Evidence map›Paper›PMID 39239613›Full record

ArticleInterventional pain medicine2023

Best practices for interventional pain procedures in the setting of a local anesthetic shortage: A practice advisory from the Spine Intervention Society.

Ameet S Nagpal, Zirong Zhao, David C Miller, Zachary L McCormick, Belinda Duszynski, Jacob Benrud, Robert Chow, Katherine Travnicek, Nathaniel M Schuster

Abstract read
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In one paragraph

Article in Interventional pain medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ameet S NagpalDepartment of Orthopaedics & Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
Zirong ZhaoDepartment of Neurology, Veterans Affairs Medical Center, Washington, DC, USA.
David C MillerQ C Kinetix, Denver, CO, USA.
Zachary L McCormickDepartment of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Belinda DuszynskiSpine Intervention Society, Hinsdale, IL, USA.
Jacob BenrudDepartment of Anesthesiology & Perioperative Medicine, Penn State College of Medicine, Hershey, PA, USA.
Robert ChowDepartment of Anesthesiology, Yale University, New Haven, CT, USA.
Katherine TravnicekPain Institute of Nevada, Las Vegas, NV, USA.
Nathaniel M SchusterCenter for Pain Medicine, Department of Anesthesiology, University of California, San Diego Health System, La Jolla, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Representatives from the Spine Intervention Society (SIS) Standards Division and Evidence Analysis Committee have developed the following best practice recommendations for the performance of interventional pain procedures in the setting of a local anesthetic shortage. The practice advisory has been endorsed by SIS, the American Academy of Pain Medicine, the American College of Radiology, the American Society of Neuroradiology, the American Society of Spine Radiology, the North American Neuromodulation Society, the North American Spine Society, and the Society of Interventional Radiology, who support the following best practice recommendations and statements for the performance of intra-articular, extra-articular, paraspinal, and epidural injections in the setting of a local anesthetic shortage. 1.Use of preservative-containing local anesthetics is discouraged in the performance of neuraxial procedures where the injectate may enter the epidural (or intrathecal) spaces.2.When performing procedures with risk of arterial injection, ropivacaine should not be mixed with dexamethasone and injected due to the risk of crystallization and embolization.3.Physicians should not withdraw directly from vials of local anesthetic for multiple patients due to infection risk as per Centers for Disease Control and Prevention (CDC) and Joint Commission guidelines [1].4.Only pharmacists may repackage local anesthetic vials for multiple patients. This must be performed under strict, sterile conditions and only in times of critical need. In such situations, physicians must adhere to the beyond-use-date and storage conditions on the repackaged label [2,3].5.Joint, tendon, bursa, and/or ligament injections may be performed with local anesthetic with or without preservative.6.Interventional pain physicians should weigh the relative chondrotoxicity risks associated with each anesthetic when performing joint injections.7.Topical anesthetics, infiltration with diphenhydramine, and nonpharmacologic therapies (

Indexed as

Best practicesInterventional painLocal anestheticPractice advisoryProceduresShortageSupply chain

Identifiers

PMID39239613
PMCPMC11372887

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.