A5011322273- Anesthesia and Pain Management
- Spine and Intervertebral Disc Pathology
- Cardiac, Anesthesia and Surgical Outcomes
- Nausea and vomiting management
- Shoulder Injury and Treatment
- Pain Mechanisms and Treatments
- Patient Safety and Medication Errors
- Risk and Safety Analysis
- Hip and Femur Fractures
- Dental Anxiety and Anesthesia Techniques
- Emergency and Acute Care Studies
- Pain Management and Treatment
- Venous Thromboembolism Diagnosis and Management
- Total Knee Arthroplasty Outcomes
- Occupational Health and Safety Research
- Hernia repair and management
- Pain Management and Opioid Use
- Image and Object Detection Techniques
- Neuroendocrine regulation and behavior
- Ultrasound in Clinical Applications
- Anesthesia and Sedative Agents
- Musculoskeletal pain and rehabilitation
- Hospital Admissions and Outcomes
- Spinal Dysraphism and Malformations
- Maternal Mental Health During Pregnancy and Postpartum
Wake Forest University
2014-2024
Atrium Health Wake Forest Baptist
2014-2023
Pain Management Institute
2022
University of North Carolina at Greensboro
2021
University of Puerto Rico at Carolina
2020
Greensboro College
2020
Unicondylar knee arthroplasty (UKA) is a commonly performed procedure with significant expected postoperative pain. Peripheral nerve blocks are 1 analgesic option, but some approaches may decrease quadriceps motor strength and interfere early ambulation. In this study, we compared the analgesia provided by an adductor canal block (ACB) psoas compartment (PCB) after UKA. We hypothesized that ACB would provide equivalent analgesia, defined as difference of <2 points on pain scale (0-10 numeric...
The term "Wrong-Site Surgery (WSS)" is commonly associated with surgical procedures; however, Joint Commission (TJC) considers any invasive procedure, not just a performed on the wrong side, at site, or patient to be WSS. For anesthesia providers, this means that wrong-site nerve block (WSNB) also constitutes WSS and would considered sentinel event by TJC. In an attempt combat WSNB, American Society of Regional Anesthesia Pain Medicine published guidelines in 2014 recommending use...
Prior studies have demonstrated that patients presenting for elective surgery may higher-than-expected residual anti-Xa level activity at or beyond 24 hours following their last treatment dose of enoxaparin. Given abstinence is currently recommended by both European and American societies before the performance neuraxial deep anesthetic/analgesic procedures, determining actual timeframe which reliably falls below 0.2 IU/mL, lower limit target range thromboprophylaxis, critical.
Currently, the American Society of Regional Anesthesia and Pain Medicine (ASRA) anticoagulation guidelines recommend that before performance a neuraxial procedure minimum 24 hours should elapse following treatment dose enoxaparin (1 mg/kg twice daily or 1.5 once daily). The have since their inception also consistently recommended against routine use anti-Xa level monitoring for patients receiving enoxaparin. However, we noted in our clinical practice levels were frequently still elevated...
Axillary pain is common after arthroscopic shoulder surgery with an open subpectoral biceps tenodesis. We hypothesized that adding a pectoral nerve block II (Pecs II) to interscalene (ISB) would improve postoperative analgesia in this surgical population.Forty patients were enrolled prospective, randomized, observer and patient-blinded, single-institution trial. All 40 received single-injection ISB 20 mL of 0.25% bupivacaine 1:400,000 epinephrine 1:600,000 clonidine. The intervention arm...
Background Open inguinal herniorrhaphy (OIH) is a commonly performed surgical procedure with expected postoperative pain. Historically, an option for regional analgesia has been ilioinguinal and iliohypogastric nerve block (IINB). More recently, the transmuscular quadratus lumborum (QLB) used as analgesic technique variety of abdominal truncal procedures. Given our own institutional experiences performance QLB combined body literature supporting proximal blockade nerves via this approach, we...
Abstract ( CRPS ) describes a constellation of symptoms including pain, trophic changes, hyperesthesia, allodynia, and dysregulation local blood flow often following trauma. It is confined to the extremities. Treatment this disorder consists variety modalities systemic pharmacotherapy, anesthetic injections or infusions, psychological nonpharmacotherapy, physical rehabilitation, surgical intervention. Chronic pain not related can also be treated with similar interventions. Despite array...
Recovery from surgery is quicker in the postpartum period, and this may reflect oxytocin action spinal cord. We hypothesized that intrathecal injection of would speed recovery pain disability after major surgery. Ninety-eight individuals undergoing elective total hip arthroplasty were randomized to receive either (100 μg) or saline. Participants completed diaries assessing opioid use daily weekly, they wore an accelerometer beginning 2 weeks before until 8 after. Groups compared using...
Abstract Background Loss of resistance (LOR) for epidural catheter placement has been utilized almost a century. LOR is subjective endpoint associated with high failure rate. Nerve stimulation (NS) described as an objective method confirming catheter. We hypothesized that the addition NS to would improve success placement. Methods One-hundred patients were randomized thoracic analgesia (TEA) utilizing LOR-alone or loss plus nerve (LOR + NS). The primary was rate success, defined sensation...
Although there are many potentially effective therapeutic options for complex regional pain syndrome (CRPS), no definitive treatment exists. Therefore, patients often exhaust both medical and surgical attempting to find relief their symptoms. As control restoration of physical movement primary goals, strategies that include anesthesia techniques commonly employed, but underutilized, modalities. The authors present a patient with refractory CRPS had significant improvement in the ability...
OBJECTIVE To examine the association between organizational safety climate (OSC), in-hospital mortality (IM), and failure to rescue (FTR) in 2 hospitals, 1 with without crew-resource-management training. BACKGROUND OSC is of most important factors that promotes at work; however, there a lack research examining relationship patient deaths hospitals. METHODS We utilized matched 2-group comparison surgical patients surveyed staff assess OSC, FTR, IM. RESULTS The assessment was completed by 261...
Abstract Failure to rescue (FTR) occurs when a clinician is unable save hospitalized patient's life they experience complication that was not present on admission. Research suggests focus patient safety, including implementing airline‐industry‐based‐crew‐resource management (CRM) training, can improve outcomes, however, the effects of CRM FTR are unknown. This study examined and 30‐day in‐hospital mortality (IM) outcomes in two hospitals determine if differences existed treatment hospital...
Pectoral nerve blocks (PECBs) provide analgesia after breast surgery.[1–3][1] Plasma concentration levels of bupivacaine (PCLBs) following fascial plane injections can exceed the threshold for local anesthetic systemic toxicity (LAST, mean venous level 2.1 µg/mL), as described