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Jiang L, Liu T, Li Z, Tang Z, Zhou X, Xiong B, Zhang L. Clinical Study of a Four-Step Program for the Treatment of Plantar Fasciitis with Bone Spurs. Orthop Surg 2024; 16:1374-1380. [PMID: 38693719 PMCID: PMC11144503 DOI: 10.1111/os.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVE The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co-exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four-step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment. METHODS Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four-step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre-and postoperative AOFAS, FAOS, and VAS scores were compared using repeated-measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t-tests. RESULTS The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow-up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05). CONCLUSION The four-step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs.
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Affiliation(s)
- Lu Jiang
- School of Traditional Chinese and Western MedicineSouthwest Medical UniversityLuzhouChina
| | - Tianyu Liu
- School of Clinical MedicineSouthwest Medical UniversityLuzhouChina
| | - Zhenyi Li
- School of Clinical MedicineSouthwest Medical UniversityLuzhouChina
| | - Zihui Tang
- School of Traditional Chinese and Western MedicineSouthwest Medical UniversityLuzhouChina
| | - Xin Zhou
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhouChina
- Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhouChina
- Luzhou Key Laboratory of Orthopedic DisordersLuzhouChina
| | - Bin Xiong
- School of Clinical MedicineSouthwest Medical UniversityLuzhouChina
| | - Lei Zhang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhouChina
- Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhouChina
- Luzhou Key Laboratory of Orthopedic DisordersLuzhouChina
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Peña-Martínez VM, Acosta-Olivo C, Simental-Mendía LE, Sánchez-García A, Jamialahmadi T, Sahebkar A, Vilchez-Cavazos F, Simental-Mendía M. Effect of corticosteroids over plantar fascia thickness in plantar fasciitis: a systematic review and meta-analysis. PHYSICIAN SPORTSMED 2024; 52:217-228. [PMID: 37293970 DOI: 10.1080/00913847.2023.2223673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/03/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Corticosteroid injections have been typically used for the management of plantar fasciitis with apparently good clinical outcomes; however, there is no information of the effect of corticosteroids on the thickness of the plantar fascia which is typically altered in this pathology. We aimed determine whether treatment with corticosteroid injections induces plantar fascia thickness changes in plantar fasciitis. METHODS MEDLINE, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCT) reporting the use of corticosteroid injection to treat plantar fasciitis to July 2022. Studies must have reported plantar fascia thickness measurement. The risk of bias in all studies was assessed with the Cochrane Risk of Bias 2.0 tool. Meta-analysis was conducted using a random-effects model and the generic inverse variance method. RESULTS Data from 17 RCT (including 1109 subjects) were collected. The follow-up period ranged from one to six months. Most studies measured the thickness of the plantar fascia at the insertion into the calcaneus using ultrasound. Pooled analysis revealed that corticosteroid injections had no significant effect on plantar fascia thickness (weighted mean differences [WMD], 0.06 mm [95% CI: -0.17, 0.29]; p = 0.61) or pain relief (WMD, 0.12 cm [95% CI: -0.36, 0.61]; p = 0.62) above active controls. CONCLUSION Corticosteroid injections do not perform better than other common interventions in terms of a decrease of plantar fascia thickness and pain relief for plantar fasciitis.
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Affiliation(s)
- Víctor M Peña-Martínez
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Carlos Acosta-Olivo
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | | | - Adriana Sánchez-García
- Universidad Autonoma de Nuevo Leon, Endocrinology Division, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Tannaz Jamialahmadi
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Félix Vilchez-Cavazos
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Mario Simental-Mendía
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
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A. L. Kalbani F, Shalash R, Qadah R, Shousha T. Comparing two protocols of shock wave therapy for patients with plantar fasciitis: A pilot study. PLoS One 2024; 19:e0302553. [PMID: 38709797 PMCID: PMC11073689 DOI: 10.1371/journal.pone.0302553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/29/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES This pilot study primarily aimed to detect the adherence as well as the effect size required to estimate the actual sample size needed for a larger scale study to compare and evaluate the effectiveness of two extracorporeal shock wave therapy (ESWT) protocols along, with a physical therapy program in reducing pain and improving function among patients suffering from plantar fasciitis. The study also aimed to report the effects of the ESWT protocols used on pain and function. METHODS A total of 26 participants took part in the study, including 17 females and 9 males. The average age of the participants was 34 years with a body mass index (BMI) of 23 kg/m2. Participants were divided into three equal groups; Group A received ESWT at a frequency of 15 Hz and intensity of 3, Group B received ESWT at a frequency of 10 Hz and intensity of 4, while Group C underwent the selected physical therapy program along with sham shock wave therapy as a control. Pain levels were assessed using the Visual Analog Scale (VAS) while functional improvements were evaluated using the Foot Function Index (FFI). Data was collected prior to treatment, after three sessions and at the end of six weeks (after six sessions). RESULTS The three groups were well matched, and the results revealed high adherence rates (90%, 90% and 80% respectively). Results also indicated reductions in pain levels and improvements in function for both intervention groups when compared to the control group. Group A demonstrated better outcomes compared to Group B while Group C showed relatively less improvement. CONCLUSION The study concluded a high adherence rate for the three groups as well as a small effect size detected of 0.282 that would suggest a total of 123 participants to be required to replicate the study on a larger scale. With regards to the findings of this pilot, the combination of ESWT and a targeted physical therapy program revealed a possible effective therapeutic approach for plantar fasciitis, with a higher frequency potentially yielding more favourable results.
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Affiliation(s)
- Fatima A. L. Kalbani
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Reime Shalash
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
| | - Raneen Qadah
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
| | - Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
- Faculty of Physical Therapy, Department of Physical Therapy for Musculoskeletal Disordered and its Surgery, Cairo University, Cairo, Egypt
- University of Sharjah Center of Excellence for Healthy Aging, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, Healthy Aging, longevity, and Sustainability Research Group, University of Sharjah, Sharjah, UAE
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Tas NP, Kaya O. Treatment of Plantar Fasciitis in Patients with Calcaneal Spurs: Radiofrequency Thermal Ablation or Extracorporeal Shock Wave Therapy? J Clin Med 2023; 12:6503. [PMID: 37892641 PMCID: PMC10607467 DOI: 10.3390/jcm12206503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES We aimed to compare the effectiveness of ESWT (Extracorporeal Shock Wave Therapy) and RFA (Radiofrequency Thermal Ablation) on pain, disability, and activity limitation in the treatment of plantar fasciitis in patients with calcaneal spurs. MATERIALS AND METHODS Patients who apply to Orthopedics and Traumatology and Physical Medicine and Rehabilitation departments with a complaint of heel pain are included in this retrospective study. We included patients diagnosed with calcaneal spurs who received treatment with ESWT (n = 80) and RFA (n = 79) between 1 August 2021 and 1 September 2022. All patients were evaluated using the Visual Analog Scale (VAS), Foot Function Index (FFI), and the Roles and Maudsley score (RM) before and after treatment. An evaluation was performed on average 6 months after treatment. RESULTS This study included 79 RFA patients (34 females and 45 males) with a mean age of 55.8 ± 9.6 years and 80 ESWT patients (20 females and 60 males) with a mean age of 49.1 ± 9.5 years. There was a significant decrease in VAS scores after treatment in both the RFA and ESWT groups (z: -4.98, z: -5.18, respectively, p < 0.001). The reductions in FFI pain, FFI activity restriction, FFI disability, and RM scores were significant in both groups, although the scores after treatment were lower in the RFA group. CONCLUSIONS This study demonstrates that ESWT and RFA significantly reduced pain, disability, and activity restriction in the treatment of plantar fasciitis in patients with calcaneal spurs. ESWT proved particularly effective in alleviating pain, whereas RFA had more pronounced effects on reducing disability and activity limitations. The choice of treatment should be based on the patient's specific complaints.
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Affiliation(s)
- Nevsun Pihtili Tas
- Department of Physical Medicine and Rehabilitation, Health Sciences University Elazig Fethi Sekin City Hospital, Elazıg 23280, Turkey
| | - Oğuz Kaya
- Department of Orthopedics and Traumatology, Elazig Fethi Sekin City Hospital, Elazıg 23280, Turkey;
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Verhaegen F, Butterworth KT, Chalmers AJ, Coppes RP, de Ruysscher D, Dobiasch S, Fenwick JD, Granton PV, Heijmans SHJ, Hill MA, Koumenis C, Lauber K, Marples B, Parodi K, Persoon LCGG, Staut N, Subiel A, Vaes RDW, van Hoof S, Verginadis IL, Wilkens JJ, Williams KJ, Wilson GD, Dubois LJ. Roadmap for precision preclinical x-ray radiation studies. Phys Med Biol 2023; 68:06RM01. [PMID: 36584393 DOI: 10.1088/1361-6560/acaf45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/30/2022] [Indexed: 12/31/2022]
Abstract
This Roadmap paper covers the field of precision preclinical x-ray radiation studies in animal models. It is mostly focused on models for cancer and normal tissue response to radiation, but also discusses other disease models. The recent technological evolution in imaging, irradiation, dosimetry and monitoring that have empowered these kinds of studies is discussed, and many developments in the near future are outlined. Finally, clinical translation and reverse translation are discussed.
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Affiliation(s)
- Frank Verhaegen
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
- SmART Scientific Solutions BV, Maastricht, The Netherlands
| | - Karl T Butterworth
- Patrick G. Johnston, Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Anthony J Chalmers
- School of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - Rob P Coppes
- Departments of Biomedical Sciences of Cells & Systems, Section Molecular Cell Biology and Radiation Oncology, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Dirk de Ruysscher
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Sophie Dobiasch
- Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Germany
- Department of Medical Physics, Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Germany
| | - John D Fenwick
- Department of Medical Physics & Biomedical Engineering University College LondonMalet Place Engineering Building, London WC1E 6BT, United Kingdom
| | | | | | - Mark A Hill
- MRC Oxford Institute for Radiation Oncology, University of Oxford, ORCRB Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
| | - Constantinos Koumenis
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kirsten Lauber
- Department of Radiation Oncology, University Hospital, LMU München, Munich, Germany
- German Cancer Consortium (DKTK), Partner site Munich, Germany
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester, NY, United States of America
| | - Katia Parodi
- German Cancer Consortium (DKTK), Partner site Munich, Germany
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München, Garching b. Munich, Germany
| | | | - Nick Staut
- SmART Scientific Solutions BV, Maastricht, The Netherlands
| | - Anna Subiel
- National Physical Laboratory, Medical Radiation Science Hampton Road, Teddington, Middlesex, TW11 0LW, United Kingdom
| | - Rianne D W Vaes
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Ioannis L Verginadis
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Germany
- Physics Department, Technical University of Munich (TUM), Germany
| | - Kaye J Williams
- Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - George D Wilson
- Department of Radiation Oncology, Beaumont Health, MI, United States of America
- Henry Ford Health, Detroit, MI, United States of America
| | - Ludwig J Dubois
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
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Ahadi T, Cham MB, Mirmoghtadaei M, Raissi GR, Janbazi L, Zoghi G. The effect of dextrose prolotherapy versus placebo/other non-surgical treatments on pain in chronic plantar fasciitis: a systematic review and meta-analysis of clinical trials. J Foot Ankle Res 2023; 16:5. [PMID: 36759882 PMCID: PMC9912486 DOI: 10.1186/s13047-023-00605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Prolotherapy is the injection of a small volume of sclerosing or irritant solutions into an injured tissue. We aimed to investigate the effect of dextrose prolotherapy (DPT) versus placebo/other non-surgical treatments on pain in chronic plantar fasciitis. METHODS We searched seven electronic databases (PubMed/MEDLINE, Web of Science, EMBASE, Scopus, ProQuest, CENTRAL, PEDro) from inception to December 31, 2021 with no language restriction for publications comparing the effect of DPT with placebo/other non-surgical treatments in patients with chronic plantar fasciitis. Our primary outcome was pain and the secondary outcomes were foot function and plantar fascia thickness. The risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS Overall, eight studies with a total of 449 patients were included in the meta-analysis. All the included studies reported short-term pain. A large effect size (dppc2 = -0.97, 95% confidence interval [CI] -1.84 to -0.10) was observed favoring the use of DPT to reduce pain in patients with chronic plantar fasciitis in the short-term. The results for foot function improvement (dppc2 = -1.28, 95% CI -2.49 to -0.07) and plantar fascia thickness reduction (dppc2 = -1.02, 95% CI -1.99 to -0.05) in the short-term were also in favor of DPT. CONCLUSIONS Since almost all the included studies had high risk of bias and multiple trials lacked long-term follow-ups, further high-quality research is required to determine the long-term effects of DPT vs placebo/other non-surgical interventions.
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Affiliation(s)
- Tannaz Ahadi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masumeh Bagherzadeh Cham
- Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mahtab Mirmoghtadaei
- Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Gholam Reza Raissi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Lobaneh Janbazi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghazal Zoghi
- grid.412237.10000 0004 0385 452XEndocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Vij N, Kaley HN, Robinson CL, Issa PP, Kaye AD, Viswanath O, Urits I. Clinical Results Following Conservative Management of Tarsal Tunnel Syndrome Compared With Surgical Treatment: A Systematic Review. Orthop Rev (Pavia) 2022; 14:37539. [PMID: 36072502 DOI: 10.52965/001c.37539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Posterior tarsal tunnel syndrome involves entrapment of the posterior tibial nerve as it travels in the groove posterior to the medial malleolus. Conventional wisdom dictates that patients with tarsal tunnel syndrome be treated with conservative treatment and medical management, with surgical options available for patients with refractory symptoms and good candidacy. Minimally invasive options for neuropathic entrapment syndromes have developed in recent years and may provide a therapeutic role in tarsal tunnel syndrome. Objective The present investigation provides a summary of the current state of knowledge on tarsal tunnel syndrome and a comparison between minimally invasive and surgical treatment options. Methods The literature search was performed in Mendeley. Search fields were varied until redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. A full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by 3 authors until an agreement was reached. Results Most commonly tarsal tunnel syndrome is idiopathic. Other reported causes include post-traumatic, lipomas, cysts, ganglia, schwannomas, ganglia, varicose plantar veins, anatomic anomalies, and systematic inflammatory conditions. Several risk factors have been described including female gender, athletic participation, hypothyroidism, diabetes mellitus, systemic sclerosis, chronic renal failure, and hemodialysis use. A few recent studies demonstrate anatomic variants that have not previously been summarized. Three articles describe clinical outcomes after conservative treatment with acceptable results for first line treatment. Two primary articles report on the use of minimally invasive treatment for tarsal tunnel syndrome. Fourteen articles report on the clinical outcomes after surgical management. Conclusion Clinical understanding of tarsal tunnel syndrome has evolved significantly, particularly with regards to the pathoanatomy of the tarsal canal over the past twelve years. A few novel anatomic studies shed light on variants that can be helpful in diagnosis. Conservative management remains a good option that can resolve the symptoms of many patients. As more prospective cohorts and clinical trials are performed on minimally invasive options, pulsed radiofrequency and neuromodulation may evolve to play a larger role in the treatment of this condition. Currently, surgical treatment is only pursued in a very select group of patients with refractory symptoms that do not respond to medical or minimally invasive options. Surgical outcomes in the literature are good and current evidence is stronger than that for minimally invasive options.
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Affiliation(s)
- Neeraj Vij
- University of Arizona College of Medicine - Phoenix
| | | | - Christopher L Robinson
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School
| | - Peter P Issa
- Louisiana State University Health Shreveport School of Medicine
| | - Alan D Kaye
- Louisiana State University, Department of Anesthesiology
| | - Omar Viswanath
- Louisiana State University Health Shreveport, Department of Anesthesiology; Creighton University School of Medicine, Department of Anesthesiology
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport
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