Publications by authors named "Bhavana Yalamuru"

5 Publications

  • Page 1 of 1

Peripheral Nerve Injections.

Phys Med Rehabil Clin N Am 2022 05;33(2):489-517

Pain Division, Department of Anesthesiology, University of Virginia Health System, 475 Ray C Hunt Drive, Charlottesville, VA 22903, USA.

Ultrasound techniques and peripheral nerve stimulation have increased the interest in peripheral nerve injections for chronic pain. The knowledge of anatomy and nerve distribution patterns is paramount for optimal use of peripheral nerve blocks in the management of chronic pain conditions. They are an important tool in an interventional pain physician's armamentarium and can be integrated into pain practices effectively to offer patients pain relief.
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http://dx.doi.org/10.1016/j.pmr.2022.02.004DOI Listing
May 2022

Minimally-invasive pain management techniques in palliative care.

Ann Palliat Med 2022 Feb 16;11(2):947-957. Epub 2021 Aug 16.

Department of Anesthesiology & Pain Management, University of Texas - Southwestern, Dallas, Texas, USA.

Pain is a common source of suffering for seriously ill patients. Typical first-line treatments consist of lifestyle modifications and medication therapy, including opioids. However, medical treatments often fail or are associated with limiting systemic toxicities, and more targeted interventional approaches are necessary. Herein, we present options for minimally invasive techniques for the alleviation of pain in palliative patients from a head-to-toe approach, with a focus on emerging therapies and advanced techniques. Head and neck: image-guided interventions targeted to sympathetic ganglia of the head and neck, such as sphenopalatine ganglion (SPG) and stellate ganglion, have been shown to be effective for some forms of sympathetically-maintained and visceral pain. Interventions targeting branches of cranial nerves and upper cervical nerves, such as the glossopharyngeal nerve (GPN), are options in treating somatic head and face pain. Abdominal and pelvic: sympathetic blocks, including celiac plexus, inferior hypogastric, and ganglion impar can relieve visceral abdominal and pelvic pain. Spine and somatic pain: fascial plane blocks of the chest and abdominal wall and myofascial trigger point injections can be used for somatic pain indications. Cementoplasties, such as kyphoplasty and vertebroplasty, are used for pain related to bony metastases and compression fractures. Tumor ablative techniques can also be used for lytic lesions of the bone. Spinal cord stimulation (SCS), intrathecal drug delivery systems (IDDS), and cordotomy have also been used successfully in patients requiring advanced options, such as those with significant spinal, ischemic, or visceral pain.
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http://dx.doi.org/10.21037/apm-20-2386DOI Listing
February 2022

Representation of women as editors in major pain journals.

Reg Anesth Pain Med 2021 04 16;46(4):356-357. Epub 2020 Nov 16.

Department of Anesthesia University of Iowa, Iowa City, Iowa, USA

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http://dx.doi.org/10.1136/rapm-2020-101675DOI Listing
April 2021

SEER Sonorheometry Versus Rotational Thromboelastometry in Large Volume Blood Loss Spine Surgery.

Anesth Analg 2016 12;123(6):1380-1389

From the Departments of *Anesthesiology, †Neurosurgery, University of Virginia, Charlottesville, Virginia; and ‡Department of Anesthesiology, University of Iowa, Iowa City, Iowa.

Background: Sonic estimation of elasticity via resonance (SEER) sonorheometry is a novel technology that uses acoustic deformation of the developing clot to measure its viscoelastic properties and extract functional measures of coagulation. Multilevel spine surgery is associated with significant perioperative blood loss, and coagulopathy occurs frequently. The aim of this study was to correlate SEER sonorheometry results with those of equivalent rotation thromboelastometry (ROTEM) and laboratory parameters obtained during deformity correction spine surgery.

Methods: Four independent SEER sonorheometry hemostatic indices (clot time, clot stiffness, fibrinogen, and platelet contribution) were measured. SEER sonorheometry clot time, using kaolin as an activator, was correlated with ROTEM intrinsic temogram clotting time and the activated partial thromboplastin time. For clot stiffness, thromboplastin was the primary activator, and this was correlated against ROTEM external temogram amplitude at 10 minutes (A10). The assay for the fibrinogen contribution was similar to clot stiffness, but abciximab was added to inhibit platelet function. The fibrinogen contribution assay was correlated with the ROTEM fibrinogen temogram A10. Finally, the SEER sonorheometry platelet contribution was calculated by subtracting the fibrinogen contribution from the clot stiffness. This variable was correlated with both absolute platelet counts, and ROTEM determined clot elasticity attributable to platelets.

Results: Fifty-one patients were enrolled in this prospective observational study. SEER sonorheometry clot stiffness, fibrinogen, and platelet contribution had a very strong correlation with ROTEM external temogram A10 (rs = .92; 99% confidence interval, .85-.96), fibrinogen temogram A10 (rs = .90; 99% confidence interval, .83-.93), and ROTEM-determined clot elasticity attributable to platelets (rs = .89; 99% confidence interval, .80-.95). SEER sonorheometry clot time exhibited moderate correlation with ROTEM intrinsic temogram clotting time (rs = .62; 99% confidence interval, .44-.77) and very weak correlation with activated partial thromboplastin time (rs = .33; 99% confidence interval, .10-.51).

Conclusions: SEER sonorheometry demonstrates very strong correlation with ROTEM for determining clot stiffness and assessing fibrinogen and platelet contribution to clot strength in major spine surgery. An advantage of SEER sonorheometry is direct measurement of clot elasticity with no need to transform amplitude oscillation to elasticity.
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http://dx.doi.org/10.1213/ANE.0000000000001509DOI Listing
December 2016

Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine.

Indian J Anaesth 2013 May;57(3):265-9

Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

Aims: Intravenous (IV) dexmedetomidine with excellent sedative properties has been shown to reduce analgesic requirements during general anaesthesia. A study was conducted to assess the effects of IV dexmedetomidine on sensory, motor, haemodynamic parameters and sedation during subarachnoid block (SAB).

Methods: A total of 50 patients undergoing infraumbilical and lower limb surgeries under SAB were selected. Group D received IV dexmedetomidine 0.5 mcg/kg bolus over 10 min prior to SAB, followed by an infusion of 0.5 mcg/kg/h for the duration of the surgery. Group C received similar volume of normal saline infusion. Time for the onset of sensory and motor blockade, cephalad level of analgesia and duration of analgesia were noted. Sedation scores using Ramsay Sedation Score (RSS) and haemodynamic parameters were assessed.

Results: Demographic parameters, duration and type of surgery were comparable. Onset of sensory block was 66±44.14 s in Group D compared with 129.6±102.4 s in Group C. The time for two segment regression was 111.52±30.9 min in Group D and 53.6±18.22 min in Group C and duration of analgesia was 222.8±123.4 min in Group D and 138.36±21.62 min in Group C. The duration of motor blockade was prolonged in Group D compared with Group C. There was clinically and statistically significant decrease in heart rate and blood pressures in Group D. The mean intraoperative RSS was higher in Group D.

Conclusion: Administration of IV dexmedetomidine during SAB hastens the onset of sensory block and prolongs the duration of sensory and motor block with satisfactory arousable sedation.
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http://dx.doi.org/10.4103/0019-5049.115616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748681PMC
May 2013
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