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AnesthesiaExam Podcast

David Rosenblum, MD, creator of AnesthesiaExam.com and ABAstagedExam.com discusses anesthesiology board prep and issues relevant to anesthesiologists.
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Now displaying: Category: Anesthesiology
Apr 7, 2020

 Due to the COVID-19 crisis, there have been unanticipated gaps in Pain Management Fellowships.
"when your fellowship is only a year long, every day counts..."
On the latest PainExam Newscast, Dr Rosenblum discusses the Virtual Pain Fellowship, releasing Premium Lectures for current fellows and asks for content donations from academia and industry to help maintain pain fellowship education.

Virtual Pain Fellowship

Mar 31, 2020

Who should do intubations? Who should Quarantine? Liability in epidural steroid injections?

NYSIPP- COVID 19 Webinar

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Mar 24, 2020

Early lessons learned during the NYC COVID-19 Outbreak

COVID-19 NYC Lessons from the Early Days

Mar 18, 2020

Dr. Rosenblum discusses an  interesting case, COVID-19 preparation for the home and the New PainExam Website!

Extracorporeal Shock Wave Therapy for Pain

 

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References

https://www.medica.com/-/media/documents/provider/coverage-policies/extracorporeal-shock-wave-therapy-cp.pdf?la=en&hash=F4A5C09D69F55931215C75119F4DB4AB7CE59956

https://bjsm.bmj.com/content/43/3/163.1.citation-tools

Mar 3, 2020

Ganglion impar ultrasound guided injection

 

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References

Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27(3):324–328

Feb 26, 2020

Ultrasound Course April 26, 2020, NYC

References

Kukreja P, MacBeth L, Sturdivant A, et al
Anterior quadratus lumborum block analgesia for total hip arthroplasty: a randomized, controlled study

 

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Feb 13, 2020

Dr. Rosenblum discusses the New PainExam and Ultrasound Course, Coronavirus, Interscalenes for Brachial Plexus Blocks and more!
See you at the April 26, 2020 EPA Ultrsound Course in NYC!

Ultrasound Pain Course NYC - April 26, 2020

Feb 5, 2020

Bryan Marascalchi, MD

Dr. Rosenblum interviews Bryan Marascalchi, MD on his company PainScored

  • Patient self reporting
  • Quality of Care
  • Improved Reimbursement

NYC Ultrasound CourseTo Pre-Register, Email DRosenblum@RMCPain.com

Jan 13, 2020

Exosomes in Pain ManagmentDr. Rosenblum discusses Exosomes:

  • Definition
  • Function
  • Studies 
  • Sotential of exosomes in the treatment of pain
  • FDA warnings

 

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References

https://www.sciencedirect.com/science/article/pii/S0304395914002085

https://www.ncbi.nlm.nih.gov/pubmed/30188455

https://sciencebasedmedicine.org/fda-warns-public-about-exosome-treatments/   

 

Dec 26, 2019

Dr. Rosenblum reviews the 2020 changes to coding or procedures such as Dry Needling, Genicular Nerve Blocks and Sacroiliac Joint Nerve Blocks and Ablation.

UPCOMING ULTRASOUND COURSE

GENICULAR NERVE BLOCK AND MORE!

CLICK HERE FOR MORE INFO

 

Interventional Pain Management Ultrasound Course

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Dec 3, 2019

Dr. Josephson discusses the IPG and programming at the NY/NJ State Pain Symposium

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Nov 26, 2019

Steve Falowski, MD

Dr. Falowski discusses Neuromodulation.

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Nov 19, 2019

Ashley Wong, MD

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Nov 11, 2019

An Interview with Chris Gharibo, MD

Discussed:

The Ideal Pain Fellow

The Future of Pain Management

How long should a Pain Fellowship be?

An Interview with Chris Gharibo, MD

 

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Nov 5, 2019

Tarsal Tunnel Pain

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 www.painexam/ultrasound

References

Peripheral Nerve Neurosurgery. Edited by Thomas Wilson, Lynda J-S Yang pt. 91-95

Oct 16, 2019

Management of a Patient with Complex Pelvic Pain Patient with malignancy and post operative Pain associated with maternal DES exposure- The Ganglion Impar Block

Ganglion Impar Block 

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References
Oct 8, 2019

The sphenopalatine ganglion block

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References

Sep 27, 2019

PRP Leukocyte Rich PRP vs. Pure PRP

 

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Sep 10, 2019

Trigger Finger- Pathophysiology, Dx and Treatment

 

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Aug 13, 2019

The PECS Block and Serratus Anterior Plane Block

Reference

https://www.nysora.com/regional-anesthesia-for-specific-surgical-procedures/thorax/pectoralis-serratus-plane-blocks/ 

 
 Thomas M, Philip FA, Mathew AP, Jagathnath Krishna KM. Intraoperative pectoral nerve block (Pec) for breast cancer surgery: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2018;34(3):318–323. doi:10.4103/joacp.JOACP_191_17 
 
Moon EJ, Kim SB, Chung JY, Song JY, Yi JW. Pectoral nerve block (Pecs block) with sedation for breast conserving surgery without general anesthesia. Ann Surg Treat Res. 2017;93(3):166–169. doi:10.4174/astr.2017.93.3.166
Aug 1, 2019

Lasers in Pain ManagmementNew PainExam Podcast
"Do LASERs Treat Pain?"

imp

Also Check out:
1. 2019 NANS SUMMER SERIES
September 7, 2019
Icahn School of Medicine, Mount Sinai
and
2. The Eastern Pain Association
on October 5, 2019 at NYU Langone Health

Jul 23, 2019

Take 2 and Pass...

Take 2 Month CME Membership to

and Pass the Pain Boards,

really,

what did you think we meant?

Medical Marijuana

Alexander Weingarten MD, James Arul MD, Grace Forde MD and Fabienne Saint-Preux MD- Slug it out, as they argue the Pros and Cons of Medical Marijuana at the New York State Pain Society's Annual Spring Meeting

 

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Jul 9, 2019

A 57 year old male with neck pain, jaw pain and a pain in the throat...

Glossopharyngeal Neuralgia

 

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References

https://en.wikipedia.org/wiki/Eagle_syndrome
https://www.google.com/search?
https://en.wikipedia.org/wiki/Glossopharyngeal_nerverlz=1C1NHXL_en&q=glossopharyngeal+nerve+block+in+eagle&tbm=isch&source=univ&sa=X&ved=2ahUKEwjCyMPI1qfjAhXTLs0KHewnBAoQ7Al6BAgJEA8&biw=1280&bih=650&dpr=1.25#imgrc=4XqCSWTBHywZ3M:
https://onlinelibrary.wiley.com/doi/abs/10.1111/papr.12497--
 
Jun 27, 2019

Minimally invasive spinal surgery

An Intense Debate between Merritt Kinon, MD, Adam Nasser, MD, Rohit Verma, MD and Kenny Susanto, MD at the NY State Pain Society Annual Meeting 2019

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Jun 18, 2019

Dr. Rosenblum reviews Prolotherapy, its uses and the evidence.  

AnesthesiaExam Podcast App For iPhone

and Android

Special Thanks to Editor, Baruch Kim, DO

of  BestDocz.com

 

Reference

https://en.wikipedia.org/wiki/Prolotherapy#Technique

Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

Ann Fam Med May/June 2013 vol. 11 no. 3 229-237

--

 

Jun 10, 2019

  Acupuncture

https://www.nypainsociety.org

AnesthesiaExam Podcast App For iPhone

and Android

Special Thanks to Editor, Baruch Kim, DO

of  BestDocz.com

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Jun 10, 2019

Cognitive Behavioral Therapy 

A lecture by Ron Lelito, PhD at the New York State Pain Society.

https://www.nypainsociety.org

AnesthesiaExam Podcast App For iPhone

and Android

Special Thanks to Editor, Baruch Kim, DO

of  BestDocz.com

 

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Jun 4, 2019

CBD

AnesthesiaExam Podcast App For iPhone

and Android

Special Thanks to Editor, Baruch Kim, DO

of  BestDocz.com

May 28, 2019

Larry Kobak, NY State Pain Society

 

Dr. Lawrence F. Kobak, DPM, Esq., is Senior Counsel in Frier Levitt’s Healthcare Department, working in the Uniondale, New York office. Prior to joining Frier Levitt, Larry was a partner at Kern, Augustine, PC, and at Abrams, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP where he was director of the firm’s Office of Professional Medical Conduct (OPMC) and Office of Professional Discipline (OPD) Defense.

 

Larry has extensive experience representing physicians in connection with licensure issues, as well as successfully defending physicians before Medical Boards, OPMC, OPD investigations, as well as Medicare Fraud, Fraud & Abuse, Hospital Actions, RAC Audits, Medicare Audits, OIG Fraud, Health Care Fraud, Medical Audits, and Health Plan Billing Audits.

As a licensed Podiatrist prior to becoming an attorney, he served as the international president of the Academy of Ambulatory Foot and Ankle Surgery. Larry is a fellow of the Academy of Ambulatory Foot and Ankle Surgery, Diplomate of the American Board of Podiatric Surgery, Ambulatory Division, Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, Diplomate of the American Academy of Pain Management, and Diplomate of the American Institute of Foot Medicine.

 

 516.222.2400

Special Thanks to Editor, Baruch Kim, DO

of BestDocz.com

May 21, 2019

Dr. Rosenblum and medical student Nicholas Bacher discuss the paucity of pain management education in medical school.

Nicholas Bacher

Nicholas is the Institutional Medical Student Liaison to the Eastern Pain Society.

May 7, 2019

An Interview with NYSIPP President and Pain Physician Ed Rubin, MD and the latest PainExam 5 Month Discounts!

Discussed on this Podcast:

-Surviving a DEA Audit
-Ketamine Infusions
-Building a Pain Practice 

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Apr 23, 2019

EPA Podcast Series:
Giving First!- An Interview with Baruch Kim, MD
-Networking
-Bestdocz
-Eastern Pain Association

Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others. 
 
Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU. 
 
Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety.
 
At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019. 

 

 

Baruch  
 

 

Apr 16, 2019

 

Doctor Yu, has 2 college degrees in Chemistry and Biological Sciences, spent 7 years in a research laboratory working in Nanotechnology, Automated technology, next level diagnostics research, and trained with experts in Cancer Immuno-therapy at the National Cancer Institute and National Institutes of Health in Bethesda, MD. He has received multiple awards in research, chapter-textbook writing, publications, and was featured in multiple newsletters and magazines. 

Doctor Yu graduated from medical school in Pennsylvania, completed a Medicine & Surgical internship in Camden, NJ, and Physical Medicine and Rehabilitation residency in New York City.  Currently, a Comprehensive and Interventional Pain Fellow at an Anesthesia and ACGME accredited fellowship at the Medical College of Wisconsin.

Doctor Yu serves as the Director at Large for Eastern Pain Association, Resident & Fellow Board Member at American Society of Interventional Pain Physicians, and trainee Mentorship at North American Neuromodulation Society.  He and a group of Expert Physicians from across the country started an Educational Podcast designed for the General Public called REGENMED101.com that discusses general medical conditions, illness, diseases and injury. 

Special Thanks to Editor Baruch Kim, MD

Website is found here:

https://regenmed101.com/podcasts/

 
Episodes are being updated. ♥ us on Spotify!. ♥Cervical Neck Whiplash♥Patellofemoral Knee Syndrome (PFKS)♥Fibromyalgia♥Achilles Injury/Rupture♥Thoracic Outlet Syndrome (Neurogenic, Venous, Arterial…
Apr 11, 2019

AnesthesiaExam.com Premium Podcast

Reference 

Sutherland TN, Lalwani K. Duchene's Muscular Dystrophy. Pediatric Anesthesia: A Problem Based Learning Approach.p. 323-327

Apr 9, 2019

Cocaine Spinal for Habitual Masturbation and More on the Latest  AnesthesiaExam Podcast!
Post Dural Puncture Headache- Diagnosis, Pathophysiology and Management

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Reference
D. K. Turnbull, D. B. Shepherd, Post‐dural puncture headache: pathogenesis, prevention and treatment, BJA: British Journal of Anaesthesia, Volume 91, Issue 5, November 2003, Pages 718–729, https://doi.org/10.1093/bja/aeg231
Apr 2, 2019

Dr. Rosenblum comments on his return to the OR and the latest RAPM Publication.  See References Below

Take advantage of our 20% discount on AnesthesiaExam.com

Enter EPASPRING19 at Checkout

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Tran DQ, Salinas FV, Benzon HT, et al
Lower extremity regional anesthesia: essentials of our current understanding
Mar 26, 2019

Dr. Rosenblum Reviews the Abdominal Cutaneous Nerve Entrapment Syndrome
- Also Eastern Pain Association Meeting April 13th in NY
- Enter EPASPRING19 for 20% OFF on AnesthesiaExam Membership until April 19th, 2019!

 

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Citation

Sheila Clarke, Saravanakumar Kanakarajan, Abdominal cutaneous nerve entrapment syndrome, Continuing Education in Anaesthesia Critical Care & Pain, Volume 15, Issue 2, April 2015, Pages 60–63, https://doi.org/10.1093/bjaceaccp/mku016
--

Mar 21, 2019

Premium Lecture Available with an AnethesiaExam.com Membership or Premium Podcast Membership

AnesthesiaExam.com

References

Hypertrophic Cardiomyopathy: A Review

Hensley, Nadia, MD; Dietrich, Jennifer, MD; Nyhan, Daniel, MD; Mitter, Nanhi, MD; Yee, May-Sann, MD; Brady, MaryBeth, MDAnesthesia & Analgesia: March 2015 - Volume 120 - Issue 3 - p 554–569

doi: 10.1213/ANE.0000000000000538
 
Cardiovascular Anesthesiology: Review Article
J Clin Diagn Res. 2013 Jun; 7(6): 1174–1176.
Published online 2013 Jun 1. doi: 10.7860/JCDR/2013/5390.3069
PMCID: PMC3708228
PMID: 23905133

Dilated Cardiomyopathy: An Anaesthetic Challenge

Mar 20, 2019

Dr. Rosenblum reviews Key Points in the 2019 ASIPP's Biologics in Pain   Medicine Guidelines

New PainExam Discount Valid until April 19th, 2019

Enter EPASPRING19 at Checkout on

AnesthesiaExam.com

and

PainExam.com

Eastern Pain Association

Don't Lose your Anesthesia Skills

Stay Up to Date with New Anesthesia Lectures at the AnesthesiaExam Podcast App

AnesthesiaExam2.1.3.jpg

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 References

Regenerative Medicine Guidelines


Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Pain physician 2019; 2019;22;S1-S74. Year Updated 2019

 

Annu Navani, MD, Laxmaiah Manchikanti, MD, Sheri L. Albers, DO, Richard E. Latchaw, MD, Jaya Sanapati, MD, Alan D. Kaye, MD, PhD, Sairam Atluri, MD,Sheldon Jordan, MD, Ashim Gupta, PhD, MBA, David Cedeno, PhD, Alejandro Vallejo, BS, Bert Fellows, MA, Nebojsa Nick Knezevic, MD, PhD, Miguel Pappolla, MD, Sudhir Diwan, MD, Andrea M. Trescot, MD, Amol Soin, MD, Adam M. Kaye, PharmD, FASCP, FCPhA, Steve M. Aydin, DO, Aaron K. Calodney, MD, Kenneth D. Candido, MD, Sanjay Bakshi, MD, Ramsin M. Benyamin, MD, Ricardo Vallejo, MD, PhD, Art Watanabe, MD, Douglas Beall, MD, Todd P. Stitik, MD, Patrick M. Foye, MD, Erik M. Helander, MBBS, and Joshua A. Hirsch, MD

Mar 12, 2019

New Lecture on DIC for Anesthesioloigists for the Boards and your Practice


 References

Disseminated Intravascular Coagulation: A Practical Approach
Mar 12, 2019

David Rosenblum, MD and Gary Schwartz, MD discuss:

  • Practice Management- missed phone calls
  • The Erector Spinae Plane Block
  • The Future of Pain Medicine
  • ER Admissions for Lumbar Radiculopathy
  • Cervical Ultrasound Injection
  • Dr. Schwartz's involvement and support of ASRA and much more!

New 20% Discount inspired by the  

Eastern Pain Association's 

Spring Meeting

Saturday April 13th, 116 E 55th St, NY, NY

Enter EPASPRING19 at Checkout on PainExam

Take Full Advantage of our CME AnesthesiaExam Membership

20 CME Credits

About 750 Hundred Questions

Lectures and Videos

Cheet Sheets and more!

 
Don't Lose your Anesthesia Skills

Stay Up to Date with New Anesthesia Lectures at the AnesthesiaExam Podcast App

AnesthesiaExam Podcast

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Mar 5, 2019

Join Dr. Rosenblum as he sits down with Sudhir Diwan to discuss:

-Regenerative Medicine
-Private Practice
-Sacroiliac Joint
-PRP
-and More!

Sudhir Diwan, MD

AnesthesiaExam Podcast App For iPhone

and Android

 

Now Available on Amazon!

 

 

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Feb 28, 2019

Dr. Rosenblum Discusses COPD, Pre-Operative, Intra-Operative and Post-Operative Mangement

References

Anaesthesia for patient with chronic obstructive pulmonary disease

Indian J Anaesth. 2015 Sep; 59(9): 574–583.
PMCID: PMC4613404
PMID: 26556916

Anaesthesia for patient with chronic obstructive pulmonary disease

 
Feb 26, 2019

Dr. Rosenblum interviews his brother, Patent Attorney, Jason Rosenblum.  Discussed in this episode:

  • Copyright vs. Trademark
  • Infringement and Penalties
  • Protecting your Inventions and Ideas
  • Steps to Patenting your Products

JHR Legal Jason Rosenblum

For a consultation with Jason Rosenblum, go to

jhr legal

JHRlegal.com

Law Office of Jason H. Rosenblum, PLLC
Offices in New York and South Carolina
 (888) 666 0062

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Feb 19, 2019

Dr. Rosenblum interview Jonathon Carlson, MD about his cutting edge work.  Discussed in this podcast

  • Burst DR
  • Latest research 
  • Impact on affect with Burst Stimulation
  • Physician Directed, Industry Independent Research
  • Opiate Utilization across the world

Jonathon Carlson, MD 

 

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Clarius Handheld ultrasound

Feb 14, 2019

 AnesthesiaExam.com

Listen on the website or via the AnesthesiaExam Podcast App For iPhone

and Android

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Feb 5, 2019

Join Dr. Rosenblum as he connects with his old colleague Jayen Patel, MD and discusses:

 

  • Multidisciplinary Private Pain Practice
  • Integrating Addiction Medicine
  • Bringing a gun to work
  • Regenerative Medicine 

And more! Jayen Patel, MD

 

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Jan 29, 2019

Dr. Rosenblum interviews Neurologist and Pain Physicians Dr. Mark Burish.

Discussed in this podcast

  • Occipital Nerve Stimulation
  • Vagal Nerve Stimulation
  • Supraorbital Nerve Stimulation

http://www.memorialhermann.org/doctors/neurologists/dr-mark-burish-md-647022/

Dr. Mark Burish MD

Neurologist

MEMORIAL HERMANN TEXAS MEDICAL CENTER

Clarius Handheld Ultrasound

 

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Jan 21, 2019

Dr. Rosenblum and Dr. Erik Shaw discusses peripheral nerve stimulation, research, psychology and more at NANS 2019 in Las Vegas.

  • T Codes for Ultrasound Injections
    Opiate Double Standards
  • Legislators ignorance of what Pain Physicians do
  • *ENTER NANS19 at checkout for 20% off PainExam.com*

 

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AnesthesiaExam Podcast App For iPhone

and Android

NANS

Clarius handheld ultrasound

Jan 15, 2019

Dr. Rosenblum reviews CMS documents relating to Telehealth.

To see the document, go to AnesthesiaExam 

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Jan 7, 2019

Dr. Rosenblum and Dr. Schwartz Discuss ASRA, NANS as well as depositions and handling the patient on high dose opiates.

Please Review our Podcast in iTunes and Share with your Colleagues 

iPhone and Android

NANS

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Jan 1, 2019

Journal Club. MILD vs. LESI in Lumbar Spinal Stenosis

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Dec 24, 2018

Dr. Rosenblum and Dr. Benett Discuss

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Dec 18, 2018

Dr. Rosenblum Reviews Discography and Discogenic Pain 

 clarius ultrasound

ultrasound tutorial- private

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AnesthesiaExam Podcast App For iPhone

and Android

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

References

An Update of the Systematic Appraisal of the
Accuracy and Utility of Discography in Chronic
Spinal Pain
Pain Physician 2018; 21:91-110
Laxmaiah Manchikanti, MD1, Amol Soin, MD2, Ramsin M. Benyamin, MD3, Vijay Singh, MD4,
Frank JE Falco, MD5, Aaron K. Calodney, MD6, Vahid Grami, MD, MPH7, and
Joshua A. Hirsch, MD8
 
 2009 ISSLS Prize Winner: Does Discography Cause Accelerated... : Spine

 

 

2009 ISSLS Prize Winner: Does DiscographyCause Accelerated Progression of Degeneration Changes in the Lumbar Disc: A Ten-Year Matched Cohort Study

Carragee, Eugene J., MD*; Don, Angus S., FRACS*; Hurwitz, Eric L., DC, PhD†; Cuellar, Jason M., MD, PhD‡; Carrino, John, MD§; Herzog, Richard, MD¶

doi: 10.1097/BRS.0b013e3181ab5432
Diagnostics
 
 

Lumbar Discography Is Associated With Poor Return to Work Status Following Lumbar Fusion... - Abstract - Europe PMC

Lumbar Discography Is Associated With Poor Return to Work Status Following Lumbar Fusion Surgery in a Workers' Compensation Setting.

Anderson JT 1 , et al 

Dec 14, 2018

AAA Repair- Endovascular and Open

 

 

   

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AnesthesiaExam Podcast App For iPhone

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Dec 11, 2018

Dilaudid for the Boards

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 Reference


https://en.wikipedia.org/wiki/Hydromorphone
Morphine and hydromorphone epidural analgesia. A prospective, randomized comparison. Chaplan SRDuncan SR Brodsky JB Brose WG  Anesthesiology
 
Dec 4, 2018

Narcissistic, Borderline, Sadistic?

Take your pick.

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You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

References

 

Clin Neurosci. 2012 Jan; 9(1): 10–14.
Published online 2012 Jan.
PMCID: PMC3280073
PMID: 22347686

Chronic Pain Syndromes and Borderline Personality

 
 

Pain

Volume 26, Issue 2, August 1986, Pages 181-197
Pain
Research report

Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria

 

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Nov 27, 2018

Dr. Rosenblum reviews the latest on neuropathic pain definition and treatment guidelines

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References
Aust Prescr. 2018 Jun; 41(3): 60–63.
Published online 2018 Jun 1. doi:  [10.18773/austprescr.2018.022]
PMCID: PMC6003018
PMID: 29921999

Neuropathic pain: current definition and review of drug treatment

Bridin P Murnion, Senior clinical lecturer1 and Senior staff specialist2

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Nov 7, 2018

Dr. Rosenblum describes a study in which the Combo-Tube is compared with the LMA, and the vitals after insertion are compared.

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Handheld ultrasound

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

References

http://eprints.hums.ac.ir/207/1/hmj-v20n6p345-en.pdf 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Nov 1, 2018

Pelvic Pain and the Pudendal Neuralgia and whether or not to give steroids

.Pudendal neuralgia

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Reference

 
 

Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

 
First published: 27 July 2016
 https://doi.org/10.1111/1471-0528.14222
Cited by: 10
Oct 23, 2018

Dr. Rosenblum discusses HIV and Pain 

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Oct 16, 2018

Ever been lied to about NPO, or "Emergent Surgeries?"

Dr. Rosenblum gets personal with and explains how to sift through the bullshit

Also, why Fidel Castro played an integral part in your Board Preparation and more!

 

Oct 3, 2018

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Dr. Rosenblum discusses the Quadratus Lumborum Block

  • Indications
  • Technique
  • Complications

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Clarius Ultrasound PainExam DiscountDISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Sep 27, 2018

Dr. Rosenblum comments on literature on line and from a major billing company regarding the ABN

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

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Sep 20, 2018

Dr. Rosenblum reviews a PainWeek Article

New Podcast- Adverse Drug Reactions in the Elderly
2019 PainExam.com Discount Enter 12MONPE

2019 AnesthesiaExam Discount Enter 12MONAE

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Jul 31, 2018

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

References

“A COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF CONVENTIONAL DISCECTOMY WITH PERCUTANEOUS ENDOSCOPIC DISCECTOMY” | Sethi | INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

 
 

“A COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF CONVENTIONAL DISCECTOMY WITH PERCUTANEOUS ENDOSCOPIC DISCECTOMY”

Dr Hardik Sethi, Dr Arvind Bhave, Dr. Sanjay Patil

Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation: a prospective case series | Neurosurgical Focus, Vol 40, No 2

Neurosurgical Focus

Feb 2016 / Vol. 40 / No. 2 / Page E3

 

Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation: a prospective case series

Unsuccessful Percutaneous Endoscopic Lumbar Discectomy | Neurosurgery | Oxford Academic
 

Unsuccessful Percutaneous Endoscopic Lumbar Discectomy: A Single-Center Experience of 10 228 Cases

Kyung-Chul Choi, MD, PhD
*
Department of Neurosurgery, The Leon Wiltse Memorial Hospital, Anyang, Korea
Search for other works by this author on:
Kyung-Chul Choi, MD, PhD
June-Ho Lee, MD, PhD
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
Search for other works by this author on:
June-Ho Lee, MD, PhD
Jin-Sung Kim, MD, PhD
§
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Korea
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Jin-Sung Kim, MD, PhD
Luigi Andrew Sabal, MD, DPBO
Department of Orthopeadics, Wooridul Spine Hospital, Seoul, Korea
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Luigi Andrew Sabal, MD, DPBO
Sol Lee, BS
Department of Clinical Research, Wooridul Spine Hospital, Seoul, Korea
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Sol Lee, BS
Ho Kim, BS
Department of Clinical Research, Wooridul Spine Hospital, Seoul, Korea
Search for other works by this author on:
Ho Kim, BS
Sang-Ho Lee, MD, PhD
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
Disclosure

This study was supported by a grant from the Wooridul Spine Foundation. The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

 
Search for other works by this author on:
Sang-Ho Lee, MD, PhD
Neurosurgery, Volume 76, Issue 4, 1 April 2015, Pages 372–381,
 
Pain Physician 2016; 19:E291-E300 • ISSN 2150-1149
 
Percutaneous Endoscopic Lumbar Discectomy as
an Alternative to Open Lumbar Microdiscectomy
for Large Lumbar Disc Herniation
Kyung-Chul Choi, MD, PhD1, Jin-Sung Kim, MD, PhD2, and Choon-Keun Park, MD, PhD3

 

 

--

Jul 24, 2018

Dr. Rosenblum reviews indications, mechanisms of action, side effects and regulatory issues regarding Buprenorphine.

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

References

A Controlled Trial of Buprenorphine Treatment for Opioid Dependence

JAMA. 1992;267(20):2750-2755. doi:10.1001/jama.1992.03480200058024

 

https://en.wikipedia.org/wiki/Buprenorphine

 

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Jul 17, 2018

Dr. Rosenblum review the lates ASRA Guidelines for Ketamine use in the treatment of chronic pain. 

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Reference

 https://journals.lww.com/rapm/Fulltext/2018/07000/Consensus_Guidelines_on_the_Use_of_Intravenous.11.aspx

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 
 Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jul 12, 2018

Dr. Rosenblum reviews Bertolotti Syndrome, ankylosing spondylitis and the Bamboo Spine.   Also discussed in this episode, Anderson lesions, lumaraization and sacralization.

Clarius Handheld Ultrasound

  

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References

https://radiopaedia.org/articles/bamboo-spine
https://radiopaedia.org/articles/andersson-lesion-1
https://en.wikipedia.org/wiki/Bertolotti%27s_syndrome
https://en.wikipedia.org/wiki/Congenital_vertebral_anomaly

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Jun 28, 2018

Dr. Rosenblum Discusses the Venous Air Embolism

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Reference

Diagnosis and Treatment of Vascular Air Embolism
Anesthesiology 1 2007, Vol.106, 164-177. 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jun 22, 2018

Purchase or lease a Clarius Ultrasound Probe and Get a 1 hour Consultation/Tutorial with Dr. Rosenblum

 

Dr. Rosenblum and Dr. Schwartz discuss managing the pregnant patient with acute radiculopathy.  Also discussed, fentanyl patch, cyclobenzaprine, trigger point and admitting a patient for lumbar radculitis.

 

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 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

 

 

Jun 12, 2018

This is a resyndication of a PainExam Podcast Episode on the syrinx   

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References

1  Khan, Sara MD; Pioro, Erik P. MD, PhDCervical Epidural Injection Complicated By Syrinx Formation: A Case Report Spine: June 1st, 2010 - Volume 35 - Issue 13 - p E614-E616

 2 Hirai, Takashi MD; Kato, Tsuyoshi MD, PhD; Kawabata, Shigenori MD, PhD; Enomoto, Mitsuhiro MD, PhD; Tomizawa, Shoji MD, PhD; Yoshii, Toshitaka MD, PhD; Sakaki, Kyohei MD; Shinomiya, Kenichi MD, PhD; Okawa, Atsushi MD,Adhesive Arachnoiditis With Extensive Syringomyelia and Giant Arachnoid Cyst After Spinal and Epidural Anesthesia: A Case ReportPh.Spine: February 1st, 2012 - Volume 37 - Issue 3 - p E195–E198

https://rarediseases.org/rare-diseases/syringomyelia/
3 Masaya Nakamura, M.D.,Kazuhiro Chiba, M.D.Takashi Nishizawa, M.D.,Hirofumi Maruiwa, M.Retrospective study of surgery-related outcomes in patients with syringomyelia associated with Chiari I malformation: clinical significance of changes in the size and localization of syrinx on pain relief.March 2004 / Vol. 100 / No. 3 / Pages 241-244

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jun 11, 2018

On this episode, Dr. Schwartz and Dr. Rosenblum discuss Pain Management in a patient with Buerger's Disease.  On the second half, Dr. Rosenblum finds a letter sent by an internist for validation.  The letter was a fake with his name at the end.  Check out the podcast as the drama unfolds...

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You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

 

Jun 4, 2018

Dr. Rosenblum and Dr. Schwartz discuss ethics, concerns, techniques and more when it comes to sedation for pain procedures.

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You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jun 4, 2018

Sugammadex for your practice and the boards!

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

May 23, 2018

Dr. Rosenblum describes a new procedure- The Cervical Facet Plane Block

Also included:

  • Ultrasound Guided Selective Nerve Root Block in the Cervical spine
  • Ultrasound Guided Medial Branch Nerve Root Block

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

May 10, 2018

This episode is inspired by the Physician Side Gig Group on Facebook.

Discussed in this episode- Starting a side business

- Autoresponder (Emailer)

- Successes/Failures (Educations)

- Legal Help- Copyright- JHRLegal.com

 and more!

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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May 3, 2018

New podcast on
Headache Management with a focus on Fiorcet, Triptans and Metoclopramide
-Enter ASRA18 at AnesthesiaExam for 20% off (until June 1, 2018)

 

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 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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May 1, 2018

A summary of commonly tested concepts in respiratory physiology

AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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Apr 24, 2018

20% off

  • PainExam
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Enter ASRA18 at checkout (Valid until June 1, 2018)

Now Available At Amazon.com

Welwyn Ardsley and the Cosmic Ninjas

Welwyn Ardsley and the Cosmic Ninjas- Preparing your Child and Yourself for Anesthesia and Surgery

Guidelines on Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

  • Aspirin use during spinal cord stimulator trial
  • Serotonin reuptake inhibitors and bleeding risk
  • Herbal and Dietary Supplements and bleeding risk

Reference 

https://www.asra.com/advisory-guidelines/article/10/interventional-spine-and-pain-procedures-in-patients-on-antiplatelet-and-anticoa

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 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


Apr 11, 2018

Dr. Rosenblum Discusses Anesthetic concerns in disease states such as:

Scleroderma

SLE

Dermatomyositis

Lyme's Disease

Temporaral Arteritis and more!

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Mar 29, 2018

Dr. Rosenblum summarizes Smith's Ansethesia for infants and children.  Peter J. Davis and Franklyn P. Cladis

AnesthesiaExam Podcast App For iPhone

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2018 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Mar 26, 2018

Dr. Rosenblum Summarizes a case report and review

Canadian Journal of Anesthesia

February 2004, 51:134 | Cite as

Pheochromocytoma and pregnancy: a case report and review of anesthetic management

  • Geoff Dugas
  • John Fuller
  • Sudha Singh
  • James Watson

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Mar 6, 2018

Dr. Rosenblum discusses the Assessment of pain.

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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Feb 27, 2018

Dr. Rosenblum discusses Post Total Knee Arthroplasty Pain.

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References

https://www.nysora.com/ultrasound-guided-saphenous-subsartoriusadductor-canal-nerve-block
 
http://www.indianjpain.org/article.asp?issn=0970-5333;year=2013;volume=27;issue=1;spage=36;epage=40;aulast=Harshe
 
http://www.painphysicianjournal.com/current/pdf?article=MjgwMg%3D%3D&journal=97
 
http://www.indianjpain.org/article.asp?issn=0970-5333;year=2013;volume=27;issue=1;spage=36;epage=40;aulast=Harshe

AnesthesiaExam Podcast App For iPhone

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

 

 

Feb 7, 2018

An overview of interventional management of headaches.

Discussed- occipital neuralgia, sphenopalatine ganglion block, cervical facet arthropathy and more.  For Video access,  obtain a CME membership at PainExam.com

AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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Feb 5, 2018

Dr. Rosenblum gives an opinion and description of his approach to  challenging case referred to his practice. 

Also, ASRA Review article on Radiofrequency of the Hip summarized. 

Radiofrequency Procedures to Relieve Chronic Hip Pain . An evidence-based narrative review.    Regional Anesthesia and Pain Medicine.  Volume 43 (1) january 2018 pp. 72-83 

Join Us in Costa Rica April 21-28

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jan 31, 2018

Audio from our recent video lecture.

EEG, SSEP, MEPs, EMGs, NCVs disused in this lecture, with a focus on applications in Pain Management.  Topics taken from the ABPM Pain Management outline

AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 


 

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Jan 29, 2018

Download the AnesthesiaExam Podcast App For iPhone

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Reet is the runs the anesthesiology services at Brooklyn Surgical Center.  He is an experienced Regional Anesthesiologist and has private practice as well as academic experience.  

Discussed in this podcast...

  • Dr. Rosenblum says the C word on audio..... Cancelitis- When to cancel a surgical case?
  • Presurgical Testing
  • Sedation for GI 
  • CMS- Change in Anesthesia units for colonoscopy  
  • Employment by Produralists 
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    DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

    You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

     

    Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

     

     

     

Jan 23, 2018

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David Rosenblum, MD gives a lecture on the physiology of pain.

For access to the video, subscribe to PainExam.com

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Jan 18, 2018

 

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Costa rica medical mission

 

     

Dr. Rosenblum summarizes a Regional Anesthesia and Pain Medicine Article

Chronic Poststernotomy Pain.  Incidenc, Risk Factors, Treatments, Prevention and the Anestheisologist's Role.  Kleiman AM, Sanders DT, Nemergut EC, , Huffmyer JL. Regional Anesthesia and Pain Medicine. Volume 42, number 6, November - December 2017 pp 698--708 

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Jan 10, 2018

An interview with Cedric Hodgman and Martina Kaser of UBELONG 

Discussion on the upcoming Costa Rican Medical Volunteer and Immersion Trip.

Costa Rica Medical Mission April 21

Dec 19, 2017

Designing, Reporting, and Interpreting Clinical Research Studies about Treatments for Pain: Evidence-Based Medicine

Critical analysis of literature and evidence-based medicine: basic concepts Principles of valid clinical research
Effects of analysis on the clinical applicability of study results
Components of clinical trials

Special features of study of pain
Other-General: Designing, reporting, and interpreting clinical research studies about treatment for pain

Animal Models of Pain and Ethics of Animal Experimentation
Common animal models in the study of pain
Ethics of animal experimentation
Other-General: Animal models of pain and ethics of animal experimentation Standards in Pain Management and Research

Ethics of pain management and research
Professionalism and quality assurance
Ethical standards of research design, review and implementation, informed consent, use of animals
Other-General: Ethical standards of pain management and research

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Oct 24, 2017

Dr. Rosenblum reviews, MIPS and MACRA and how they can impact your bottom line.

For Free Updates and Board Review Materials...

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Oct 4, 2017

An interview with CA-3 David Blumenkranz, DO 

AnesthesiaExam Board Review

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Sep 24, 2017

Regional Anesthesiology vs. Interventional Pain Management. Not sure what to pick?
Dr. Rosenblum and Resident Marc Dany, MD discuss the pros and cons of both subspecialties and poke fun at drug company marketing tactics.   

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

 

Sep 17, 2017

What to do in the setting of a nerve injury?  When to get and EMG?

Listen to the Podcast by Dr. Rosenblum

References

Click Here

Sep 12, 2017

Dr. Rosenblum Reviews the Below Article and describes the TAVR as well as anesthetic considerations

Reference

Transcatheter Aortic Valve Implantation: Anesthetic Considerations

Billings, Frederic T. IV MD*; Kodali, Susheel K. MD†; Shanewise, Jack S. MD*

Aug 29, 2017

Levorphanol and Compression Fracture Review

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Aug 7, 2017

Dr. Rosenblum summarizes an article that reviews controlled prospective trials of hypnosis for the treatment of chronic pain.

Reference

Gary Elkins,1 Mark P. Jensen, and David R. PattersonHypnotherapy for the Management of Chronic PainInt J Clin Exp Hypn. 2007 Jul; 55(3): 275–287.

 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Jul 28, 2017

A different type of podcast this week.  Dr. Rosenblum opens up about a troubling finding on an imaging in an apparently healthy patient and discusses the much talked about opiate epidemic.  

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Pain Exam doctor reviewing an MRI

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Jul 25, 2017
A Review of these commonly tested hematologic disorders
Semin Thromb Hemost. Von Willebrand Disease and Pregnancy: A Review of Evidence Review Article and Expert Opinion 2016; 42(07): 717-723
DOI: 10.1055/s-0036-1587686

Akari Yoshida1Yoshiki Kimoto1, Kanako Ejiri1,Yasuyuki Mitani2 and Tomoyuki Kawamata1

Anesthetic management of a patient with factor VII deficiency undergoing laparoscopic colectomy: a case reportJA Clinical Reports20162:30

 

Jul 21, 2017

Dr. Rosenblum reviews myasthenia gravis pathophysiology and discusses relevant anesthetic concerns.

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For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Jul 8, 2017

Dr. Rosenblum discuss 2 hot Pain Management Keywords for the ABA and ABPM Pain Management Exams:

Synovial Cyst- Diagnosis, Etiology, Treatment

Hypnosis- Definition and parts of the Brain effected

 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2017 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Pages 96-106 | Received 15 Aug 1985, Published online: 31 Jan 2008
 
 
 
https://en.wikipedia.org/wiki/Hypnosis
Jun 29, 2017

A discussion with Lou Ezrick, PT and patient who received Bone Marrow Aspirate for his knee pain.  Lou describes his pain, treatment, and response to stem cell derived from bone marrow aspirate.

Lou is currently 80% better and is very active.  He is currently working full time managing his physical therapy practice, Evolve Physical Therapy in Brooklyn.

Pain physicians interested in learning more about stem cells should contact Dr. Rosenblum via email DRosenblum@QBazaar.com

David Rosenblum, MD- Director of Pain Management, AABP Integrative Pain Care 

Patients interested in Stem Cell Therapy are encouraged to schedule an evaluation with David Rosenblum, MD at 

Brooklyn Office 6010 Bay Parkway. 6th floor (718) 436 7246

Great Neck Office  (516) 436 7246

DRosenblum@aabpcorp.com

 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This video is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

Copyright © 2017 David Rosenblum All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Jun 15, 2017

Dr. Rosenblum interviews Anthony about SEO for and internet marketing.  Anthony is currently helping Dr. Rosenblum spread the word about his interventional pain practice. Dr. Rosenblum has been having success with his regenerative medicine program and believes stem cells and PRP will be more and more utilized in the near future.  While insurance companies are not reimbursing these procedures, Dr. Rosenblum feels that they will eventually be come mainstream, as they have benefitted many of his patients and avoided the risks associated with NSAIDs, steroids and opiates. 

For more information on how to market your Anesthesia Groups practice, contact Anthony at:

 

Anthony Sarandrea
Marketing & Sales Strategist
888.684.2048 
anthony@siteflood.com siteflood.com 
 
Featured in: 
 
 
Connect with me:
Jun 1, 2017

 

 

Reference

 

 

 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

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Reference

https://en.wikipedia.org/wiki/Methemoglobinemia

May 30, 2017

David Rosenblum, MD reviews the syllabus for the ABA Pain Exam and is amazed to find that they are asking about animal models in pain medicine.

 

May 23, 2017

 

 

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

May 23, 2017

 

 

Interventional Pain WebinarDISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

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May 16, 2017

Dr. Rosenblum Reviews important Pain Topics that the ABA will ask

 

Anesthesiology Board Review

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May 10, 2017

Dr. Rosenblum reviews the CDC's recommendations for prescribing opiates

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

 

For more information, CME credit and Primary Board Prep,

For more information, CME credit and  Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

 

Subscribe to our mailing list

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Apr 30, 2017

I was recently connected to the founder of Clinic Marketers (www.ClinicMarketers.com), Anthony Sarandrea. 

After our first conversation, I was extremely impressed with their track record of growing pain practices in the healthcare space. I was also impressed how they are regularly quoted by Forbes and Inc. magazine regarding upcoming marketing trends in the healthcare industry: https://www.inc.com/ilya-pozin/9-branding-experts-to-look-out-for-in-2017.html

I was so impressed that I decided to hire them to perform an audit on our company’s marketing efforts.

They uncovered that we were wasting over 30% of our marketing dollars! 

I asked Anthony if he would be open to recording an interview to share his insights for other doctors to take advantage of. He agreed and you can find the full recording here:

https://soundcloud.com/clinic-marketers/painexam-podcast

Listen to the interview if you’re interested in learning how to trim the fat and scale your practice profitably.

He and his team offered to perform their deep dive analysis and audits that they charge $2500 for, FREE of charge for the first 7 of you who read this email and reach out to him at: anthony@clinicmarketers.com or fill out a form on www.ClinicMarketers.com

Enjoy!

 

-David

 

Apr 26, 2017

 

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AnesthesiaExam Podcast- Subscription Premium Episodes Now Available For Board Review and Practice Management Updates TEXT the word ANESTHESIAEXAM to the number 33444 For more information, CME credit and MOCA and Primary Board Prep, For more information, CME credit and MOCA and Primary Anesthesiology Board Prep, Go to AnesthesiaExam.com For Basic and Advanced Anesthesia Exam Review, Go to ABAStagedExams.com For CRNA Board Prep, go to CRNABoardPrep.com For the Pediatric Anesthesiology Board Review, Go to PedsAE.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.AnesthesiaExam Podcast- Subscription Premium Episodes Now Available For Board Review and Practice Management Updates TEXT the word ANESTHESIAEXAM to the number 33444 For more information, CME credit and MOCA and Primary Board Prep, For more information, CME credit and MOCA and Primary Anesthesiology Board Prep, Go to AnesthesiaExam.com For Basic and Advanced Anesthesia Exam Review, Go to ABAStagedExams.com For CRNA Board Prep, go to CRNABoardPrep.com For the Pediatric Anesthesiology Board Review, Go to PedsAE.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Mar 9, 2017

Dr. Rosenblum discusses a challenging case of cancer invasion into the chest, neck and pain related to lymphedema in a patient with metastatic breast cancer.

 

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Feb 23, 2017

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

References

http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Feb 7, 2017

This is a review for those who practice Anesthesia and may participate in resuscitation.  Information was valid as of february 2017, per ACLS.net

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Feb 7, 2017

Dr. Rosenblum, reviews the latest guidelines (as of 2017 for ACLS)

Discussed in this podcast are new revelations bout lidocaine, vasopressin, etc.

References

ACLS.net

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Jan 31, 2017

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

References

https://en.wikipedia.org/wiki/Breast_pain
BeLieu RM. Mastodynia. Obstetrics and Gynecology Clinics of North America [1994,21(3):461-477]

Raj, PP. Radiographic imaging for regional anesthesia and Pain Management. 2005. p302-311

Jan 31, 2017

 

Pain Unit

Breast Pain and Intrathecal Pump 

References

https://en.wikipedia.org/wiki/Breast_pain
BeLieu RM. Mastodynia. Obstetrics and Gynecology Clinics of North America [1994,21(3):461-477]

Raj, PP. Radiographic imaging for regional anesthesia and Pain Management. 2005. p302-311

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

Jan 24, 2017

A review of tarsal tunnel syndrome 

Free version does not contain patellofemoral syndrome

Reference

https://en.wikipedia.org/wiki/Tarsal_tunnel_syndrome

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Jan 24, 2017

Patellofemoral pain syndrome and tarsal tunnel syndrome

an in depth review 

 

 

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Nov 8, 2016

 

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

Aug 17, 2016

Lower Extremity nerve block review for the Anesthesia Boards

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Jul 5, 2016

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

References

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 100

 

Jun 23, 2016

 

Dr. Rosenblum discusses the evaluation and management of Cervical Spondylotic Myelopathy

Be sure to Check out our partner Boston Biolife

The next Hands on Boston Biolife Workshops is on July 16-17, and features:

-Stem Cell Therapies

-Biologics

Focusing on Regenerative Applications in Pain Medicine

Hands-On Overview:

  • Each participant will attend a variety of diverse educational workstations. 
  • Each station will be structured to a particular technology and offer a comprehensive review of the principles and their applications. 
  • In addition to the clinical workstations the attendee will participate in other informative, small group sessions that relate to practice management and professional development surrounding regenerative medicine.

CME Presentation Topics:

  • Clinical Applications & Research Landscape of Stem Cell Therapy
  • Cellular Anatomy of Regenerative Medicine
  • Fundamentals of Implementing Regenerative Medicine in your Pain Practice
  • Musculoskeletal (MSK) Regenerative Medicine Research & Historical Perspective
  • Adipose Derived Regenerative Medicine
  • Computerized Radiographic Measurement Analysis (CRMA)
  • Biochemistry of Alpha2 Macroglobulin (A2M)
  • Comprehensive Approach to Regeneration of Injured Skeletal Muscles via Delivery of Growth Factors & Progenitor Cells
  • 3D Targeting Analytics for BMAC Harvesting

Day 1 Agenda*

  • 7:00 - 8:00 am Registration/Breakfast
  • 8:00 - 1:00 pm CME Lecture Series
  • 2:30 - 6:30 pm CME Break-out Stations

Day 2 Agenda*

  • 7:00 - 8:00 am Registration/Breakfast
  • 8:00 - 11:45 am CME Lecture Series
  • 11:45 - 4:45 pm CME Break-out Stations

*Lunch & breaks are included on both days - Times / agenda subject to change
For all travel plans: Please plan on course completion at 4:45 on Day 2

Hands-On Stations: 

(Completed Over 2-Days) You will participate in 4 workstations on day 1 AND 4 workstations on day 2 (all workstations will remain the same on both days). There will be time during and after for questions and answers.

  • Platelet Rich Plasma (PRP)
    • Anatomy • Composition • Processing
  • Bone Marrow Acquisition Techniques with Cadaver
    • Anatomy • Composition • Harvesting Techniques
  • Stem Cell Basics
    • Biochemical Composition, Amniotic Fluid • Stem Cells 
    • Growth Factors & Cytokines
  • Lipo Aspiration Techniques with Cadaver
    • Clinical Techniques • Acquisition & Processing • Equipment
  • Flouroscopic Interventional Biologics for Pain Management with Cadaver
    • Joints • Discs • Fibrin & Other Biologics
  • Bone Marrow Aspiration Imaging Technologies
    • Imaging • Targeting • Bone Marrow Acquisitions
  • Live Patient MSK Joint Imaging & Anatomy Using Ultrasonography
    • Shoulders, Knees, Elbows, Ankles
  • Laboratory Fundamentals for Regenerative Medicine
    • Protocol Development • Sample Preparation • GMP

CME

  • 18 CME Credits Offered for this course (complies with ACCME standards)

 

For more information Call: 978 569-8080

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

References

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 1

May 31, 2016

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

References

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 54

May 24, 2016

AnesthesiaExam Podcast-  Subscription Premium Episodes Now Available

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

References

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 53

Does Regional anaesthesia improve outcome after total hip arthroplasty?  A systematic review

Br. J.anaesth. (2009)103 (3) 335-345

May 17, 2016

A Brief Review of Neuromuscular Blocking Agents

For the Premium Version, Subscribe here

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For Board Review and Practice Management Updates TEXT the word 

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Go to AnesthesiaExam.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Skeletal Muscle relaxants

Classification

  • Peripherally acting (Neuromuscular blockers)
    1. Pre synaptic neuromuscular blocker
      • Inhibit Ach synthesis: triethylacholine – hemicholinium
      • Inhibit Ach release: Mg, aminoglycosides, botulinum toxin
    2. Post synaptic neuromuscular blocker
      • Competitive (non depolarizing blockers):
        • d- tubocurarine
        • Gallamine
        • Atracurium
        • Pancuronium
        • Vecuronium
      • Depolarizing blockers: succinylcholine (suxamethonium)
  • Centrally acting skeletal muscle relaxants
    1. Baclofen – Diazepam  
  • Direct acting skeletal muscle relaxants
    1. Dantrolene

 

Mechanism of action

  1. Non depolarizing relaxant drugs
    • All neuromuscular blocking agents used in USA except succinylcholine are classifies as non depolarizing agents
    • When small doses of nondepolarizing muscle relaxants are administered, they act predominantly at nicotinic receptor site by competing with acetylcholine
    • The least potent relaxant (eg. Rocuronium) have the fastest onset and the shortest duration of action
    • In large doses, nondepolarizing drugs enter the pore of ion channel to produce a more intense motor blockade. This action further weakens neuromuscular transmission and diminishes the ability of the cholinesterase inhibitor (eg. Neostigmine, edrophonium, pyridostigmine) to antagonize the effect of non depolarizing muscle relaxants.
    • They also block prejunctional sodium channels. As a result of this action, muscle relaxants interfere with the metabolization of acetylcholine at the nerve ending.
    • Both halothane and succinylcholine increase the intensity and duration of action of pancuronium. (1)

 

  1. Depolarizing relaxant drugs
    1. Phase I block (depolarizing)
      • Succinylcholine is the only available depolarizing neuromuscular blocking drug. (2)
      • It produces a longer effect at the myoneural junction
      • It reacts with the nicotinic receptor to open the channel and cause depolarization of the motor end plate, and this in turn spreads to the adjacent membranes, causing contractions of muscle motor units.
      • Because succinylcholine is not metabolized at the synapse, the depolarized membranes remain depolarized and unresponsive to subsequent impulses
      • This is called Phase I (depolarizing) block, not reversed by cholinesterase inhibitors
    2. Phase II block (desensitizing)
      • With prolonged exposure to succinylcholine, initial end plate depolarization decreases and the membrane become repolarized
      • Despite this repolarization, the membrane cannot be easily depolarized again because it is desensitized
      • The channel block is more important than agonist action at the receptor in phase II of succinylcholine’s neuromuscular blocking action
      • Later in phase II, the characteristics of the blockade are nearly identical to those of a non depolarizing block (ie, a nonsustained twitch response to a titanic stimulus) with possible reversal by acetylcholinesterase inhibitors

 

  • Succinylcholine produce reversible contracture of intrafusal fibers of the muscle spindle and leads to acceleration of the afferent discharge. (3)
  • Another study by Martin Jeevendra and Duriex Marcel E found that: (4)

              1. Succinylcholine caused initial activation of the muscle AchR followed by desensitization

              2. At clinically relevant concentrations, succinylcholine has no stimulatory or inhibitory interactions                            with α3β2 (presynaptic) or α3β4 (ganglionic) AchRs

              3. High doses of succinylcholine caused inhibition of both α3β2 and α3β4 receptor. 

 

 

Pharmacokinetics of neuromuscular blocking drugs

  • Succinylcholine has the fastest onset of action among all the muscle relaxants. (5)
  • The elimination of succinylcholine appears to follow first order kinetics with linear relationship between intensity of the effect and logarithm of the dose. The rate of recovery is independent of dose for each age group. The rate of recovery is faster in children than in infants; the rate of recovery is faster in infants than in adults. The elimination rate constant for infabts was similar to that of children, but is dissimilar from those of adults. (6)

 

Drug

Elimination

Clearance (mL/kg/min)

Approximate duration of action (minutes)

Approximate potency relative to Tubocurarine

Atracurium

Spontaneous

6.6

20-35

1.5

Cisatracurium

Mostly spontaneous

5-6

25-44

1.5

Doxacurium

Kidney

2.7

> 35

6

Metocurine

Kidney (40%)

1.2

> 35

4

Mivacurium

Plasma ChE

(Butyrylcholinesterase)

70-95

10-20

4

Tubocurarine

Kidney (40%)

2.3-2.4

> 50

1

Pancuronium

Kidney (80%)

1.7-1.8

> 35

6

Pipecuronium

Kidney (60%) and liver

2.5-3.0

> 35

6

Rocuronium

Liver (75-90%) and kidney

2.9

20-35

0.8

Vecuronium

Liver (75-90%) and kidney

3-5.3

20-35

6

Succinylcholine

Plasma ChE (100%)

(Butyrylcholinesterase)

>100

< 8

0.4

Soutce: Bertram G. Katzung, Susan B. Masters and Anthony J. Trevor. Basic amd Clinical Pharmacology. 11th Edition. Chapter 27. Skeletal Muscle Rexants. Page 451-465.

 

Pharmacology of Neuromuscular blocking drugs

Drug

ED95a (mg/kg)

Intubating dose (mg/kg)

Onset timeb (s)

Clinical durationc(min)

Succinylcholine

0.3

1.0d

60

10

Benzylisoquinolone

Tubocurarine

0.5

0.5-0.6

220

80+

Atracurium

0.23

0.5

110

43

Mivacurium

0.08

0.15-0.2

170

16

Doxacurium

0.025

0.05

250

83

Cisatracurium

0.05

0.1

150

45

Aminosteroids

Pancuronium

0.07

0.1

220

75

Vecuronium

0.05

0.1

180

33

Pipecuronium

0.045

0.08

300

95

Rocuronium

0.3

0.6

75

33

Rapacuronium

1.2

1.5

<75

15

a: The dose that depresses the twitch height by 95%

b: time to 95% depression of first twitch of train-of-four

c: time to 25% recovery of first twitch of train-of-four

d: This is about three times the ED95

Source: Jonnas Appiah-Ankam, Jennifer M Hunter. Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain. 2004;4(1):2-7. 

 

Side effects of succinylcholine: (2)

  • Cardiovascular effects: bradycardia. It can cause arrhythmias when administered with halothane anesthesia
  • Muscle pain: experienced the day after surgery and is worse in ambulatory patients. It is more common in the young and healthy with a large muscle mass. The pain is thought to be a result of the initial fasciculations and occurs in unusual sites, such as the diaphragm, intercostal muscles and between the scapulae. 
  • Hyperkalemia: Administration of succinylcholine 1.0 mg kg−1 produces a small increase (∼0.5 mmol litre−1) in serum potassium concentration in patients undergoing halothane anaesthesia.
  • Malignant hyperthermia: Succinylcholine is a recognized trigger factor for malignant hyperthermia and may also precipitate muscle contracture in patients with myotonic dystrophies.
  • Hypersensitivity: Succinylcholine accounts for about 50% of hypersensitivity reactions to NMBDs. The incidence is estimated to be 1 in 4000 administrations.
  • Increased intraocular pressure: The average increase in intra-ocular pressure after succinylcholine 1.0 mg kg−1 is 4–8 mm Hg. The increase occurs promptly after intravenous injection, peaking at 1–2 min and lasting as long as the neuromuscular block.
  • Increased intragastric pressure: 
  • This complication is likely to occur in patients with delayed gastric emptying (those with diabetes), traumatic injury, esophageal dysfunction and morbid obesity. 
  • Prolonged paralysis: Reduced plasma cholinesterase activity, a result of inherited or acquired factors, may alter the duration of action of succinylcholine, leading to prolonged paralysis.

 

Effects of muscle relaxants:

  • Vecuronium, pipecuronium, doxacurium, cisatracurium and rocuronium all have minimal cardiovascular effects
  • Pancuronium, atracurium and mivacurium produce cardiovascular effects that are mediated by either autonomic or histamine receptors
  • Tubocurarine and to lesser extent metocurine, mivacuronium and atracurium can produce hypotension as a result of histamine release
  • With larger doses, ganglionic blockade may occur with tubocurarine and metocurine
  • Pancuronium causes a moderate increase in heart rate and a smaller increase in cardiac output, with little or no change in systemic vascular resistance
  • Pancuronium induced tachycardia is primarily due to vagolytic action, release of norepinephrine from adrenergic nerve endings and blockade of neuronal uptake of norepinephrine may be secondary mechanisms

 

 

 

Drug

Effect on autonomic ganglia

Effect on cardiac muscarinic receptors

Tendency to cause histamine release

Atracurium

None

None

Slight

Cisatracurium

None

None

None

Doxacurium

None

None

None

Metocurine

Weak block

None

Slight

Mivacurium

None

None

Moderate

Tubocurarine

Weak block

None

Moderate

Pancuronium

None

Moderate block

None

Pipecuronium

None

None

None

Rocuronium

None

Slight

None

Vecuronium

None

None

None

Gallamine

None

Strong block

None

Succinylcholine

Stimulation

Stimulation

Slight

Source: Bertram G. Katzung, Susan B. Masters and Anthony J. Trevor. Basic amd Clinical Pharmacology. 11th Edition. Chapter 27. Skeletal Muscle Rexants. Page 451-465.

 

Interactions with other drugs

  1. Anesthetics
    • Inhaled anesthetic potentiate the neuromuscular blockade produced by non depolarizing muscle relaxants in dose dependent fashion
    • Inhaled anesthetic augment the effect of muscle relaxants in the following order:

Isoflurane (most); sevoflurane, desflurane, enflurane and halothane; nitrous oxide (least)

  • Rare interaction of succinylcholine with volatile anesthetics results in malignant hyperthermia
  • Isobolographic and fractional analysis of the suxamethonium-mivacurium and suxamethonium-atracurium combinations demonstrated antagonistic interactions. (7)
  • The recovery from the effects of one nondepolarizing muscle relaxant given after partial recovery from another, more resembles the recovery from the muscle relaxant given first. (8)

 

  1. Antibiotics
    • Neuromuscular blockade is enhanced by antibiotics (eg. aminoglycosides)
    • For patients treated with gentamycin and tobramycin, atracurium offers advantage over vecuronium when prolonged block is not desired. (9) 
    • Many antibiotics have shown to cause a depression of evoked release of acetylcholine similar to that caused by administering magnesium. The mechanism of this prejunctional effect appears to be blockade of specific P-type calcium channels in the motor nerve terminal

 

  1. Antiarrhythmic drugs and local anesthetics
    • The antiarrhythmics lidocaine, procainamide, propanolol and diphenylhydantoin increase the intensity and duration of d-Tubocurarine neuromuscular blockade. (10) 
    • Higher concentrations of bupivacaine have been associated with cardiac arrhythmias independent of the muscle relaxant used.
    • In small doses, local anesthetics can depress posttetanic potentiation via a prejunctional neural effect.
    • In large doses, local anesthetics can block neuromuscular transmission
    • With higher doses, local anesthetics block acetylcholine- induced muscle contractions as a result of blockade of the nicotinic receptor ion channels
    • Neuromuscular blocking agents potentiate the action of local anesthetics by acting on different sites of the neuromuscular junction. The block caused by combination of local anesthetic and neuromuscular blocking agent can be reversed by 4-aminopyridine. (11)
  1. Other neuromuscular blocking drugs
    • The end plate depolarizing effect of succinylcholine can be antagonized by administering a small dose of non depolarizing blocker
    • To prevent the fasciculation associated with succinylcholine administration, a small non paralyzing dose of a nondepolarizing drug can be given before succinylcholine (eg. d-tubourarine, 2 mg IV, or pancuronium, 0.5 mg iv)
  2. Lithium: Lithium enhances the myoneural blocking effects of suxamethonium, pancuronium and vecuronium. (12)

 

Reversal of nondepolarizing neuromuscular blockade

  • The cholinesterase inhibitors effectively antagonize the neuromuscular blockade caused by nondepolarizing drugs
  • Neostigmine and pyridostigmine antagonize the nondepolarizing neuromuscular blockade by increasing the availability of acetylcholine at the motor end plate, mainly by inhibition of acetylcholinesterase
  • Edrophonium antagonized the neuromuscular blockade purely by inhibiting acetylcholinesterase activity. Edrophonium has a more rapid onset of action but may be less effective than neostigmine in reversing the effects of nondepolarizing blockers in the presence of a profound degree of neuromuscular blockade.
  • A novel cyclodextrin reversal drug, sugammadex, has been submitted for FDA approval. It can rapidly inactivate steroidal neuromuscularblocking drugs by forming an inactive complex, which is excreted in the urine.

 

References:

  1. Katz Ronald L. Modification of the action of pancuronium by succinylcholine and halothane. Anesthesiology December 1971;35(6). 
  2. Jonnas Appiah-Ankam, Jennifer M Hunter. Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain. 2004;4(1):2-7. 
  3. Cedric M Smith, Earl Eldred. Mode of action of succinylcholine on sensory endings of mammalian muscle spindles. JPET February 1961;131(2):237-242.
  4. Martyn Jeevendra, Durieux Marcel E. Succinylcholine: New insights into mechanism of action of old drug. Anesthesiology April 2006;104(4):633-634. 
  5. Sluga M, Ummenhofer W, Studer W, Seigemund M, Marsch SC. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: A prospective, randomized trial in emergent cases. Anesth Analg 2005;101:1356-61. 
  6. Cook DR, Wingard LB, Taylor FH. Pharmacokinetics of succinylcholine in infants, children and adults. Clinical Pharmacology and Therapeutics. 1976;20(4):493-498. 
  7. KS Kim, DJ Na, SU Chon. Interactions between suxamethonium and mivacurium or atracurium. British Journal of Anesthesia. 1996;77:612-616. 
  8. Harrop-Griffiths AW, Hood JR. Interactions between non depolarizing muscle relaxants. Anesthesiology 1997;86(1):263. 
  9. JY Dupuis, R Martin, JP Tetrault. Atracurium and vecuronium interaction with gentamycin and tobramycin. Can J Anaesth. 1989;36(4):407-11. 
  10. Katzung BG, Walter M, Harrah Marvin D. The interactions of d-Tubocurarine with Antiarrhythmic drugs. Anesthesiology October 1970;33(4). 
  11. Matsuo S, Rao DBS, Chaudry I, Foldes FF. Interaction of muscle relaxant and local anesthetics at the neuromuscular junction. Anesthesia & Analgesia. September/October 1978;57(5). 
  12. Saarnivaara L, Ertama P. Interactions between lithium/rubidium and six muscle relaxants. A study on the rat phrenic nerve-hemidiaphragm preperation. Des Anaesthesist. 1992;41(12):760-764. 

 

     

May 12, 2016

A Brief Review of Neuromuscular Blocking Agents

For this Premium Version, Subscribe here

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

Skeletal Muscle relaxants

Classification

  • Peripherally acting (Neuromuscular blockers)
    1. Pre synaptic neuromuscular blocker
      • Inhibit Ach synthesis: triethylacholine – hemicholinium
      • Inhibit Ach release: Mg, aminoglycosides, botulinum toxin
    2. Post synaptic neuromuscular blocker
      • Competitive (non depolarizing blockers):
        • d- tubocurarine
        • Gallamine
        • Atracurium
        • Pancuronium
        • Vecuronium
      • Depolarizing blockers: succinylcholine (suxamethonium)
  • Centrally acting skeletal muscle relaxants
    1. Baclofen – Diazepam  
  • Direct acting skeletal muscle relaxants
    1. Dantrolene

 

Mechanism of action

  1. Non depolarizing relaxant drugs
    • All neuromuscular blocking agents used in USA except succinylcholine are classifies as non depolarizing agents
    • When small doses of nondepolarizing muscle relaxants are administered, they act predominantly at nicotinic receptor site by competing with acetylcholine
    • The least potent relaxant (eg. Rocuronium) have the fastest onset and the shortest duration of action
    • In large doses, nondepolarizing drugs enter the pore of ion channel to produce a more intense motor blockade. This action further weakens neuromuscular transmission and diminishes the ability of the cholinesterase inhibitor (eg. Neostigmine, edrophonium, pyridostigmine) to antagonize the effect of non depolarizing muscle relaxants.
    • They also block prejunctional sodium channels. As a result of this action, muscle relaxants interfere with the metabolization of acetylcholine at the nerve ending.
    • Both halothane and succinylcholine increase the intensity and duration of action of pancuronium. (1)

 

  1. Depolarizing relaxant drugs
    1. Phase I block (depolarizing)
      • Succinylcholine is the only available depolarizing neuromuscular blocking drug. (2)
      • It produces a longer effect at the myoneural junction
      • It reacts with the nicotinic receptor to open the channel and cause depolarization of the motor end plate, and this in turn spreads to the adjacent membranes, causing contractions of muscle motor units.
      • Because succinylcholine is not metabolized at the synapse, the depolarized membranes remain depolarized and unresponsive to subsequent impulses
      • This is called Phase I (depolarizing) block, not reversed by cholinesterase inhibitors
    2. Phase II block (desensitizing)
      • With prolonged exposure to succinylcholine, initial end plate depolarization decreases and the membrane become repolarized
      • Despite this repolarization, the membrane cannot be easily depolarized again because it is desensitized
      • The channel block is more important than agonist action at the receptor in phase II of succinylcholine’s neuromuscular blocking action
      • Later in phase II, the characteristics of the blockade are nearly identical to those of a non depolarizing block (ie, a nonsustained twitch response to a titanic stimulus) with possible reversal by acetylcholinesterase inhibitors

 

  • Succinylcholine produce reversible contracture of intrafusal fibers of the muscle spindle and leads to acceleration of the afferent discharge. (3)
  • Another study by Martin Jeevendra and Duriex Marcel E found that: (4)

              1. Succinylcholine caused initial activation of the muscle AchR followed by desensitization

              2. At clinically relevant concentrations, succinylcholine has no stimulatory or inhibitory interactions                            with α3β2 (presynaptic) or α3β4 (ganglionic) AchRs

              3. High doses of succinylcholine caused inhibition of both α3β2 and α3β4 receptor. 

 

 

Pharmacokinetics of neuromuscular blocking drugs

  • Succinylcholine has the fastest onset of action among all the muscle relaxants. (5)
  • The elimination of succinylcholine appears to follow first order kinetics with linear relationship between intensity of the effect and logarithm of the dose. The rate of recovery is independent of dose for each age group. The rate of recovery is faster in children than in infants; the rate of recovery is faster in infants than in adults. The elimination rate constant for infabts was similar to that of children, but is dissimilar from those of adults. (6)

 

Drug

Elimination

Clearance (mL/kg/min)

Approximate duration of action (minutes)

Approximate potency relative to Tubocurarine

Atracurium

Spontaneous

6.6

20-35

1.5

Cisatracurium

Mostly spontaneous

5-6

25-44

1.5

Doxacurium

Kidney

2.7

> 35

6

Metocurine

Kidney (40%)

1.2

> 35

4

Mivacurium

Plasma ChE

(Butyrylcholinesterase)

70-95

10-20

4

Tubocurarine

Kidney (40%)

2.3-2.4

> 50

1

Pancuronium

Kidney (80%)

1.7-1.8

> 35

6

Pipecuronium

Kidney (60%) and liver

2.5-3.0

> 35

6

Rocuronium

Liver (75-90%) and kidney

2.9

20-35

0.8

Vecuronium

Liver (75-90%) and kidney

3-5.3

20-35

6

Succinylcholine

Plasma ChE (100%)

(Butyrylcholinesterase)

>100

< 8

0.4

Soutce: Bertram G. Katzung, Susan B. Masters and Anthony J. Trevor. Basic amd Clinical Pharmacology. 11th Edition. Chapter 27. Skeletal Muscle Rexants. Page 451-465.

 

Pharmacology of Neuromuscular blocking drugs

Drug

ED95a (mg/kg)

Intubating dose (mg/kg)

Onset timeb (s)

Clinical durationc(min)

Succinylcholine

0.3

1.0d

60

10

Benzylisoquinolone

Tubocurarine

0.5

0.5-0.6

220

80+

Atracurium

0.23

0.5

110

43

Mivacurium

0.08

0.15-0.2

170

16

Doxacurium

0.025

0.05

250

83

Cisatracurium

0.05

0.1

150

45

Aminosteroids

Pancuronium

0.07

0.1

220

75

Vecuronium

0.05

0.1

180

33

Pipecuronium

0.045

0.08

300

95

Rocuronium

0.3

0.6

75

33

Rapacuronium

1.2

1.5

<75

15

a: The dose that depresses the twitch height by 95%

b: time to 95% depression of first twitch of train-of-four

c: time to 25% recovery of first twitch of train-of-four

d: This is about three times the ED95

Source: Jonnas Appiah-Ankam, Jennifer M Hunter. Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain. 2004;4(1):2-7. 

 

Side effects of succinylcholine: (2)

  • Cardiovascular effects: bradycardia. It can cause arrhythmias when administered with halothane anesthesia
  • Muscle pain: experienced the day after surgery and is worse in ambulatory patients. It is more common in the young and healthy with a large muscle mass. The pain is thought to be a result of the initial fasciculations and occurs in unusual sites, such as the diaphragm, intercostal muscles and between the scapulae. 
  • Hyperkalemia: Administration of succinylcholine 1.0 mg kg−1 produces a small increase (∼0.5 mmol litre−1) in serum potassium concentration in patients undergoing halothane anaesthesia.
  • Malignant hyperthermia: Succinylcholine is a recognized trigger factor for malignant hyperthermia and may also precipitate muscle contracture in patients with myotonic dystrophies.
  • Hypersensitivity: Succinylcholine accounts for about 50% of hypersensitivity reactions to NMBDs. The incidence is estimated to be 1 in 4000 administrations.
  • Increased intraocular pressure: The average increase in intra-ocular pressure after succinylcholine 1.0 mg kg−1 is 4–8 mm Hg. The increase occurs promptly after intravenous injection, peaking at 1–2 min and lasting as long as the neuromuscular block.
  • Increased intragastric pressure: 
  • This complication is likely to occur in patients with delayed gastric emptying (those with diabetes), traumatic injury, esophageal dysfunction and morbid obesity. 
  • Prolonged paralysis: Reduced plasma cholinesterase activity, a result of inherited or acquired factors, may alter the duration of action of succinylcholine, leading to prolonged paralysis.

 

Effects of muscle relaxants:

  • Vecuronium, pipecuronium, doxacurium, cisatracurium and rocuronium all have minimal cardiovascular effects
  • Pancuronium, atracurium and mivacurium produce cardiovascular effects that are mediated by either autonomic or histamine receptors
  • Tubocurarine and to lesser extent metocurine, mivacuronium and atracurium can produce hypotension as a result of histamine release
  • With larger doses, ganglionic blockade may occur with tubocurarine and metocurine
  • Pancuronium causes a moderate increase in heart rate and a smaller increase in cardiac output, with little or no change in systemic vascular resistance
  • Pancuronium induced tachycardia is primarily due to vagolytic action, release of norepinephrine from adrenergic nerve endings and blockade of neuronal uptake of norepinephrine may be secondary mechanisms

 

 

 

Drug

Effect on autonomic ganglia

Effect on cardiac muscarinic receptors

Tendency to cause histamine release

Atracurium

None

None

Slight

Cisatracurium

None

None

None

Doxacurium

None

None

None

Metocurine

Weak block

None

Slight

Mivacurium

None

None

Moderate

Tubocurarine

Weak block

None

Moderate

Pancuronium

None

Moderate block

None

Pipecuronium

None

None

None

Rocuronium

None

Slight

None

Vecuronium

None

None

None

Gallamine

None

Strong block

None

Succinylcholine

Stimulation

Stimulation

Slight

Source: Bertram G. Katzung, Susan B. Masters and Anthony J. Trevor. Basic amd Clinical Pharmacology. 11th Edition. Chapter 27. Skeletal Muscle Rexants. Page 451-465.

 

Interactions with other drugs

  1. Anesthetics
    • Inhaled anesthetic potentiate the neuromuscular blockade produced by non depolarizing muscle relaxants in dose dependent fashion
    • Inhaled anesthetic augment the effect of muscle relaxants in the following order:

Isoflurane (most); sevoflurane, desflurane, enflurane and halothane; nitrous oxide (least)

  • Rare interaction of succinylcholine with volatile anesthetics results in malignant hyperthermia
  • Isobolographic and fractional analysis of the suxamethonium-mivacurium and suxamethonium-atracurium combinations demonstrated antagonistic interactions. (7)
  • The recovery from the effects of one nondepolarizing muscle relaxant given after partial recovery from another, more resembles the recovery from the muscle relaxant given first. (8)

 

  1. Antibiotics
    • Neuromuscular blockade is enhanced by antibiotics (eg. aminoglycosides)
    • For patients treated with gentamycin and tobramycin, atracurium offers advantage over vecuronium when prolonged block is not desired. (9) 
    • Many antibiotics have shown to cause a depression of evoked release of acetylcholine similar to that caused by administering magnesium. The mechanism of this prejunctional effect appears to be blockade of specific P-type calcium channels in the motor nerve terminal

 

  1. Antiarrhythmic drugs and local anesthetics
    • The antiarrhythmics lidocaine, procainamide, propanolol and diphenylhydantoin increase the intensity and duration of d-Tubocurarine neuromuscular blockade. (10) 
    • Higher concentrations of bupivacaine have been associated with cardiac arrhythmias independent of the muscle relaxant used.
    • In small doses, local anesthetics can depress posttetanic potentiation via a prejunctional neural effect.
    • In large doses, local anesthetics can block neuromuscular transmission
    • With higher doses, local anesthetics block acetylcholine- induced muscle contractions as a result of blockade of the nicotinic receptor ion channels
    • Neuromuscular blocking agents potentiate the action of local anesthetics by acting on different sites of the neuromuscular junction. The block caused by combination of local anesthetic and neuromuscular blocking agent can be reversed by 4-aminopyridine. (11)
  1. Other neuromuscular blocking drugs
    • The end plate depolarizing effect of succinylcholine can be antagonized by administering a small dose of non depolarizing blocker
    • To prevent the fasciculation associated with succinylcholine administration, a small non paralyzing dose of a nondepolarizing drug can be given before succinylcholine (eg. d-tubourarine, 2 mg IV, or pancuronium, 0.5 mg iv)
  2. Lithium: Lithium enhances the myoneural blocking effects of suxamethonium, pancuronium and vecuronium. (12)

 

Reversal of nondepolarizing neuromuscular blockade

  • The cholinesterase inhibitors effectively antagonize the neuromuscular blockade caused by nondepolarizing drugs
  • Neostigmine and pyridostigmine antagonize the nondepolarizing neuromuscular blockade by increasing the availability of acetylcholine at the motor end plate, mainly by inhibition of acetylcholinesterase
  • Edrophonium antagonized the neuromuscular blockade purely by inhibiting acetylcholinesterase activity. Edrophonium has a more rapid onset of action but may be less effective than neostigmine in reversing the effects of nondepolarizing blockers in the presence of a profound degree of neuromuscular blockade.
  • A novel cyclodextrin reversal drug, sugammadex, has been submitted for FDA approval. It can rapidly inactivate steroidal neuromuscularblocking drugs by forming an inactive complex, which is excreted in the urine.

 

References:

  1. Katz Ronald L. Modification of the action of pancuronium by succinylcholine and halothane. Anesthesiology December 1971;35(6). 
  2. Jonnas Appiah-Ankam, Jennifer M Hunter. Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain. 2004;4(1):2-7. 
  3. Cedric M Smith, Earl Eldred. Mode of action of succinylcholine on sensory endings of mammalian muscle spindles. JPET February 1961;131(2):237-242.
  4. Martyn Jeevendra, Durieux Marcel E. Succinylcholine: New insights into mechanism of action of old drug. Anesthesiology April 2006;104(4):633-634. 
  5. Sluga M, Ummenhofer W, Studer W, Seigemund M, Marsch SC. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: A prospective, randomized trial in emergent cases. Anesth Analg 2005;101:1356-61. 
  6. Cook DR, Wingard LB, Taylor FH. Pharmacokinetics of succinylcholine in infants, children and adults. Clinical Pharmacology and Therapeutics. 1976;20(4):493-498. 
  7. KS Kim, DJ Na, SU Chon. Interactions between suxamethonium and mivacurium or atracurium. British Journal of Anesthesia. 1996;77:612-616. 
  8. Harrop-Griffiths AW, Hood JR. Interactions between non depolarizing muscle relaxants. Anesthesiology 1997;86(1):263. 
  9. JY Dupuis, R Martin, JP Tetrault. Atracurium and vecuronium interaction with gentamycin and tobramycin. Can J Anaesth. 1989;36(4):407-11. 
  10. Katzung BG, Walter M, Harrah Marvin D. The interactions of d-Tubocurarine with Antiarrhythmic drugs. Anesthesiology October 1970;33(4). 
  11. Matsuo S, Rao DBS, Chaudry I, Foldes FF. Interaction of muscle relaxant and local anesthetics at the neuromuscular junction. Anesthesia & Analgesia. September/October 1978;57(5). 
  12. Saarnivaara L, Ertama P. Interactions between lithium/rubidium and six muscle relaxants. A study on the rat phrenic nerve-hemidiaphragm preperation. Des Anaesthesist. 1992;41(12):760-764. 

 

     

May 10, 2016
AnesthesiaExam Podcast For Board Review and Practice Management Updates TEXT the word ANESTHESIAEXAM to the number 33444 For more information, CME credit and MOCA and Primary Board Prep,For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,Go to AnesthesiaExam.comFor Basic and Advanced Anesthesia Exam Review, Go to ABAStagedExams.comFor CRNA Board Prep, go to CRNABoardPrep.comFor the Pediatric Anesthesiology Board Review, Go to PedsAE.comDavid Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medicaal Center and AABP Pain ManagmentFor evaluation and treatment of a Paianful Disorder, go to www.AABPPain.com718 436 7246DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional.  Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.       
 
References
 
Validity of the Straight-Leg Raise Test for Patients With Sciatic Pain With or Without Lumbar Pain Using Magnetic Resonance Imaging Results as a Reference Standard



 
Pathogenesis. Baastrup’s disease is a term referring to close approximation of adjacent spinous processes due to general degenerative changes of the spine.
Apr 26, 2016

Dr. Rosenblum Discusses the management and treatment of

Femoral Neuropathy

PainExam Podcast

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or Purchase our Full Lecture Library at PainExam.com

AnesthesiaExam Podcast 

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ANESTHESIAEXAM to the number 33444 

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For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

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For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

References     

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 49-50

Apr 19, 2016

Dr. Rosenblum Discusses the management and treatment of

Hip OA and anesthetic management

PainExam Podcast

For the Full version Subscribe to the premium subscription via our App 

or Purchase our Full Lecture Library at PainExam.com

AnesthesiaExam Podcast 

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ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPai

Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

References     

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 48

https://www.hss.edu/professional-conditions_anesthesia-analgesia-for-total-knee-hip-replacement.asp

Apr 12, 2016

Dr. Rosenblum discusses a patient who was injured by and IED and developed RSD, and PTSD.

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

References

http://emedicine.medscape.com/article/1819950-overview#a2

 
http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/basics/symptoms/con-20022540
Apr 5, 2016

Chronic post operative pain, abdominal pain, phrenic nerve block, the splanchnic nerve block and the TAP Block all discussed.

 

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

     

Mar 29, 2016

Multiple Sclerosis for the Anesthesia Boards

 

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Mar 24, 2016

Dr. Rosenblum Discusses the management and treatment of

Lumbar DDD

PainExam Podcast

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or Purchase our Full Lecture Library at PainExam.com

 

Coming Soon, the AnesthesiaExam Podcast Premium Subscriptions

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ANESTHESIAEXAM to the number 33444 

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Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

  

References     

Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed.

Copyright © 2008 Saunders, An Imprint of Elsevier Chapter 42

Mar 15, 2016

halothane

Effects on CNS

  • Do not cause retrograde amnesia or prolonged impairment of intellectual function. Cerebral metabolic oxygen requirement are decreased parallel with drug induced decreases in cerebral activity.
  • Drug induced increases in cerebral blood flow may increase intra cranial pressure in patients with space occupying lesion.
  • Volatile anesthetics produce an imprecision in the control of thermoregulatory responses at the level of the anterior hypothalamus. It produces shivering like activity during emergence. (1)

Effects on circulation

  • Halothane sensitizes the heart to catecholamines
  • It is liable to cause cardiac arrhythmias, occasionally fatal, particularly if hypercapnia has been allowed to develop.
  • Arrhythmias are very common in children anesthetized with halothane.
  • Halothane depresses cardiac index and myocardial contractility in patients with congenital heart disease. (2)
  • Halothane causes reduction in heart rate and hypotension during anesthesia. It has no effect in bronchomotor tone. (3)
  • 1.0 MAC enflurane, halothane and isoflurane mildly disrupt coronary blood flow (CBF) autoregulation, increasing CBF out of proportion to myocardial demands. These anesthetics do not affect maximal CBF or coronary vascular reserve. (4)
  • Volatile anesthetics alter tissue excitability by decreasing the extent of gap junction-mediated cell-cell coupling and by altering the activity of the channels that underlie action potential. The magnitude of the effect of halothane on channel open time isleast for Cx40-like channels and greatest for heteromeric channels. (5)

Effects on neuromuscular function

  • It is a potent trigger to malignant hyperthermia
  • It relaxes uterine smooth muscles and this may increase blood loss during delivery or termination of pregnancy.
  • Halothane should not be used in patients with neuromuscular disease like Duchenne muscular dystrophy. These patients show evidence of muscle damage with increased serum creatinine kinase concentration and myoglobinuria.

Effects on renal function

  • Halothane anesthesia does not affect early post operative renal functions. (6)

Effects on hepatic function

  • Repeated exposure of halothane can result in severe liver injury.This halothane hepatitis is the result from the metabolism of halothane to triflouroacetic acid via oxidative reactions in the liver.
  • Halothane has more deleterious effect on liver blood flow , interferes with liver cell ability to absorb and excrete indocyanine green (ICG). (7)

Effects on hematologic and immune systems

  • A study on the effect of halothane on division of cultured, murine bone-marrow cells showed that halothane caused a dose-dependent depression of growth rate ranging from a minimal effect at 0.5% to almost total inhibition at 2.0%.
  • Halothane exposure results in increased number of IgG secreting cells as well as the circulating 7S serum agglutinins. (8)

Minimum alveolar concentration and pressures

  • Oil: gas partition coefficient = 224
  • Blood: gas partition coefficient = 2.3
  • MAC = 0.75 vol %
  • Vapor Pressure  244 mmHg (at 20 Deg C)

                           288 mm Hg (at 24 Deg C)

Trace concentrations, O.R. pollution, personnel hazards

  • Halothane should be used with caution in patients with Phaechromocytoma, Renal failure, Pre existing liver disease, Myasthenia gravis

Advantages

  • Pleasant odor
  • Slower induction and recovery

References:

  1. Farber NE, Poterack KA, Kampine JP, Schmeling WT. The effects of halothane, isoflurane and enflurane on the thermoregulatory responses in the neuraxis of cats. Anesthesiology 1994 Apr;80(4): 879-91. 
  2. Rivenes SM, Lewin MB, Stayer SA, Bent ST, SchoeniqHM, McKenzie ED, Fraser CD, Andropoulos DB. Cardiovascular effects of sevoflurane, isoflurane, halothane and fentanyl-midazolam in children with congenital heart disease: an echocardiographic study of myocardial contractility and hemodynamics. Anesthesiology 2001 Feb;94(2):223-9.
  3. Van den Berg AA, Honjol NM. effects of heart arte, blood pressure and bronchomotor tone of halothane, enflurane and isoflurane in young fit patients. Middle East J Anesthesiol 1993 Oct;12(3): 271-86. 
  4. Hickey Robert F, Sybert Peter E, Verrier Edward D, Cason Brian A. Effects of Halothane, Enflurane and Isoflurane on coronary blood flow autoregulation and coronary vascular reserve in the canine heart. Anesthesiology Jan 1988; 6(1). 
  5. Ding Sheng He, Janis M Burt. Mechanism and selectivity of the effects of halothane on gap junction channel function. Circulation Research. 2000;86:e104-e109. 
  6. Saricaoqlu, Akinci SB, Oc B, Kanbak M, Akbulut B, Celebioqlu B. The effects of halothane, isoflurane, sevoflurane and propofol infusion on renal function after coronary artery bypass surgery. Middle East J Anesthesiol 2006 Jun;18(5):955-64. 
  7. Gelman Simon, Fowler Kathryn, Smithg Lloyd R. Liver circulation and function during isoflurane and halothane anesthesia. Anesthesiology December 1984; 61(6). 
  8. Puing NR, Elena GA, Barragan J, Comba JO, Amerio N. Halothane associated enhancement of the secondary immune response to sheep erythrocytes in mice: cell transfer studies. Acta Anaesthesiol Scand. 1993 Oct;37(7):647-51. 

 

 

 

 

 

Isoflurane

Effects on CNS

  • Isoflurane causes an increase in cerebral blood flow at deeper levels of anaesthesia, (1·5%), and this may give rise to an increase in cerebral spinal fluid pressure. Where appropriate, this can be prevented or reversed by hyper-ventilating the patient before or during anaesthesia.
  • Isoflurane must be used with caution in patients with increased intracranial pressure
  • Several incidence of postoperative convulsive disorder have been reported after isoflurane anesthesia. If seizures occured after anesthesia, volatile anesthesia itself may not be the cause. (1)
  • 2% isoflurane given immediately after hypoxic ischemia, reduce brain infarct volume in short term as well as brain atrophy and neurobehavioural effects in the long term. (2)

Effects on circulation

  • Isoflurane is a powerful systemic and coronary arterial dilator.
  • The phenomenon of "coronary steal" means that isoflurane should be used with caution in patients with coronary artery disease. In particular, patients with subendocardial ischaemia might be anticipated to be more susceptible.
  • Isoflurane preserve cardiac index in patients with congenital heart disease. (3)
  • Most appropriate isoflurane dose level is 1.5% v/v yielding stable mean arterial pressure (MAP) and heart rate (HR) with minute to minute variability in MAP and HR of <11%. (4)

Effects on respiration

  • Isoflurane is a profound respiratory depressant, this effect being accentuated by narcotic premedication or concurrent use of other respiratory depressants.
  • No change in respiratory rate occurs with isoflurane at increasing alveolar concentration whereas at each level of anesthesia, inspiratory time is significantly reduced. (5)

Effects on GI function

  • Salivation and tracheo-bronchial secretions may be stimulated in children but pharyngeal and laryngeal reflexes are quickly diminished.
  • Gastrointestinal motility is 50% reduced 120 min after the isoflurane anesthesia. (6)

Effects on neuromuscular function

  • Isoflurane produces sufficient muscle relaxation for some intra- abdominal operations.
  • Isoflurane is compatible with all commonly used muscle relaxants, the effects of which may be markedly potentiated by isoflurane.
  • The effect is most notable in non-depolarising agents, thus lower doses should be used in the presence of isoflurane.
  • The effect of non-depolarising muscle relaxants can be counteracted by administering neostigmine as this has no effect on the relaxant properties of isoflurane.
  • Interaction of rocuronium and volatile anesthetics results in augmentation of the neuromuscular block but does not significantly affect duration of or recovery from the block. (7)
  • 0.95% isoflurane and 1.70% sevoflurane augments and prolongs the neuromuscular block produced by vecuronium, pancuronium and atracurium to a similar degree. (8)

Effects on hepatic function

  • Isoflurane causes frequent increase in the level of liver enzymes like Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), glutamyl transpeptidase (GTP). (9)
  • Repeat anaesthesia with isoflurane within a short period of time should be approached with caution since the risk of hepatotoxicity is not fully understood.
  • Caution should be exercised when administering isoflurane to patients with pre-existing liver disease.

Other system

  • Repeated exposure to isoflurane at anaesthetic concentrations has no effect on fertility, pregnancy or delivery. The viability of the offspring was unaffected.

Biotransformation; reaction with CO2 absorbants; toxicity

  • Isoflurane has been reported to interact with dry carbon dioxide adsorbents during closed circuit anaesthesia, to form carbon monoxide.
  • Inhalation of carbon monoxide may lead to formation of significant levels of carboxyhaemoglobin in exposed patients.

Minimum alveolar concentration and pressures

MAC = 1.15 vol %

Vapor pressure

238 mm Hg 31.7 kPa (at 20 deg C)

295 mm Hg 48.9 kPa (at 25 deg C)

367 mm Hg 48.9 kPa (at 30 deg C)

450 mm Hg 60.0 kPa (at 35 deg C)

 

Blood gas partition coefficient = 1.4

Oil: gas partition coefficient = 98

Trace concentrations, O.R. pollution, personnel hazards

  • Isoflurane causes postoperative cognitive dysfunction (POCD)
  • Isoflurane induce apoptsis and accumulation and aggregation of amyloid beta protein
  • Adverse effects of isoflurane are hypotension, respiratory depression and arrhythmias
  • It has pungent odor (not suitable for children)
  • Broncho-irritant

Advantages

  • Stable cardiac rhythm
  • Rapid onset/ recovery
  • Minimal metabolism- low tox potential
  • Excellent muscle relaxant

References:

  1. J Kurata, T Adachi, S Nakao, M Murakawa, T Shichino, M Shibata. Sevoflurane, enflurane and isoflurane have no persistent effects on central nervous system in cats. British Journal of Anesthesia. 1996;76:721-725. 
  2. ZhouY, Lekic T, Fathali N, Ostrowski RP, Martin RD, Tang J, Zhang JH. Isoflurane posttreatment reduced neonatal hypoxic-ischemic brain injury in rats by the sphingosine-1-phosphate/ Phosphatidylinositol-3-kinase/Akt pathway. Stroke.2010;41:1521-1527. 
  3. Rivenes SM, Lewin MB, Stayer SA, Bent ST, SchoeniqHM, McKenzie ED, Fraser CD, Andropoulos DB. Cardiovascular effects of sevoflurane, isoflurane, halothane and fentanyl-midazolam in children with congenital heart disease: an echocardiographic study of myocardial contractility and hemodynamics. Anesthesiology 2001 Feb;94(2):223-9. 
  4. Christakis Constantinides, Richard Mean and Ben J Janssen. Effects of isoflurane anesthesia on cardiovascular function of the C57BL/6 Mouse. ILAR J 2011;52:e21-e31. 
  5. Murat I, Chaussain M, Hamza J, Saint-Maurice C. The respiratory effects of isoflurane, enflurane and halothane in spontaneously breathing children. Anesthesia 1987 Jul;42(7):711-8. 
  6. Torjman MC, Joseph JI, Munsick C, Morishita M, Grunwald Z. Effects of isoflurane on gastrointestinal motility after brief exposure in rats. Int J Pharm 2005 Apr 27;294(1-2): 65-71. 
  7. Wulf H, Ledowski T, Linstedt U, Proppe D, Sitzlack D. Neuromuscular blocking effects of rocuronium during desflurane, isoflurane and sevoflurane anaesthesia. Can J Anaesth 1998 Jun;45(6):526-32. 
  8. LEH Vanlinthout LHDJ Booij, Van Egmond, EN Robertson. effect of isoflurane and sevoflurane on the magnitude an dtime course of neuromuscular block produced by vecuronium, pancuronium and atracurium. British Journal of Anesthesia. 1996;76:389-395. 
  9. Tomoki Nishiyama, Takeshi Yokoyama, Kazou Hanaoka. liver function after sevoflurane or isoflurane anesthesia in neurosurgical patients. Can J Anaesth 1998;45(8): 753-756. 

 



 

 

 

Sevoflurane

Effects on CNS

  • Sevoflurane raises intracranial pressure
  • Sevoflurane had minimal effect on intracranial pressure (ICP) and preserved CO2, responsiveness in patients with normal ICP.
  • Rare cases of seizures have been reported in association with sevoflurane use.
  • Sevoflurane suppresses the background central nervous system electrical activities in a dose dependent manner, leaving the reactive capabilities facilitated at deep anesthesia. (1)

Effects on circulation

  • During the maintenance of anaesthesia, increasing the concentration of sevoflurane produces dose-dependent decreases in blood pressure.
  • Excessive decrease in blood pressure may be related to depth of anaesthesia and in such instances may be corrected by decreasing the inspired concentration of sevoflurane.
  • Sevoflurane has not been associated with untoward cardiovascular changes in volunteers and patients undergoing elective surgery and may have less potent effects on the vascular smooth muscle. (2)
  • Autonomic nerve activity is attenuated by sevoflurane. Parasympathetic input to the heart by respiration is suppressed following apperance of isoelectric EEG. (3)
  • Sevoflurane uptake is higher in patients with higher cardiac output. (4)

Effects on respiration

  • Sevoflurane causes respiratory depression which increase as anesthesia is deepened
  • Sevoflurane is a suitable agent for induction under spontaneous respiration with higher concentrations in pediatric anesthesia. (5)
  • Sevoflurane produce more profound respiratory depression at high MAC. (6)

Effects on GI function

  • Deep sedatioj with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy is as safe as conventional sedation technique, potentially less expensive, increases endoscopy unit productivity and eliminates the inconvenience associated with obtaining intravenous access in children. (7)

Effects on neuromuscular function

  • Use of sevoflurane can cause malignant hyperthermia.
  • The syndrome may include non-specific features such as muscle rigidity, tachycardia, tachypnoea, cyanosis, arrhythmias and unstable blood pressure.
  • Treatment includes discontinuation of triggering agents (e.g. Sevoflurane), administration of intravenous dantrolene sodium, and application of supportive therapy.
  • Renal failure may appear later, and urine flow should be monitored and sustained if possible.
  • Use of sevoflurane has been associated with very rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in children during the postoperative period.
  • The condition has been described in patients with latent as well as overt neuromuscular disease, particularly Duchenne muscular dystrophy.

Effects on renal function

  • Sevoflurane should be used with caution in patients with renal insufficiency
  • No significant renal effects are seen with low flow or high flow sevoflurane. (8)

Effects on hepatic function

  • Sevoflurane can be administered to patients with normal or mild-to-moderately impaired hepatic function.
  • Use of sevoflurane in patients with severe hepatic dysfunction has not been investigated.
  • Very rare cases of mild, moderate and severe post-operative hepatic dysfunction or hepatitis with or without jaundice have been reported from post marketing experiences. Clinical judgement should be exercised when sevoflurane is used in patients with underlying hepatic conditions or under treatment with drugs known to cause hepatic dysfunction.
  • Sevoflurane at concentrations less than 2.0 MAC preserves hepatic arterial blood flow, total hepatic O2 delivery and the O2 delivery to consumption ratio. (9)

Effects on hematologic and immune systems

  • Transient increases in serum inorganic fluoride levels may occur during and alter Sevoflurane anaesthesia.
  • Generally, concentrations of inorganic fluoride peak within 2 hours of the end of sevoflurane anaesthesia and return within 48 hours to pro-operative levels.

Biotransformation; reaction with CO2 absorbants; toxicity

  • Sevoflurane produces low levels of Compound A (pentafluoroisopropenyl fluoromethyl ether (PIFE)) and trace amounts of Compound B (pentafluoromethoxy isopropyl fluoromethyl ether (PMFE)), when in direct contact with CO2 absorbents. Levels of Compound A Increase with:- increase in canister temperature; increase in anaesthetic concentration; decrease in gas flow rate and increase more with the use of Baralyme rather than Soda lime.
  • The exothermic reaction that occurs with sevoflurane and CO2 absorbents is increased when the CO2 absorbent becomes desiccated, such as after an extended period of dry gas flow through the CO2 absorbent canisters.
  • Rare cases of extreme heat, smoke and/or spontaneous fire in the anesthesia machine have been reported during sevoflurane use in conjunction with the use of desiccated CO2 absorbent.
  • An unusually delayed rise or unexpected decline of inspired sevoflurane concentration compared to the vaporizer setting may be associated with excessive heating of the CO2 absorbent canister.

Minimum alveolar concentration and pressures

MAC = 2.1 vol %

MAC of sevoflurane decrease with age and with the addition of nitrous oxide

Vapor pressure

157 mm Hg 22.9 kPa (at 20 deg C)

197 mm Hg 26.3 kPa (at 25 deg C)

317 mm Hg 42.3 kPa (at 36 deg C)

 

Blood gas partition coefficient = 0.68

Oil: gas partition coefficient = 47

 

Trace concentrations, O.R. pollution, personnel hazards

  • Frequent adverse effects of sevoflurane are nausea and vomiting
  • Other adverse effects are:

in adults, hypotension; in elderly, hypotension and bradycardia; in children, agitation and increased cough.

 

  • Less frequent adverse events associated with sevoflurane administration were; agitation, somnolence, chills, bradycardia, dizziness, increased salivation, respiratory disorder, hypertension, tachycardia, laryngismus, fever, headache, hypothermia, increased SGOT.

 

  • Occasionally reported adverse effects associated with the administration of sevoflurane administration include : arrhythmias, increased LDH, increased SGPT, hypoxia, apnoea, leukocytosis, ventricular extrasystoles, supraventricular extrasystoles, asthma, confusion, increased creatinine, urinary retention, glycosuria, atrial fibrillation, complete AV block, bigeminy, leucopenia. Allergic reactions, such as rash, urticaria, pruritus, bronchospasm, anaphylactic or anaphylactoid reactions have also been reported. As with all potent inhaled anaesthetics, sevoflurane may cause dose-dependent cardiorespiratory depression.

 

 

  • Convulsions may occur extremely rarely following sevoflurane administration, particularly in children. There have been very rare reports of pulmonary oedema.

 

Advantages

  • Fast induction/ recovery
  • High potency (least soluble)
  • Non irritating vapor

References:

  1. Osawa M, Shingu K, Murakawa M, Adachi T, Kurata J, Seo N, Murayama T, Nakao S, Mori K. Effects of sevoflurane on central nervous system electrical activity in cats. Anesth Analg. 1994 Jul;79(1):52-7. 
  2. Ebert TJ. Cardiovascular and autonomic effects of sevoflurane. Acta Anaesthesiol Belg. 1996;47(1):15-21. 
  3. Itsuo Nakatsuka, Ryoichi Ochai, Junzo Takeda. Changes in heart rate variability in sevoflurane and nitrous oxide anesthesia: effects of respiration and depth of anesthesia. Journal of Clinical Anesthesia. May 2002;14(3):196-200. 
  4. JFA Hendrickx, AAJ Van Zundert, AM De Wulf. Sevoflurane pharmacokinetics: effect of cardiac output. British Journal of Anesthesia. 1998;81:495-501
  5. Mori N, Suzuki M. Sevoflurane in pediatric anesthesia: effects on respiration and circulation during induction and recovery. Pediatr Anaesth. 1996;6(2):95-102.  
  6. M Yamakage,K Tamiyamd,  Dai Horikawa, K Sato, A Namikimd. Effects of halothane and sevoflurane on the pediatric respiratory pattern. Pediatric Anesthesia. January 1994;4(1):53-56.
  7. Montes RG, Bohn RA. Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr. 2000 Jul;31(1):41-6. 
  8. Bito Hiromichi, Ikeuchi Yukako, Ikeda Kazuyuki. Effects of low flow sevoflurane anesthesia on renal function: comparison with high flow sevoflurane anesthesia and low flow isoflurane anesthesia. Anesthesiology 1997;86(6):1231-1237. 
  9. Frink Edward J, Morgan Scott EBS, Coetzee Andre, Conzen Peter F, Brown Burnell R. The effects of sevoflurane, halothane, enflurane and isoflurane on hepatic blood flow and oxygenation in chronically instrumented greyhound dogs. Anesthesiology January 1992;76(1). 



 

 

 

Desflurane

Effects on CNS

  • Desflurane causes dose dependent decrease in cerebrovascular resistance and cerebral metabolic rate of oxygen consumption (CMRO2). (1)
  • It is a cerebral arteriolar dilator
  • Desflurane cause cerebral vasodilation and may result in change in intracranial pressure in vulnerable patients, however if adequate hyperventilation and depth of anesthesia are maintained, it is safe to use desflurane. (1)
  • With desflurane anesthesia, there is increase in activity in the midbrain at surgical end tidal anesthetic concentration. (2)

Effects on circulation

  • Use of desflurane causes tachycardia
  • Increase in desflurane concentration increase the sympathetic and renin angiotensin system activity and cause transient increase in arterial blood pressure and heart rate. It also causes a transient increase in plasma AVP concentration. (3)
  • 6% desflurane significantly prolongs QTc interval in children with normal QTc interval undergoing inguinal herniorraphy. (4)

Effects on respiration

  • It causes airway irritability and laryngospasm at concentration greater than 10 vol %.
  • Desflurane causes respiratory depression at concentration higher than 1 MAC due to decrease in tidal volume. So, it should be avoided at high concentration in infants and chuildren with spontaneous ventilation. (5)
  • There is dose dependent decrease in tidal volume and increase in respiratory rate, arterial carbon dioxide tension, dead space/tidal ventilation ratio, and intrapulmonary shunt fraction. (6)
  • Desflurane does not affect respiratory resistance at 1 MAC, but at 1.5 MAC it causes significant increase in both total and airway resistance with return to baseline values after discontinuation. (7)

Effects on GI function

  • Desflurane maintain the esophageal barrier pressure (BrP = Lower esophageal sphincter pressure - gastric pressure). Hence, it can be used in patients with high risk of regurgitation. (8)

Effects on neuromuscular function

  • In susceptible individuals, desflurane may trigger a skeletal muscle hypermetabolic state leading to high oxygen demand and the clinical syndrome known as malignant hyperthermia.
  • The clinical syndrome is signaled by hypercapnea, and may include muscle rigidity, tachycardia, tachypnea, cyanosis, arrhythmias, and/or unstable blood pressure. Some of these nonspecific signs may also appear during light anesthesia: acute hypoxia, hypercapnia, and hypovolemia.

Effects on renal function

  • Concentrations of 1-4% desflurane in nitrous oxide /oxygen have been used in patients with chronic renal or hepatic impairment and during renal transplantation surgery.
  • Because of minimal metabolism, a need for dose adjustment in patients with renal and hepatic impairment is not to be expected.
  • Desflurane does not aggravate renal impairment in patients with preexisting renal insufficiency. (9)

Effects on hepatic function

  • Use of desflurane may cause sensitivity hepatitis in patients who have been sensitized by previous exposure to halogenated anesthetics
  • Better post operative hepatic tests and INR are seen using desflurane in living donors undergoing right hepatectomy. (10)

Effects on hematologic and immune systems

  • It has the most rapid onset and offset among the volatile anesthetic drugs used for general anesthesia due to its low solubility in blood.

Biotransformation; reaction with CO2 absorbants; toxicity

  • Desflurane has been shown to react with the carbon dioxide absorbent in anesthesia circuits to produce detectable levels of carbon monoxide through degradation of the anesthetic agent.
  • The CO2 absorbent, Baralyme, when dried, is most culpable for the production of carbon monoxide from desflurane degradation, although it is also seen with soda lime absorbent as well.
  • Dry conditions in the carbon dioxide absorbent are conducive to this phenomenon, such as those resulting from high fresh gas flows

Minimum alveolar concentration and pressures

MAC = 6 vol %

Vapor pressure

672 mm Hg 88.5 kPa (at 20 deg C)

804 mm Hg 107 kPa (at 24 deg C)

 

Blood gas partition coefficient = 0.42

Oil: gas partition coefficient = 19

 

Trace concentrations, O.R. pollution, personnel hazards

  • Very pungent
  • Irritating to airways
  • Laryngospasm
  • Expensive
  • Desflurane is a green house gas and contributes to global warming.
  • Adverse effects associated with use of desflurane include arrhythmia, myocardial ischemia, vasodilation; hepatitis; agitation, diziiness; dyspnea, hypoxia;increased creatinine phosphokinase level; myalgia and pruritis

Advantages

  • Rapid onset/recovery
  • High potency (least soluble)
  • Even less metabolism

References: 

  1. WL Young. Effects of desflurane on the central nervous system. Anesthesia & Analagesia. 1992;75(4):S32-7. 
  2. DJA Vaughan, C Thornton, DR Wright, JR Fernandes, P Robbins, C Dore, MD Brunner. Effects of different concentrations of sevoflurane and desflurane on subcortical somatosensory evoked responses in anesthetized, non stimulated patients. Br J Anaesth. 2001;86(1):59-62.
  3. Weiskopf RB, Moore MA, Eqer EI, Noorani M, McKay L, Chortkoff B, Hart PS, Damask M. Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans. Anesthesiology 1994 May;80(5):1035-45. 
  4. Aypar E, Karaqoz AH, Ozer S, Celiker A, Ocal T. The effects of sevoflurane and desflurane anesthesia on QTc interval and cardiac rhythm in children. Paediatr Anaesth. 2007 Jun;17(6):563-7. 
  5. Behforouz N, Dubousset AM, Jamali S, Ecoffey C. Respiratory effects of desflurane anesthesia on spontaneous ventilation in infants and children. Anesth Analg. 1998 Nov;87(5):1052-5. 
  6. Warltier DC, Pagel PS. Cardiovascular and respiratory actions of desflurane: is desflurane different from isoflurane? Anesth Analg. 1992 Oct;75(4 Suppl):S17-29. 
  7. V. Nyktari, A papaioannou, N. Volakakis, A lappa, P Margaritsanaki, H Askitopoulou. Respiratory depression during anesthesia with isoflurane, sevoflurane and desflurane: a randomized clinical trial. Br J Anaesth 2011. 
  8. D Chassard, JP Tournadre, KR Berrada, B Bryssine, P Bouletreau. Effect of halothane, isoflurane anbd desflurane on lower esophageal sphincter tone. British Journal of anesthesia. 1996;77:781-783. 
  9. Litz RJ, Hubler M, Lorenz W, Meier VK, Albrecht DM. Renal responses to desflurane and isoflurane in patients with renal insufficiency. Anesthesiology 2002 Nov;97(5):1133-6. 
  10. Topark HI, Sahin T, Aslan S, Karahan K, Sanli M, Ersoy MO. Effects of desflurane and isoflurane on hepatic an drenal functions and coagulation profile during donor hepatectomy. Transplant Proc. 2012 Jul-Aug;44(6):1635-9. 

 

Mar 8, 2016

N2O

Effects on CNS

  • Mild depression of central nervous system (cerebral cortex) in conjunction with physiological levels of O2 (greater than 20%)
  • Sensations depressed (sight, hearing, touch and pain )
  • It offers both hypnotic and analgesic characteristics. It decreases the propofol consumption and does not reduce the remifentanil consumption when given by a closed loop automated controller to maintain a similar Bispectral index (BIS) (1)
  • In view of the limited evidence of human studies and the sufficient evidence of experimental studies, there is a significant association between exposure to nitrous oxide and Parkinson's disease. (2)
  • Nitrous oxide exerts analgesia by inhibition of N-methyl-D-aspartate receptors. However, nitrous oxide anesthesia was not associated with decreased opioid administration, pain, or incidence of moderate to severe pain in the early postoperative phase. (3)

Effects on circulation

  • Blood pressure remains stable with only slight decrease
  • Cutaneous vasodilation    
  • No changes in heart rate and cardiac output  
  • The pulmonary vascular resistance is increased due to constriction in pulmonary vascular smooth muscle, so nitrous oxide should be avoided in patients with pulmonary hypertension. (4)
  • Nitrous oxide result in less depression of cardiac index when given with isoflurane than when given with halothane. (5)

Effects on respiration

 

  • Changes (drop) in rate and depth more likely due to anxiolytic effects
  • Non irritating to pulmonary epithelium
  • Slight elevation in resting respiratory minute volume at 50%/50%
  • Nitrous oxide causes decrease in tidal volume and increase in respiratory rate. it also causes reduction in ventilatory response to hypoxia and hypercapnia. It decrease tracheal mucociliary flow and neutrophil chemotaxis. This may increase post operative complication. (4)

Effects on GI function

  • No clinically significant effect, unless there is a closed space (obstruction)
  • N/V rarely seen unless hypoxia present

Effects on neuromuscular function

  • No direct relaxation of skeletal muscle
  • Anxiolytic effects help relaxation
  • Administration of nitrous oxide may increase motor activity with clonus and opisthotonus even in clinically used concentration.

Effects on hepatic function

  • It can be used in hepatic dysfunction

Effects on hematologic and immune systems

  • Long term exposure (greater than 24 hours) can produce transient bone marrow depression.
  • Repeated use of nitrous oxide, particularly during lengthy procedures, may precipitate megaloblastic anemia and spinal cord degeneration. (4)

Other system

  • Uterine contractions not inhibited
  • Pregnancy is a relative contraindication (avoid in first trimester)
  • Nitrous oxide provided less effective pain relief than epidural anesthesia in labor pain management. (6)

Minimum alveolar concentration and pressures

  • Oil: gas partition coefficient = 1.4
  • Blood: gas partition coefficient = 0.47
  • MAC (%) = 105

Trace concentrations, O.R. pollution, personnel hazards

  • It is a compressed liquefied gas, an asphyxiation risk, and a dissociative anesthetic.
  • Acute toxicity: N/V
  • Exposure to Nitrous oxide causes short term decrease in mental performance, audio-visual ability and mental dexterity.
  • Long term exposure can cause vitamin B12 deficiency, numbness, reproductive side effects (in pregnant females)

Advantages

  • No odor
  • Fast induction and recovery
  • Minimal cardio pulmonary depression
  • Good analgesic
Clinical implications 
  • general anesthesia 
  • obstetrics 
  • pain management (4)

References

  1. Liu N, Le Guen M, Boichut N et al. Nitrous oxide does not produce a clinically important sparing effect during closed-loop delivered propofol-remifentanil anaesthesia guided by the bispectral index: a randomized multicentre study.Br J Anaesth. 2014 Jan 31. 
  2. Mastrangelo G, Comiati V, dell'Aquila M, Zamprogno E. Exposure to anesthetic gases and Parkinson's disease: a case report. BMC Neurol. 2013 Dec 9;13:194.
  3. Duma A, Helsten D, Brown F, Bottros MM, Nagele P. The effect of nitrous oxide anesthesia on early postoperative opioid consumption and pain.Reg Anesth Pain Med. 2014 Jan-Feb;39(1):31-6.
  4. Amelia Banks, Jonathan G Hardman. Nitrous Oxide. Contin Edus Anaesth Crit Care Pain (October 2005) 5(5): 145-148
  5. MS McKinney, JPH Fee. Cardiovascular effects of 50% nitrous oxide in older adult patients anesthetized with isoflurane or halothane. British Journal of Anesthesia. 1998; 80: 169-173. 
  6. Likis FE, Andrews JC, Collins MR, Lewis RM, Seroogy JJ, Starr SA, Walden RR, McPheeters ML. Nitrous oxide for the management of labor pain: a systematic review. Anesth Analg. 2014 Jan;118(1):153-67.

 

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

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DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

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Feb 2, 2016

Discussed in this Podcast

Renal Failure

Morphine

Fentanyl

Codeine

Buprenorphine

Oxycodone

Alfentanil

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References

http://www.bmj.com/rapid-response/2011/10/31/pain-management-renal-failure-choice-opioid

http://www.palliativedrugs.com/download/08_06_Prescribing%20Opioids%20in%20Renal%20Patients%5B1%5D%5B1%5D.pdf
 
http://www.jpsmjournal.com/article/S0885-3924(04)00335-5/fulltext#sec2.1

 

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

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Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

    

Jan 19, 2016

Dr. Rosenblum discusses why and how he made the leap from anesthesiology to pain management. He also covers how using ultrasound guided imaging from anesthesiology helps him to be a better pain management specialist.

 

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

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718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

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Jan 12, 2016

Basic information that any anesthesiologist should know regarding Trigeminal Neuralgia

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

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Dec 29, 2015

Dr. Rosenblum discusses a basic overview of the diagnosis and treatment of spinal stenosis.

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Dec 22, 2015

Dr. DerParghesian discusses Anesthesiology, Fellowships and the path he took to becoming a doctor.

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

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Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Dec 15, 2015

Dr. Rosenblum introduces pelvic pain for the anesthesia boards 

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For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

 

For Board Review and Practice Management Updates TEXT the word 

PMREXAM to the number 33444 

Dr. Rosenblum reviews diagnosis, eitology, and treatment of SI joint and Piriformis Syndrome.

For the full version, subscribe at PainExam.com for a premium membership.

For Board Review and Practice Management Updates TEXT the word 

PAINEXAM to the number 33444 

Download our iphone App!

Download our Android App!

 

 

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

Reference:

Benzon, HT, et al. Essentials of Pain Medicine and Regional Anesthesia. Second Edition. 2005. p. 410.

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

Dec 8, 2015

Dr. Rosenblum and Claire Flanagan, Marketing Director, discuss the merits and caveats of social media

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

Download our iphone App!

Download our Android App!

For more information on Pain Management Topics and keywords

Go to PainExam.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Dec 4, 2015

Dr. Rosenblum gives an introduction to pelvic pain.

For the Full Version, subscribe to the Premium Episode

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

Download our iphone App!

Download our Android App!

For more information on Pain Management Topics and keywords

Go to PainExam.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

Reference:

Benzon, HT, et al. Essentials of Pain Medicine and Regional Anesthesia. Second Edition. 2005. p. 410

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Nov 24, 2015

Dr. Rosenblum discusses the management of Phantom Limb Pain

For the Full Version, subscribe to the Premium Episode

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

Download our iphone App!

Download our Android App!

For more information on Pain Management Topics and keywords

Go to PainExam.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

Reference:

Benzon, HT, et al. Essentials of Pain Medicine and Regional Anesthesia. Second Edition. 2005. p. 394-398

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Nov 17, 2015

Dr. Rosenblum reviews diagnosis, eitology, and treatment of SI joint and Piriformis Syndrome.

For the full version, subscribe at PainExam.com for a premium membership.

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Anesthesiology Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For CRNA Board Prep, go to CRNABoardPrep.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

 

Reference:

Benzon, HT, et al. Essentials of Pain Medicine and Regional Anesthesia. Second Edition. 2005. p. 356-365.

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

Nov 10, 2015

Dr. Rosenblum gives a mock oral exam to CA-2 Dr. John on his first day of the pain rotation.  Discussed here:

CRPS

RSD

Stellate ganglion

atrophy

allodynia

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

 

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

Nov 3, 2015

In this second episode reviewing the 2015 guidelines, Dr. Rosenblum summarizes and quotes ASRAs latest Guidelines for Patients who are on anticoagulants and are planning to undergo pain procedures.

 

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

 References

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications: Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain

Regional Anesthesia & Pain Medicine:
Oct 27, 2015

Rey Soto of FRS Management discusses Cyber Security in a medical office, Hipaa, omnibus ruling with David Rosenblum, MD.

For more info go to ..

 www.NYTechservice.net 

718 887 9787

Fines for use of gmail, texting, lost laptop...

A MUST if you have a private office.

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Oct 20, 2015

In this second episode reviewing the 2015 guidelines, Dr. Rosenblum summarizes and quotes ASRAs latest Guidelines for Patients who are on anticoagulants and are planning to undergo pain procedures.

 

AnesthesiaExam Podcast 

For Board Review and Practice Management Updates TEXT the word 

ANESTHESIAEXAM to the number 33444 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 References

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications: Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain

Regional Anesthesia & Pain Medicine:
Oct 13, 2015

Dr. Rosenblum summarizes and quotes ASRAs latest Guidelines for Patients who are on anticoagulants and are planning to undergo pain procedures.

 

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 References

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications: Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain

Regional Anesthesia & Pain Medicine:
Oct 6, 2015

Salim Durrani and Dr. Rosenblum discuss use of the Suprascapular nerve block in the treatment of Cervical radiculitis.

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Sep 22, 2015

A review of Osteoarthritis  for the the Pain Practitioner.

For the remainder of the podcast and Ankylosing spondylitis please subscribe to our premium episodes

Discussed:

Joint Replacement

DMARDs

NSAIDs

Syndesmophytes

Crepitus

Xray findings

Bouchards

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

References

https://en.wikipedia.org/wiki/Ankylosing_spondylitis
https://en.wikipedia.org/wiki/Osteoarthritis
  1. "Ankylosing Spondylitis -Professional reference for Doctors - Patient UK"Patient UK. Retrieved 26 May 2014.
  2. Jump up ^ Jiménez-Balderas FJ, Mintz G (1993). "Ankylosing spondylitis: clinical course in women and men". J Rheumatol 20 (12): 2069–72. PMID 7516975.
  3. Jump up ^ Longo, Dan Louis; Fauci, Anthony S.; Harrison, Tinsley Randolph; Kasper, Dennis L.; Hauser, Stephen L.; Jameson, J. Larry; Loscalzo, Joseph (2012). Harrison's Principles of Internal Medicine. Vol. 1 (18th ed.). McGraw-Hill. ISBN 978-0-07-163244-7.
  4. Jump up ^ "Ankolysing Spondylitis"Arthritis Action. Retrieved 12 August 2015.
  5. Jump up ^ Thomas E, Silman AJ, Papageorgiou AC, Macfarlane GJ, Croft PR (1998). "Association between measures of spinal mobility and low back pain. An analysis of new attenders in primary care". Spine 23 (2): 343–7. doi:10.1097/00007632-199802010-00011PMID 9507623.
  6. Jump up ^ Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994). "A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index". J Rheumatol 21 (12): 2286–91. PMID 7699630.
  7. Jump up ^ Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, Jenkinson T (1994). "A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index". J Rheumatol 21 (12): 2281–5. PMID 7699629.
  8. Jump up ^ Toivanen A, Möttönen T (1998). "Ankylosing spondylitis: current approaches to treatment". BioDrugs 10 (3): 193–200. doi:10.2165/00063030-199810030-00003PMID 18020595.
  9. Jump up ^ Williams RO, Paleolog E, Feldmann M (2007). "Cytokine inhibitors in rheumatoid arthritis and other autoimmune diseases". Curr Opin Pharmacol 7 (4): 412–7. doi:10.1016/j.coph.2007.06.001PMID 17627887.
  10. Jump up ^ Kroon F, Landewé R, Dougados M, van der Heijde D (October 2012). "Continuous NSAID use reverts the effects of inflammation on radiographic progression in patients with ankylosing spondylitis"Ann. Rheum. Dis. 71 (10): 1623–9. doi:10.1136/annrheumdis-2012-201370PMID 22532639.
  11. Jump up ^ Chen J, Lin S, Liu C (27 November 2014). "Sulfasalazine for ankylosing spondylitis.". The Cochrane database of systematic reviews 11: CD004800. doi:10.1002/14651858.CD004800.pub3PMID 25427435.
  12. Jump up ^ Chen J, Veras MM, Liu C, Lin J (28 February 2013). "Methotrexate for ankylosing spondylitis.". The Cochrane database of systematic reviews 2: CD004524. doi:10.1002/14651858.CD004524.pub4PMID 23450553.
  13. Jump up ^ Braun J, van den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, Dagfinrud H, Dijkmans B, Dougados M, Emery P, Geher P, Hammoudeh M, Inman RD, Jongkees M, Khan MA, Kiltz U, Kvien T, Leirisalo-Repo M, Maksymowych WP, Olivieri I, Pavelka K, Sieper J, Stanislawska-Biernat E, Wendling D, Ozgocmen S, van Drogen C, van Royen B, van der Heijde D (June 2011). "2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis"Ann. Rheum. Dis. 70 (6): 896–904. doi:10.1136/ard.2011.151027PMC 3086052PMID 21540199.
  14. Jump up ^ Braun J, Sieper J (2007). "Ankylosing spondylitis". Lancet 369 (9570): 1379–90. doi:10.1016/S0140-6736(07)60635-7PMID 17448825.
  15. Jump up ^ Brulhart L, Nissen MJ, Chevallier P, Gabay C (February 2010). "Mixed response to tocilizumab for ankylosing spondylitis". Annals of the Rheumatic Diseases 69 (12): 2217–2218. doi:10.1136/ard.2009.126706PMID 20851032.
  16. Jump up ^ Rodríguez-Escalera C, Fernández-Nebro A (2008). "The use of rituximab to treat a patient with ankylosing spondylitis and hepatitis B". Rheumatology47 (11): 1732–1733. doi:10.1093/rheumatology/ken362PMID 18786966.
  17. Jump up ^ "Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions: overview and methodology". Phys Ther 81 (10): 1629–40. 2001. PMID 11589641.
  18. Jump up ^ Dagfinrud H, Kvien TK, Hagen KB (23 January 2008). "Physiotherapy interventions for ankylosing spondylitis.". The Cochrane database of systematic reviews (1): CD002822. doi:10.1002/14651858.CD002822.pub3PMID 18254008.
  19. Jump up ^ Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A (2002). "Ankylosing spondylitis: an overview"Ann. Rheum. Dis. 61 Suppl 3: iii8–18. doi:10.1136/ard.61.suppl_3.iii8PMC 1766729PMID 12381506.
  20. Jump up ^ Bond D (2013). "Ankylosing spondylitis: diagnosis and management". Nurs Stand 28 (16-18): 52–9; quiz 60. doi:10.7748/ns2013.12.28.16.52.e7807PMID 24345154.
  21. Jump up to: a b Alpert, Joseph S. (2006). The AHA Clinical Cardiac Consult. Lippincott Williams & Wilkins. ISBN 0-7817-6490-4.
  22. Jump up ^ Ahn NU, Ahn UM, Nallamshetty L, Springer BD, Buchowski JM, Funches L, Garrett ES, Kostuik JP, Kebaish KM, Sponseller PD (2001). "Cauda Equina Syndrome in AS (The CES-AS Syndrome): Meta-analysis of outcomes after medical and surgical treatments". J of Spinal Disorders 14 (5): 427–433. doi:10.1097/00002517-200110000-00009PMID 11586143.
  23. Jump up to: a b Bakland G, Gran JT, Nossent JC (November 2011). "Increased mortality in ankylosing spondylitis is related to disease activity". Ann. Rheum. Dis.70 (11): 1921–5. doi:10.1136/ard.2011.151191PMID 21784726.
  24. Jump up ^ Radford EP, Doll R, Smith PG (September 1977). "Mortality among patients with ankylosing spondylitis not given X-ray therapy". N. Engl. J. Med. 297(11): 572–6. doi:10.1056/NEJM197709152971103PMID 887115.
  25. Jump up ^ Del Din S, Carraro E, Sawacha Z, Guiotto A, Bonaldo L, Masiero S, Cobelli C (2011). "Impaired gait in ankylosing spondylitis". Med Biol Eng Comput 49(7): 801–9. doi:10.1007/s11517-010-0731-xPMID 21229328
  26. "Ankylosing Spondylitis -Professional reference for Doctors - Patient UK". Patient UK. Retrieved 26 May 2014.

    2.Jump up ^ Jiménez-Balderas FJ, Mintz G (1993). "Ankylosing spondylitis: clinical course in women and men". J Rheumatol 20 (12): 2069–72. PMID 7516975.

    3.Jump up ^ Longo, Dan Louis; Fauci, Anthony S.; Harrison, Tinsley Randolph; Kasper, Dennis L.; Hauser, Stephen L.; Jameson, J. Larry; Loscalzo, Joseph (2012). Harrison's Principles of Internal Medicine. Vol. 1 (18th ed.). McGraw-Hill. ISBN 978-0-07-163244-7.

    4.Jump up ^ "Ankolysing Spondylitis". Arthritis Action. Retrieved 12 August 2015.

    5.Jump up ^ Thomas E, Silman AJ, Papageorgiou AC, Macfarlane GJ, Croft PR (1998). "Association between measures of spinal mobility and low back pain. An analysis of new attenders in primary care". Spine 23 (2): 343–7. doi:10.1097/00007632-199802010-00011. PMID 9507623.

    6.Jump up ^ Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994). "A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index". J Rheumatol 21 (12): 2286–91. PMID 7699630.

    7.Jump up ^ Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, Jenkinson T (1994). "A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index". J Rheumatol 21 (12): 2281–5. PMID 7699629.

    8.Jump up ^ Toivanen A, Möttönen T (1998). "Ankylosing spondylitis: current approaches to treatment". BioDrugs 10 (3): 193–200. doi:10.2165/00063030-199810030-00003. PMID 18020595.

    9.Jump up ^ Williams RO, Paleolog E, Feldmann M (2007). "Cytokine inhibitors in rheumatoid arthritis and other autoimmune diseases". Curr Opin Pharmacol 7 (4): 412–7. doi:10.1016/j.coph.2007.06.001. PMID 17627887.

    10.Jump up ^ Kroon F, Landewé R, Dougados M, van der Heijde D (October 2012). "Continuous NSAID use reverts the effects of inflammation on radiographic progression in patients with ankylosing spondylitis". Ann. Rheum. Dis. 71 (10): 1623–9. doi:10.1136/annrheumdis-2012-201370. PMID 22532639.

    11.Jump up ^ Chen J, Lin S, Liu C (27 November 2014). "Sulfasalazine for ankylosing spondylitis.". The Cochrane database of systematic reviews 11: CD004800. doi:10.1002/14651858.CD004800.pub3. PMID 25427435.

    12.Jump up ^ Chen J, Veras MM, Liu C, Lin J (28 February 2013). "Methotrexate for ankylosing spondylitis.". The Cochrane database of systematic reviews 2: CD004524. doi:10.1002/14651858.CD004524.pub4. PMID 23450553.

    13.Jump up ^ Braun J, van den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, Dagfinrud H, Dijkmans B, Dougados M, Emery P, Geher P, Hammoudeh M, Inman RD, Jongkees M, Khan MA, Kiltz U, Kvien T, Leirisalo-Repo M, Maksymowych WP, Olivieri I, Pavelka K, Sieper J, Stanislawska-Biernat E, Wendling D, Ozgocmen S, van Drogen C, van Royen B, van der Heijde D (June 2011). "2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis". Ann. Rheum. Dis. 70 (6): 896–904. doi:10.1136/ard.2011.151027. PMC 3086052. PMID 21540199.

    14.Jump up ^ Braun J, Sieper J (2007). "Ankylosing spondylitis". Lancet 369 (9570): 1379–90. doi:10.1016/S0140-6736(07)60635-7. PMID 17448825.

    15.Jump up ^ Brulhart L, Nissen MJ, Chevallier P, Gabay C (February 2010). "Mixed response to tocilizumab for ankylosing spondylitis". Annals of the Rheumatic Diseases 69 (12): 2217–2218. doi:10.1136/ard.2009.126706. PMID 20851032.

    16.Jump up ^ Rodríguez-Escalera C, Fernández-Nebro A (2008). "The use of rituximab to treat a patient with ankylosing spondylitis and hepatitis B". Rheumatology 47 (11): 1732–1733. doi:10.1093/rheumatology/ken362. PMID 18786966.

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    25.Jump up ^ Del Din S, Carraro E, Sawacha Z, Guiotto A, Bonaldo L, Masiero S, Cobelli C (2011). "Impaired gait in ankylosing spondylitis". Med Biol Eng Comput 49 (7): 801–9. doi:10.1007/s11517-010-0731-x. PMID 21229328

  1. Jump up to: a b c d e f g h i "Osteoarthritis"National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2015. Retrieved 13 May 2015.
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  3. Jump up ^ Berenbaum F (2013). "Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!)". Osteoarthritis and Cartilage 21 (1): 16–21. doi:10.1016/j.joca.2012.11.012PMID 23194896.
  4. Jump up to: a b Conaghan P (2008). "Osteoarthritis — National clinical guideline for care and management in adults" (PDF).
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  7. Jump up ^ MedlinePlus Encyclopedia Osteoarthritis
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  9. Jump up ^ "Water on the knee"MayoClinic.com.
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  11. Jump up ^ Bosomworth NJ (September 2009). "Exercise and knee osteoarthritis: benefit or hazard?"Can Fam Physician 55 (9): 871–8. PMC 2743580PMID 19752252.
  12. Jump up ^ Deweber K, Olszewski M, Ortolano R (2011). "Knuckle cracking and hand osteoarthritis". J Am Board Fam Med 24 (2): 169–74. doi:10.3122/jabfm.2011.02.100156PMID 21383216.
  13. Jump up ^ Valdes AM, Spector TD (August 2008). "The contribution of genes to osteoarthritis". Rheum. Dis. Clin. North Am. 34 (3): 581–603. doi:10.1016/j.rdc.2008.04.008PMID 18687274.
  14. Jump up ^ Spector TD, MacGregor AJ (2004). "Risk factors for osteoarthritis: genetics". Osteoarthr. Cartil. 12 Suppl A: S39–44. doi:10.1016/j.joca.2003.09.005PMID 14698640.
  15. Jump up ^ Hogervorst T, Bouma HW, de Vos J (August 2009). "Evolution of the hip and pelvis.". Acta orthopaedica. Supplementum 80 (336): 1–39. doi:10.1080/17453690610046620PMID 19919389.
  16. Jump up ^ van der Kraan PM, van den Berg WB (April 2008). "Osteoarthritis in the context of ageing and evolution. Loss of chondrocyte differentiation block during ageing.". Ageing Research Reviews 7 (2): 106–13. doi:10.1016/j.arr.2007.10.001PMID 18054526.
  17. Jump up ^ Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C (May 2001). "Knee osteoarthritis and obesity". Int. J. Obes. Relat. Metab. Disord. 25 (5): 622–7. doi:10.1038/sj.ijo.0801585PMID 11360143.
  18. Jump up ^ Pottie P, Presle N, Terlain B, Netter P, Mainard D, Berenbaum F (November 2006). "Obesity and osteoarthritis: more complex than predicted!"Ann. Rheum. Dis. 65 (11): 1403–5. doi:10.1136/ard.2006.061994PMC 1798356PMID 17038451.
  19. Jump up ^ Linn S, Murtaugh B, Casey E (May 2012). "Role of sex hormones in the development of osteoarthritis". PM R 4 (5 Suppl): S169–73. doi:10.1016/j.pmrj.2012.01.013PMID 22632696.
  20. Jump up ^ Tanamas SK, Wijethilake P, Wluka AE, Davies-Tuck ML, Urquhart DM, Wang Y, Cicuttini FM (June 2011). "Sex hormones and structural changes in osteoarthritis: a systematic review". Maturitas 69 (2): 141–56. doi:10.1016/j.maturitas.2011.03.019PMID 21481553.
  21. Jump up ^ Ma HL, Blanchet TJ, Peluso D, Hopkins B, Morris EA, Glasson SS (June 2007). "Osteoarthritis severity is sex dependent in a surgical mouse model". Osteoarthr. Cartil. 15 (6): 695–700. doi:10.1016/j.joca.2006.11.005PMID 17207643.
  22. Jump up ^ King KB, Rosenthal AK (2015). "The adverse effects of diabetes on osteoarthritis: update on clinical evidence and molecular mechanisms". Osteoarthritis Cartilage 23 (6): 841–50. doi:10.1016/j.joca.2015.03.031PMID 25837996.
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  24. Jump up ^ Bollet AJ, Nance JL (July 1966). "Biochemical Findings in Normal and Osteoarthritic Articular Cartilage. II. Chondroitin Sulfate Concentration and Chain Length, Water, and Ash Content"J. Clin. Invest. 45 (7): 1170–7. doi:10.1172/JCI105423PMC 292789PMID 16695915.
  25. Jump up to: a b Brocklehurst R, Bayliss MT, Maroudas A, Coysh HL, Freeman MA, Revell PA, Ali SY (January 1984). "The composition of normal and osteoarthritic articular cartilage from human knee joints. With special reference to unicompartmental replacement and osteotomy of the knee". J Bone Joint Surg Am 66 (1): 95–106. PMID 6690447.
  26. Jump up ^ Chou MC, Tsai PH, Huang GS, Lee HS, Lee CH, Lin MH, Lin CY, Chung HW (April 2009). "Correlation between the MR T2 value at 4.7 T and relative water content in articular cartilage in experimental osteoarthritis induced by ACL transection". Osteoarthr. Cartil. 17 (4): 441–7. doi:10.1016/j.joca.2008.09.009PMID 18990590.
  27. Jump up ^ Grushko G, Schneiderman R, Maroudas A (1989). "Some biochemical and biophysical parameters for the study of the pathogenesis of osteoarthritis: a comparison between the processes of ageing and degeneration in human hip cartilage". Connect. Tissue Res. 19 (2–4): 149–76. doi:10.3109/03008208909043895PMID 2805680.
  28. Jump up ^ Mankin HJ, Thrasher AZ (January 1975). "Water content and binding in normal and osteoarthritic human cartilage". J Bone Joint Surg Am 57 (1): 76–80. PMID 1123375.
  29. Jump up to: a b Venn M, Maroudas A (April 1977). "Chemical composition and swelling of normal and osteoarthrotic femoral head cartilage. I. Chemical composition"Ann. Rheum. Dis. 36 (2): 121–9. doi:10.1136/ard.36.2.121PMC 1006646PMID 856064.
  30. Jump up ^ Madry H, Luyten FP, Facchini A (2012). "Biological aspects of early osteoarthritis". Knee Surg. Sports Traumatol. Arthrosc. 20 (3): 407–22. doi:10.1007/s00167-011-1705-8PMID 22009557.
  31. Jump up ^ Englund M, Roemer FW, Hayashi D, Crema MD, Guermazi A (2012). "Meniscus pathology, osteoarthritis and the treatment controversy". Nat. Rev. Rheumatol. 8 (7): 412–9. doi:10.1038/nrrheum.2012.69PMID 22614907.
  32. Jump up ^ Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, Zheng MH (2013). "Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes". Arthritis Res. Ther. 15 (6): 223. doi:10.1186/ar4405PMID 24321104.
  33. Jump up ^ Hill CL, Gale DG, Chaisson CE, Skinner K, Kazis L, Gale ME, Felson DT (2001). "Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis". J. Rheumatol. 28 (6): 1330–7. PMID 11409127.
  34. Jump up ^ Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001). "The association of bone marrow lesions with pain in knee osteoarthritis". Ann Intern Med. 2001 Apr 3;134(7):541-9 134 (7): 541–9. doi:10.7326/0003-4819-134-7-200104030-00007PMID 11281736.
  35. Jump up ^ Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, Herrero-Beaumont G, Kirschner S, Leeb BF, Lohmander LS, Mazières B, Pavelka K, Punzi L, So AK, Tuncer T, Watt I, Bijlsma JW (March 2010). "EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis". Ann. Rheum. Dis. 69 (3): 483–9. doi:10.1136/ard.2009.113100PMID 19762361.
  36. Jump up ^ Bierma-Zeinstra SM, Oster JD, Bernsen RM, Verhaar JA, Ginai AZ, Bohnen AM (August 2002). "Joint space narrowing and relationship with symptoms and signs in adults consulting for hip pain in primary care". J. Rheumatol. 29 (8): 1713–8. PMID 12180735.
  37. Jump up ^ Osteoarthritis (OA): Joint Disorders at Merck Manual of Diagnosis and Therapy Professional Edition
  38. Jump up ^ Phillips CR, Brasington RD (2010). "Osteoarthritis treatment update: Are NSAIDs still in the picture?"Journal of Musculoskeletal Medicine 27 (2).
  39. Jump up ^ Kalunian KC (2013). "Patient information: Osteoarthritis symptoms and diagnosis (Beyond the Basics)". UpToDate. Retrieved 15 February 2013.
  40. Jump up ^ Altman R, Alarcón G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Gray R (November 1990). "The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand". Arthritis Rheum. 33 (11): 1601–10. doi:10.1002/art.1780331101PMID 2242058.
Sep 8, 2015

Dr. Rosenblum discusses Rheumatoid Arthritis

Discussed in this podcast:

Diagnosis

Treatment

SLE

Osteoarthritis

DMARDs

Methotrexate

 

PainExam/AnesthesiaExam Podcast

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

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718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     References

  1. "Handout on Health: Rheumatoid Arthritis"National Institute of Arthritis and Musculoskeletal and Skin Diseases. August 2014. Retrieved 2 July 2015.
  2. ^ Majithia V, Geraci SA (2007). "Rheumatoid arthritis: diagnosis and management". Am. J. Med. 120 (11): 936–9. doi:10.1016/j.amjmed.2007.04.005PMID 17976416.
  3. Scott DL, Wolfe F, Huizinga TW (Sep 25, 2010). "Rheumatoid arthritis". Lancet 376 (9746): 1094–108. doi:10.1016/S0140-6736(10)60826-4PMID 20870100.
  4.  Singh, JA; Wells, GA; Christensen, R; Tanjong Ghogomu, E; Maxwell, L; Macdonald, JK; Filippini, G; Skoetz, N; Francis, D; Lopes, LC; Guyatt, GH; Schmitt, J; La Mantia, L; Weberschock, T; Roos, JF; Siebert, H; Hershan, S; Lunn, MP; Tugwell, P; Buchbinder, R (16 February 2011). "Adverse effects of biologics: a network meta-analysis and Cochrane overview.". The Cochrane database of systematic reviews (2): CD008794. PMID 21328309.
  5.  Efthimiou P, Kukar M (2010). "Complementary and alternative medicine use in rheumatoid arthritis: proposed mechanism of action and efficacy of commonly used modalities". Rheumatology international 30 (5): 571–86. doi:10.1007/s00296-009-1206-yPMID 19876631.
  6. "Rheumatoid Arthritis and Complementary Health Approaches". National Center for Complementary and Integrative Health. Retrieved July 1,2015.
  7. GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013."Lancet 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2PMC 4340604PMID 25530442.
  8. ^ Landré-Beauvais AJ (1800). La goutte asthénique primitive (doctoral thesis). Paris. reproduced in Landré-Beauvais AJ (2001). "The first description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800". Joint Bone spine 68 (2): 130–43. doi:10.1016/S1297-319X(00)00247-5PMID 11324929.
  9. Paget, Stephen A.; Lockshin, Michael D.; Loebl, Suzanne (2002). The Hospital for Special Surgery Rheumatoid Arthritis Handbook Everything You Need to Know. New York: John Wiley & Sons. p. 32. ISBN 9780471223344.
  10. Turesson C, O'Fallon WM, Crowson CS, Gabriel SE, Matteson EL (2003). "Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years"Ann. Rheum. Dis. 62 (8): 722–7. doi:10.1136/ard.62.8.722PMC 1754626PMID 12860726.
  11. Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston, eds. (2010). Davidson's principles and practice of medicine. (21st ed.). Edinburgh: Churchill Livingstone/Elsevier. ISBN 978-0-7020-3084-0.
  12. "An approach to Early Arthritis"Pn.lifehugger.com. 12 January 2009. Archived from the original on 2010-05-27.
  13. https://en.wikipedia.org/wiki/Rheumatoid_arthritis

 

 

     

Sep 1, 2015

Acute Back Pain

Diagnosis

MRI, CT scan, Bone Scintigraphy

X rays

Comorbid psychological illness, substance a buse

Cauda equina syndrome

Reference

Benzon HT Essentials of Pain Management and Regional Anesthesia. Second ed. 2005

p. 315-321

AnesthesiaExam Podcast 

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Aug 19, 2015

Brian Henck, MD, anesthesiology attending reviews the history, uses, and considerations of the Laryngeal Mask Airway.

AnesthesiaExam Podcast 

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For Basic and Advanced Anesthesia Exam Review, 

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David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Aug 11, 2015

David Rosenblum, MD interviews EP Cardiologist Ron Shnitzer, MD

Topics discussed in this podcast include:

QT Prolongation

Tricyclic Medication Side Effects

Cardiac Clearance vs. Optimization

Interventional Procedures in the Anticoagulated Patient

 

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

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For Basic and Advanced Anesthesia Exam Review, 

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For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

Download our iphone App!

Download our Android App!

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

     

Jul 21, 2015

Dr. Rosenblum interviews Dr. Schwartz of AABP Pain Management

Topics Discussed

Combined Anethesia Pain Jobs vs. 100% Pain Jobs

Private Practice vs. Academic Practice vs. Hybrid Anesthesia/Pain Jobs

growing a pain practice

Ethical Pain Medicine

Hippa 

Encryption

Ultrasound utility in practice growth

ERAS protocol

Narcotic sparing 

Acute Pain Practice

 

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Jul 15, 2015

David Rosenblum, MD interviews Pain Management Nurse, Darlene Saberito

Discussed on this Podcast:

Setting up a pain practice

Residents with bad attitudess

PI

Communication failures

Networking 

acute pain service

Alarm fatigue

regional anethesia service

AnesthesiaExam Podcast 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

 

 

     

Jul 14, 2015

Dr. Rosenblum Reviews Hot Board Review Topics:

Pronator Syndrome

Anterior Interiosseous Syndrome

Patient Controlled Analgesia

Ketamine

Hydromorphone

Methadone

Morphine

Fentanyl 

Suflentanil

 

For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. 

You should regularly consult a physician in matters relating to yours or another’s health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 

 

Copyright © 2015 QBazaar.com, LLC  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

References

Rodner CM et al. Pronator Syndrome and anterior interosseous syndrome. J Am Acad Orthop Surg. 2013 May ;21 (5):268-75.

Benzon HT.  Essentials of Pain Medicine and Regional Anethesia. 2nd ed 2005 p 239-245

Jul 7, 2015

Dr. Rosenblum Reviews this hot Anesthesia Board Topic

Mentioned in this Podcast:

WDN

Glutamate

NMDA

Peripheral and Central Sensitization

GABA analogs (Pregabalin, Gabapentin)

Hyperalgesia

Allodynia

Dr. Rosenblum Reviews this hot Pain Management Board Topic

Mentioned in this Podcast:

WDN

Glutamate

NMDA

Peripheral and Central Sensitization

GABA analogs (Pregabalin, Gabapentin)

Hyperalgesia

Allodynia

For more information on Pain Management Topics and keywords

Go to PainExam.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246     

References

Benzon HT. Preemptive Analgesia: Physiology and Clinical Studies. Essentials of Pain Medicine and Regional Analgesia.  Second Ed. p. 229-233.  
 
 
Mishra AK.  Pre-emptive analgesia: Recent trends and evidencesThe Indian Journal of Pain  REVIEW ARTICLE  2013  Vol 27  Issue : 3  Page : 114-120
 For more information, CME credit and MOCA and Primary Board Prep,

Go to AnesthesiaExam.com

For Basic and Advanced Anesthesia Exam Review, 

Go to ABAStagedExams.com

For the Pediatric Anesthesiology Board Review, Go to PedsAE.com

David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment

For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com

718 436 7246

 

 

References

Benzon HT. Preemptive Analgesia: Physiology and Clinical Studies. Essentials of Pain Medicine and Regional Analgesia.  Second Ed. p. 229-233.  
 
 


Mishra AK.  Pre-emptive analgesia: Recent trends and evidences

 

The Indian Journal of Pain  REVIEW ARTICLE  2013  Vol 27  Issue : 3  Page : 114-120