1
|
Pressler MP, Brenner B, Amgalan A, Mendelson AM. Approach to a patient with chemotherapy-induced peripheral neuropathy: problem-based learning discussion. Pain Med 2024; 25:303-305. [PMID: 38128041 DOI: 10.1093/pm/pnad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Mark P Pressler
- Department of Anesthesiology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
| | - Brian Brenner
- Department of Anesthesiology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
| | - Ariunzaya Amgalan
- Department of Anesthesiology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
| | - Andrew M Mendelson
- Department of Anesthesiology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
- Division of Pain Medicine, University of Virginia Medical Center, Charlottesville, VA 22903, United States
| |
Collapse
|
2
|
Pressler MP, Brenner B, Kohan LR, Mendelson AM. New-Onset Tinnitus After Dorsal Root Ganglion Stimulator Implantation: A Case Report. A A Pract 2024; 18:e01747. [PMID: 38416112 DOI: 10.1213/xaa.0000000000001747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Dorsal column (dcSCS) and dorsal root ganglion stimulation (DRG-S) complications are similar, typically related to placement and device failure. We present the first case of tinnitus after DRG-S implantation. The patient presented with complex regional pain syndrome (CRPS) type 2. After previous failed treatments, she had a lumbosacral DRG-S trial, which provided relief; however, she briefly noted ringing in her ears. After permanent implantation, she reported persistent, intolerable left-sided tinnitus. Tinnitus can be modulated by secondary somatosensory inputs to the cochlear nucleus from the dcSCS. Therefore, lumbosacral DRG-S stimulating distal sensory neurons leading to tinnitus is a feasible complication.
Collapse
Affiliation(s)
- Mark P Pressler
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Brian Brenner
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Lynn R Kohan
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
- Department of Anesthesiology, University of Virginia Pain Management Center, Charlottesville, Virginia
| | - Andrew M Mendelson
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
- Department of Anesthesiology, University of Virginia Pain Management Center, Charlottesville, Virginia
| |
Collapse
|
3
|
Schmidt RF, Vibbert MD, Vernick CA, Mendelson AM, Harley C, Labella G, Houser J, Becher P, Simko E, Jabbour PM, Tjoumakaris SI, Gooch MR, Sharan AD, Farrell CJ, Harrop JS, Rosenwasser RH, Jaffe RC, Jallo J. Standardizing postoperative handoffs using the evidence-based IPASS framework through a multidisciplinary initiative improves handoff communication for neurosurgical patients in the neuro-intensive care unit. J Clin Neurosci 2021; 92:67-74. [PMID: 34509265 DOI: 10.1016/j.jocn.2021.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 07/13/2021] [Accepted: 07/25/2021] [Indexed: 11/25/2022]
Abstract
Errors in communication are a major source of preventable medical errors. Neurosurgical patients frequently present to the neuro-intensive care unit (NICU) postoperatively, where handoffs occur to coordinate care within a large multidisciplinary team. A multidisciplinary working group at our institution started an initiative to improve postoperative neurosurgical handoffs using validated quality improvement methodology. Baseline handoff practices were evaluated through staff surveys and serial observations. A formalized handoff protocol was implemented using the evidence based IPASS format (Illness severity, Patient summary, Action list, Situational awareness and contingency planning, Synthesis by receiver). Cycles of objective observations and surveys were employed to track practice improvements and guide iterative process changes over one year. Surveys demonstrated improved perceptions of handoffs as organized (17.1% vs 69.7%, p < 0.001), efficient (27.0% vs. 72.7%, p < 0.001), comprehensive (17.1% vs. 66.7%, p < 0.001), and safe (18.0% vs. 66.7%, p < 0.001), noting improved teamwork (31.5% vs. 69.7%, p < 0.001). Direct observations demonstrated improved communication of airway concerns (47.1% observed vs. 92.3% observed, p < 0.001), hemodynamic concerns (70.6% vs. 97.1%, p = 0.001), intraoperative events (52.9% vs. 100%, p < 0.001), neurological examination (76.5% vs. 100%, p < 0.001), vital sign goals (70.6% vs. 100%, p < 0.001), and required postoperative studies (76.5% vs. 100%, p < 0.001). Receiving teams demonstrating improved rates of summarization (47.1% vs. 94.2%, p = 0.005) and asking questions (76.5% vs 98.1%, p = 0.004). The mean handoff time during long-term follow-up was 4.4 min (95% confidence interval = 3.9-5.0 min). Standardization of handoff practices yields improvements in communication practices for postoperative neurosurgical patients.
Collapse
Affiliation(s)
- Richard F Schmidt
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States.
| | - Matthew D Vibbert
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Coleen A Vernick
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Andrew M Mendelson
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Caitlin Harley
- Department of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Giuliana Labella
- Department of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jessica Houser
- Department of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Patrick Becher
- Department of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Erin Simko
- Department of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Pascal M Jabbour
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | | | - M Reid Gooch
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Ashwini D Sharan
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Christopher J Farrell
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - James S Harrop
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Robert H Rosenwasser
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Rebecca C Jaffe
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jack Jallo
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| |
Collapse
|
4
|
Mendelson AM, Kohan L, Okai J, Wanees M, Gonnella JC, Torjman MC, Viscusi ER, Schwenk ES. Adverse drug effects related to multiday ketamine infusions: multicenter study. Reg Anesth Pain Med 2020; 45:rapm-2019-101173. [PMID: 32054666 DOI: 10.1136/rapm-2019-101173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/26/2019] [Accepted: 12/29/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Andrew M Mendelson
- Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Lynn Kohan
- Division of Pain Medicine/Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
| | - Joseph Okai
- Division of Pain Medicine/Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
| | - Mariam Wanees
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joseph C Gonnella
- Department of Anesthesiology, Division of Pain Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Marc C Torjman
- Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Eugene R Viscusi
- Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Eric S Schwenk
- Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| |
Collapse
|