An Overview of Strategies to Reduce
ERRORS, DEFECTS, AND MISTAKE-PROOFING In manufacturing, the concept of quality includes the making of a product that performs as expected and has zero defects.1 This concept can be applied to…
ANESTHESIA
Complications Associated with Radiofrequency Treatment for Chronic Pain
FIGURE 32-1. Conventional RF lesion. A 10-cm RF cannula with a 5-mm active tip is immersed in egg white and a lesion is carried out at 80°C for 90 seconds….
Findings from the ASA Closed Claims Project
REGIONAL ANESTHESIA Neuraxial Blocks for Regional Anesthesia Claims A total of 443 claims associated with nonobstetric neuraxial (epidural/spinal blockade) anesthesia in the surgical setting were identified in the ASA Closed…
Complications Associated with Neurolytic Blocks
DEFINITION Neurolytic blocks involve the destruction of a nerve and are commonly performed in patients with severe pain secondary to advanced cancer or occlusive vascular disease, while their use in…
Complications Associated with Lysis of Epidural Adhesions and Epiduroscopy
THE TECHNIQUE OF EPIDURAL LYSIS OF ADHESIONS Our discussion is limited mostly to the procedure that involves accessing the epidural space via the sacral hiatus. This is similar to the…
Informed Consent and Documentation
THE DOCTRINE OF INFORMED CONSENT Definition of Informed Consent Informed consent is obtained when a patient intentionally agrees to treatment in the absence of external controlling influences, based on an…
Unintended Destinations of Local Anesthetics
DEFINITION Unintended neuraxial anesthesia is one of the most severe complications that can occur during performance of a peripheral or plexus block (Box 18-1). The interscalene approach to the brachial…
Adjuvant and Preservative Toxicity
DEFINITION The term toxicity, as it is considered in regional anesthesia and pain medicine, refers generally to the effects of substances that are injurious to tissues and/or the body. In…
Local Anesthetic Systemic Toxicity
DEFINITION OF THE PROBLEM Local anesthetic systemic toxicity (LAST) may result from unintended intravascular injection of what would have been an appropriate dose of LA (had it been injected in…
Neuraxis Ischemic Injury
DEFINITION Broadly speaking, the spinal cord is at risk of ischemic injury under any circumstances in which the supply of oxygen or nutrients is insufficient to meet metabolic demands. Thus,…
