anesthesia in Obstetric Patients With Disorders of the Vertebral Column, Spinal Cord, and Neuromuscular System
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic Approach to Neuraxial Anesthesia in Obstetric Patients With Disorders of the Vertebral Column, Spinal Cord, and Neuromuscular System. Obstetric Anesthesia Digest 2021, 41: 164-165. DOI: 10.1097/01.aoa.0000796068.53863.3d.Peer-Reviewed Original ResearchSpecial Considerations – Indwelling Spinal Cord Stimulators and Intrathecal Pumps
Beals C, Chow R, Vadivelu N, Rajput K. Special Considerations – Indwelling Spinal Cord Stimulators and Intrathecal Pumps. 2021, 335-343. DOI: 10.1007/978-3-030-55262-6_25.ChaptersSpinal cord stimulatorContinuous opioid useChronic pain patientsPaucity of literatureIT clonidineCentral sensitizationMultimodal analgesiaSystemic medicationsOpioid toleranceOpioid usePerioperative managementPain patientsPain physiciansPump dysfunctionIntrathecal pumpNeuraxial anesthesiaAmbulatory surgeryLong actingRegional anesthesiaPatientsSurgeryUnique subsetNormal functionAnesthesiaStimulator
2020
Neuraxial and Peripheral Nerve Block Placement in Patients with Anatomical Anomalies
Thomas D, Antony S, Sum D, Asgerally A. Neuraxial and Peripheral Nerve Block Placement in Patients with Anatomical Anomalies. 2020, 359-371. DOI: 10.1007/978-3-030-55660-0_16.Peer-Reviewed Original ResearchPeripheral nerve blocksNerve blockAnatomical anomaliesAnatomical variationsCommon anatomical anomalyNerve block placementUse of sonographyNeuraxial analgesiaNerve stimulationNeuraxial anesthesiaSkeletal changesCadaver studySuccessful placementSuccess rateAnatomical landmarksPatientsPlacementBlock placementAnalgesiaAnesthesiaKyphosisSonographyScoliosisPragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system. Regional Anesthesia & Pain Medicine 2020, 46: 258-267. PMID: 33115718, DOI: 10.1136/rapm-2020-101792.Peer-Reviewed Original ResearchConceptsNeuraxial anesthesiaObstetric patientsSpinal cordCesarean delivery anesthesiaCesarean deliveryLabor analgesiaNeuraxial analgesiaVertebral columnCase seriesGeneral anesthesiaObstetrical patientsRetrospective studyDelivery anesthesiaPatient injuryAnesthesiaPatient harmPatientsNarrative reviewAvailable evidenceUnwarranted fearsNeuromuscular systemAdditional riskPresent unique challengesAnalgesiaCordNitrous oxide analgesia for external cephalic version: A randomized controlled trial
Straube LE, Fardelmann KL, Penwarden AA, Chen F, Harker E, Redmon BF, Li Q, Strauss R, Smith KA. Nitrous oxide analgesia for external cephalic version: A randomized controlled trial. Journal Of Clinical Anesthesia 2020, 68: 110073. PMID: 33017784, DOI: 10.1016/j.jclinane.2020.110073.Peer-Reviewed Original ResearchConceptsExternal cephalic versionNitrous oxide analgesiaCephalic versionNitrous oxide groupOxygen placeboBreech presentationPatient satisfactionDouble-blinded randomized placebo-controlled trialRandomized placebo-controlled trialAnesthesiology physical status IRoutine useIntra-procedural painMean pain scorePlacebo-controlled trialPhysical status IYears of ageMinimal side effectsNitrous oxide/50Analgesic benefitPain scoresSecondary outcomesSingleton pregnanciesStatus IPrimary outcomeNeuraxial anesthesiaLumbar Neuraxial Procedures in Thrombocytopenic Patients Across Populations: A Systematic Review and Meta-analysis
Bauer M, Toledano R, Houle T, Beilin Y, MacEachern M, McCabe M, Rector D, Cooper J, Gernsheimer T, Landau R, Leffert L. Lumbar Neuraxial Procedures in Thrombocytopenic Patients Across Populations: A Systematic Review and Meta-analysis. Obstetric Anesthesia Digest 2020, 40: 118-118. DOI: 10.1097/01.aoa.0000693644.32975.42.Peer-Reviewed Original ResearchNeuraxial anesthetic proceduresSpinal epidural hematomaEpidural hematomaThrombocytopenic patientsNeuraxial proceduresAnesthetic proceduresSystematic reviewThreshold platelet countCesarean deliveryFetal factorsNeuraxial anesthesiaGeneral anesthesiaPlatelet countSide effectsMeta-analysisHematomaPatientsAnesthesiaReviewPopulationUltrasound-Guided Neuraxial Anesthesia
Li J, Krishna R, Zhang Y, Lam D, Vadivelu N. Ultrasound-Guided Neuraxial Anesthesia. Current Pain And Headache Reports 2020, 24: 59. PMID: 32812182, DOI: 10.1007/s11916-020-00895-3.Peer-Reviewed Original ResearchConceptsNeuraxial anesthesiaHigher first-attempt success rateFirst-attempt success rateNon-obstetric patientsAcute pain managementAttempt success ratePurpose of ReviewTherePain managementRegional anesthesiaNeuraxial spacePatient safety implicationsVertebral levelAnesthesiaOverall efficacyRecent FindingsUltrasoundNeedle passPatient safetyCatheter visualizationUltrasound utilizationClinical accuracySuccess rateCommon typeClinical applicationUltrasoundPatientsPeriprocedural management of patients on oral anticoagulation: focus on regional anesthesia.
Li J, Oprea AD. Periprocedural management of patients on oral anticoagulation: focus on regional anesthesia. Polish Archives Of Internal Medicine 2020, 130: 1081-1092. PMID: 32491305, DOI: 10.20452/pamw.15416.Peer-Reviewed Original ResearchConceptsRegional anesthesia proceduresOral anticoagulantsAnesthesia proceduresPermanent neuronal damageBlood loss volumePeripheral nerve blocksOperating room proceduresNoncompressible areasOral anticoagulationPeriprocedural managementAnticoagulant medicationNeuronal damageNerve blockNeuraxial anesthesiaDeep plexusThrombotic riskCurrent guidelinesRegional anesthesiaLoss volumeRoom proceduresStandardized usePatientsAnesthesiaAnticoagulantsPatient anatomy
2019
Use of neuraxial anesthesia for hybrid lower extremity revascularization is associated with reduced perioperative morbidity
Fereydooni A, O'Meara T, Popescu WM, Dardik A, Ochoa Chaar CI. Use of neuraxial anesthesia for hybrid lower extremity revascularization is associated with reduced perioperative morbidity. Journal Of Vascular Surgery 2019, 71: 1296-1304.e7. PMID: 31708304, DOI: 10.1016/j.jvs.2019.07.072.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseLower extremity revascularizationPeripheral arterial diseaseObstructive pulmonary diseaseNeuraxial anesthesiaGeneral anesthesiaPulmonary diseaseVentilator requirementHospital stayPerioperative morbidityBaseline characteristicsExtremity revascularizationWound infectionFunctional statusSurgeons National Surgical Quality Improvement Program datasetNational Surgical Quality Improvement Program datasetComplex peripheral arterial diseaseUse of NADependent functional statusInvasive hybrid proceduresPrimary anesthetic techniqueSicker patient populationGroup of patientsNAA groupHybrid procedureThe Impact of Spinal Needle Selection on Postdural Puncture Headache: A Meta-Analysis and Metaregression of Randomized Studies
Zorrilla-Vaca A, Mathur V, Wu C, Grant M. The Impact of Spinal Needle Selection on Postdural Puncture Headache: A Meta-Analysis and Metaregression of Randomized Studies. Obstetric Anesthesia Digest 2019, 39: 82-82. DOI: 10.1097/01.aoa.0000557666.40775.e4.Peer-Reviewed Original ResearchDon’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia
Leffert L, Horlocker T, Landau R. Don’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia. International Journal Of Obstetric Anesthesia 2019, 39: 7-11. PMID: 31202587, DOI: 10.1016/j.ijoa.2019.05.001.Peer-Reviewed Original Research
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