Before and After: Ultrasound and Anesthesia for Reducing Surgical Pain

Taking advantage of today’s technology

ultrasound and regional anesthesia for pain

Ultrasound can be used to treat patients with surgical pain before, during and after surgery. (Photo: Bigstock)

A few decades ago, the thought of using ultrasound for anesthesia seemed silly and unnecessary. Today, ultrasound has become one of the leading technological innovations for many regional anesthesia procedures. The benefits of using ultrasound for needle injections are incredible, as you’re able to see the needle on the screen as you make your way around internal structures to your target destination. In this case, seeing is truly believing.

Using ultrasound and regional anesthesia to manage pain during surgery is one of its many benefits, but it can also help patients before and after surgery as well. The most important thing a patient wants is to be as pain-free as possible throughout the entire surgical experience, including the pre-op and post-op stages. By using ultrasound, a team of anesthesiologists can provide the patient with exactly that.

Here’s a breakdown of the added advantages to using ultrasound before and after surgery:

Pre-op assessment

When managing pain for surgery, it all starts with the pre-op routines. Ultrasound can come in handy when placing IVs in patients whose veins might be difficult to reach, or even see. By using ultrasound to find hidden or hard to reach veins, it decreases the amount of painful needle sticks a patient might otherwise have to receive. Ultrasound allows even the most inexperienced physician to find the vein quickly and easily, often with the patient fully awake and conscious. With the help of ultrasound, it usually only takes a single needle insertion to get the job done.

Post-op assessment

Some surgeries come with agonizing post-surgical pain, including surgeries on the hips and shoulder. With ultrasound, post-op pain can be significantly reduced. By using it to place blocks for pain relief, it can help visualize the target nerves and surround them with a pain-blocking local anesthetic. Using these techniques also reduces the need for narcotics, which can lessen the amount of nausea and vomiting a patient might experience. It also increases the rate at which it takes the affected joints to become more mobile again.

The advantages of ultrasound use in anesthesia and pain management are clear, but the possibilities shouldn’t end here. As new benefits are discovered over time, it’s only a matter of time until the next breakthrough is realized.

To read more on the benefits of using ultrasound for regional anesthesia, click here: Anesthesia Alert: Are You Using Ultrasound to Its Full Potential?


Since 1981, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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5 Tips for Overcoming Continuous Nerve Block Obstacles

Helpful hints for better, more successful blocks

Using ultrasound for continuous nerve blocks

Continuous nerve blocks have many distinct advantages that outweigh any drawbacks.

Continuous nerve blocks have a number of advantages for both the surgeon and the patient, but what exactly are they?

Continuous peripheral nerve blocks (CPNBs) are used in a number of surgeries that before would necessitate an overnight stay in a hospital for postoperative pain control. A surgeon places a pain catheter in the vicinity of the target nerve which acts as a conduit for the continuous flow of anesthetic. The technique provides target-specific analgesia for a variety of surgeries and gets patients through the first 48 hours after surgery with little or no pain medication.

Continuous nerve blocks decrease the time it takes for a patient to be cleared for discharge from the hospital, giving many patients the chance to return home on the same day of surgery. There’s also very little hospital readmission related to pain control associated with the procedure.

For all the advantages continuous nerve blocks have, they aren’t without obstacles. Here are five tips for surgeons to help overcome the hurdles and place successful blocks:

  1. Prepare ahead of time by placing single-shot blocks – there’s no denying it takes a lot of skill and training to place pain catheters successfully. One way to overcome the difficulty is by practicing with single-shot blocks for several months beforehand. Pain catheters are like an extension of single-shot blocks, except they’re more advanced and complex. For one, you’re using a bigger needle, most often an 18-gauge instead of a 22-gauge that’s commonly used for single-shot blocks. Practicing with single-shot blocks first will ultimately help once you’re ready for CPNBs.
  2. Use technology to your advantage – the use of continuous nerve blocks and pain catheters has become more common because ultrasound guidance has improved and become more affordable over time. Without ultrasound, catheters are very hard to place. Ultrasound makes it easier to see nerves and blood vessels, which helps to guide your needle through. Above all else, being able to see the needle at all times is essential. As you advance, you should always be able to see the tip of the needle on the ultrasound screen. This kind of visibility will help make certain you’re not damaging anything else in the process.
  3. Reimbursement comes in patient care, not monetary value – continuous nerve blocks are a huge investment for good patient outcomes. Most patients would prefer them because they allow them to leave on the same day of their surgery. With more attention on patient quality and satisfaction than ever before, CPNBs are a value-added service that can help boost those measures for your hospital.
  4. Remember: pain catheters take more time to place – even the most experienced doctor can take about 15 minutes to place the pain catheter. New practitioners may require even more time, around 30 to 40 minutes. For time efficiency, be sure to place the catheter somewhere other than the OR so you’re not wasting valuable turnover time, or worse making surgeons wait for you to begin.
  5. Manage your patient’s expectations – be sure to remind your patients that take-home pain catheters will bring their pain down significantly, but not fully. It helps with reducing postoperative pain to a more manageable level, about a four or five out of 10. By combining it with oral pain medication, pain can be reduced to around a two or three. Also remind them that the biggest problem with the catheter is not taking it out, but keeping it in. Getting one caught on something is no laughing matter. By managing patient expectations, you’ll get better results for everyone.

For more information on the advantages of using continuous nerve blocks, click here: Are Continuous Nerve Blocks Worth the Trouble?


For over 30 years, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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Cloud Computing: Why Your Dental Practice Should Make the Switch

Cloud-based storage systems are becoming the norm for healthcare

Cloud computing for your dental practice

Cloud computing is changing the way healthcare organizations around the world store data.

These days, it seems like the cloud is everywhere. That’s because, quite literally, it is.

Already, the cloud has made sweeping changes across the medical field, as hospitals and practices make the change from paper-based and hardware storage systems to cloud-based systems. Now, it’s time for dentistry to do the same.

The cloud is a revolutionary advancement, and it can be a valuable tool for dentistry. When you’re “in the cloud,” it essentially means you’re using an Internet-based space to store all of your data. Patient records, X-rays, images – all of your electronic data can be stored in the cloud. By using the cloud, you get a data-storage solution that is flexible and responsive to your practice’s needs.

One of the best advantages of moving to the cloud is the ability to access the most up-to-date information anywhere, anytime. It’s always there to see no matter where you’re at or what device you’re using, as long as that device supports the cloud. It used to be hard to know whether you had the most updated version of your patient’s records, and outdated information can be harmful to both the patient and your practice. By using the cloud, all changes made to a patient’s file are updated automatically, and these changes can be seen by all users across multiple teams or offices, as long as they have authorization to do so. Anyone viewing a patient’s file through the cloud can rest assured that they’re looking at the most recent information on their patient.

Another advantage to the cloud is its flexibility. Making the switch is relatively simple, and storage space is practically unlimited. In addition, using the cloud is highly cost-effective. Most cloud service providers also provide IT support, which can save your dental practice a lot of money in the long run.

Many dentists new to the cloud worry about its reliability. With the cloud, the loss of data is nearly impossible. As far as security, the chance of someone accessing your data without permission or hacking into your cloud is low. Protection is offered through your cloud service provider, and it’s actually more secure than a traditional desktop program. You can be certain that only the people you want seeing your information will have access to it.

More than anything, the biggest reason for dentists to move to the cloud is simply because it’s the wave of the future. More and more health care organizations are implementing the cloud for their data storage, and nobody wants to be standing in the dust while their competition stays ahead of the times.

For more in-depth information on using the cloud for your dental practice, click here: Why You Need to Move Your Dental Practice to the Cloud.


For over 30 years, Havel’s has offered premium quality surgical scalpel blades, miniature blades and sutures to dentists, doctors, hospitals and other leading medical professionals. To learn more about Havel’s selection of surgical blades and sutures, please click here: Havel’s Surgical Scalpel Blades, Miniature Blades and Sutures.


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Join Havel’s Inc. at TOBI 2015

This year’s theme: “Protocols, Research and Practice”

Shelly Ast, Havel's Assistant Sales Manager

Shelly Ast, Assistant Sales Manager for Havel’s Inc.

The Orthobiologic Institute (TOBI) is proud to welcome industry thought leaders from around the world for the 6th annual “PRP and Regenerative Medicine Symposium and Cadaver Lab” on June 13-14, 2015 at the Red Rock Resort in Las Vegas, Nevada. The Havel’s team will be attending the TOBI 2015 weekend event, which offers the year’s best networking and orthobiologic research and lectures focusing on the latest advances in the practice of Platelet Rich Plasma (PRP) and Regenerative Medicine therapies.

Dr. Steven Sampson founded The Orthobiologic Institute to bring together the brightest minds in the field to share the latest research and best practices in PRP and Regenerative Medicine. TOBI has become the annual event for thought leaders to converge and collaborate to advance the field.

Physicians new to PRP attend to learn from pioneers through lectures, networking and hands-on cadaver labs. The growing event maintains a boutique feel as TOBI builds a community of enthusiastic physicians who return annually for updates in this rapidly expanding field.

The Symposium moves beyond basics to provide the latest research and best practice protocols in PRP, Bone Marrow, Adipose and more regenerative therapies. Attendees will be able to network with global field leaders, observe live patient orthobiologic procedures and connect with vendors for the latest medical products in regenerative medicine.

The Cadaver Lab features two hands-on tracks to choose from: Ultrasound-Guided Injections with Dr. Kenneth Mautner and Bone Marrow Aspirate with Dr. Philippe Hernigou teaching his bone marrow aspirate technique.

There will also be a Pre-Event Workshop on Friday, June 12 on Neural Prolotherapy with Dr. John A. Lyftogt, MD.

If you can’t make it to Vegas this year, you can also live stream the event online.

For more information and event details, visit the TOBI 2015 event website.

For a detailed TOBI 2015 agenda, click here.

Register online here and use the promo code SAVE300EX.

We look forward to seeing you there!


Since 1981, Havel’s has offered premium quality ultrasound needles and procedure needles for anesthesia, pain control, radiology and biopsy for physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of ultrasound and procedure needles, please click here: Havel’s Ultrasound Needles, Anesthesia and Pain Control Needles and Radiology and Biopsy Needles.

 

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The Economic Advantages of Regional Anesthesia

Peripheral nerve blocks, continuous local anesthetic infusions save time and money

Regional anesthesia is more effective for post-op pain management

Regional anesthesia techniques are being used more for post-op pain management due to the benefits they can provide to both patients and surgical facilities. (Photo: Outpatientsurgery.net)

For most modern-day anesthesia providers, the biggest reason to use regional anesthesia is because of the vast improvements the techniques can bring to a patient’s post-op experience. Improved patient outcomes can result in major efficiency gains, which means saving time and money for the patient and the facility. Overall, it’s a win-win for everyone.

Regional anesthesia’s post-op analgesic effects are known to dramatically lower pain scores in patients, which then leads to a decline in the use of opioids. Opioid use for post-op pain can increase the risk of grogginess, nausea, vomiting and delirium in patients, some of which are the main causes for prolonged stays in a hospital or surgical facility. More time means higher costs for both patients and insurers. By decreasing the need for opioids and using regional anesthesia, patients recover quicker and are discharged much sooner.

“For an outpatient facility, any technique that avoids the use of opioids is advantageous,” said Mark E. Hudson, MD, MBA, associate professor of anesthesia at the University of Pittsburgh School of Medicine, in an article in Outpatient Surgery magazine.

“Under regional, within minutes after surgery they’re having 7-Up and crackers,” added David Rosen, MD, president of Midwest Anesthesia Partners of Naperville, Illinois. “In 20 to 25 minutes they’re dressed. In 30 minutes, they’re in a wheelchair, heading for the car.”

Fast-track to success

It’s no secret that fast-tracking surgical recovery times can be financially rewarding, as long as the techniques are seen as beneficial to a particular patient. Since regional anesthesia has already proven to be just as effective, if not more, for post-op pain management, it’s no wonder facilities are beginning to see the benefits these techniques can provide for them as well.

Although there isn’t a big difference between the cost of drugs used for general anesthesia and the ones used in regional anesthesia, others resources still play a pivotal role in the discussion.

“Anything that reduces the time the patient spends in the facility is going to save the facility dollars,” said Dr. Hudson.

“When people are out in under an hour, as opposed to 2-plus hours, you’re saving a lot of money on your personal costs,” added Dr. Rosen.

For more information on the economic advantages of regional anesthesia, including what you’ll need in order to take full advantage of these techniques, click here: Regional Anesthesia’s Economic Advantages.


For over 30 years, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.

 

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How to Get Started with Peripheral Nerve Blocks

Advanced technology has made placing blocks safer, quicker and more efficient

Regional anesthesia nerve blocks work well with ultrasound guidance

Advances in ultrasound technology has allowed regional anesthesia techniques like peripheral nerve blocks to become more prominent for surgical pain control. (Photo: Bigstock)

Over the years, advances in ultrasound technology has allowed regional anesthesia to become a viable alternative for pain control and pain management. Procedures like peripheral nerve blocks are now a common option for many practitioners due to the effectiveness of ultrasound guidance. The switch to ultrasound-guided regional anesthesia techniques has transformed the field, giving new light to possibilities that were once thought out of reach.

Today, a well-trained anesthesiologist can use ultrasound to place nerve blocks with the kind of care and efficiency that couldn’t be achieved a decade ago. Ultrasound gives doctors a more complete visualization when placing blocks, giving practitioners the chance to see the needle as it moves along its path. It also lets them see different internal structures along the way, and avoid any further damage in the process. In the end, all of this leads to more successful blocks and better patient outcomes.

Of course, proper placement and technique can take some time to develop, but with the help of modern technology nerve blocks are easier than ever to perform. In order to get the most out of ultrasound guidance, here are a few basic fundamentals you’ll need:

  1. Training — advanced training is crucial for any anesthesia providers new to ultrasound guidance. Ultrasound regional courses are available throughout the country, and most are often reasonably priced and not too long. The benefits certainly outweigh any extra time it may take for a course or two.
  2. A designated room — ultrasound-guided regional anesthesia is best performed in a designated area with easy access to all the necessary tools and supplies needed for the procedure. Things like adequate lighting and ample work space help make peripheral nerve block procedures even safer than they already are.
  3. Educate patients — it’s important to educate everyone unfamiliar, including staff and patients, on the advantages of peripheral nerve blocks. Appointing roles to those assisting you in the procedure, such as a block nurse, can also be very helpful.
  4. Ultrasound machine — what good is ultrasound guidance without the proper machine? A good ultrasound machine is key, and can run anywhere from $5,000 to $100,000. Depending on your preference, many new machines are easily portable and offer high quality images. The more bells and whistles you want, the higher the price may be. In the end, there are many factors to consider before purchasing the right ultrasound machine, and it’s always better to do research to find the perfect machine for your blocks.
  5. Needles — like a good ultrasound machine, placing a peripheral nerve block is impossible without the right nerve block needle. Today, there are a variety of needles to choose from, based on length, gauge, echogenicity, bevel and insulation qualities. With ultrasound, echogenicity is an important factor to consider, and most new needles tend to focus on their ability to enhance visualization under ultrasound.

To learn more about the essentials for peripheral nerve blocks, click here: Basics of Blocks.


Since 1981, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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3 Things to Discuss With Your Anesthesiologists Before Going Under

Anesthesia has never been safer, but that doesn’t mean risks aren’t still involved 

Mature female surgeon in operating suite adjusting latex gloves-anesthesia-anesthesiologist-surgery

The ASA is urging all patients to talk with their anesthesiologist before going under for surgery or other operations and procedures. (Photo: Bigstock)

In the U.S., over 100 million operations and procedures are performed every year using anesthesia. While it’s true that it has advanced and become safer than ever before, many people still overlook the serious risks involved with anesthesia. That’s why the American Society of Anesthesiologists is urging every person scheduled for a procedure or surgery to have a conversation with their anesthesiologist about their anesthesia delivery plan ahead of time.

 

Here are three things everyone should know about anesthesia to ensure both safety and comfort:

  1. Sedation or anesthesia – Depending on the procedure, it’s good to know whether sedation or anesthesia is the right fit. There are various types of anesthesia and sedation, and understanding their differences is critical before any surgery.
  2. Surgery risks – Preexisting health conditions like high blood pressure, heart disease, obesity and certain lung conditions like asthma could increase the risks of surgery and anesthesia. Discussing these, as well as any history of adverse or allergic reactions to anesthesia, is important for patient safety.
  3. Anesthesia and the elderly – For people 65 and older, surgical risks can increase dramatically. A recent topic of discussion is how the aging brain is more vulnerable to the side effects of anesthesia. Two common conditions tied to anesthesia and the elderly are postoperative delirium and postoperative cognitive dysfunction, or POCD. Planning ahead of time with the patient, the anesthesiologist and a patient’s caregiver could decrease the potential risks involved with anesthesia.

For more information, click here.


Since 1981, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other medical professionals. To see Havel’s selection of anesthesia and pain management needles, please click here: Havel’s Anesthesia Needles and Pain Control Needles.


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Cleveland Clinic Adapts to Changing Health Care Landscape

The industry is evolving, and so is the clinic

Changes in health care

Health care is changing rapidly, and Cleveland Clinic wants to be on the front line of this change. (Photo: Bigstock)

Health care systems big and small are trying to adapt to the constant changes within the industry. The same can be said for the Cleveland Clinic, one of the country’s largest and most well-known health systems, according to an article in The New York Times.

In the past, Cleveland Clinic prided itself with the ability to treat the “sickest of the sick,” but now that might not be good enough. Patients are starting to look for care outside of the hospital setting, and insurance providers are moving towards new payment models, as well as encouraging health care systems to be able to manage all of a patient’s medical needs, not just a few specialties. Because of this, the clinic is beginning to reposition itself as a place to treat primary care and chronic conditions in addition to performing other more complicated procedures.

Many of the clinic’s 10 community hospitals and 16 family health centers are already starting to implement this change. Dr. Delos M. Cosgrove, the Cleveland Clinic’s chief executive, shut down the affiliated Huron Hospital in 2011 and replaced it with a new family health center focusing on primary care. It also expanded hours at its separate walk-in clinic in order to encourage patients who have minor health problems to visit there rather than an emergency room.

Another aspect the Cleveland Clinic is looking into is how to cut down on costs without sacrificing quality care. Private insurers are starting to move further and further away from hospitals they deem too costly. Last year the clinic reduced costs by about $500 million, a huge leap forward in the eyes of insurers.

Since taking over a decade ago, Dr. Cosgrove has put a focus on measuring patient outcomes, which he feels will help Cleveland Clinic get a better sense of how it’s delivering care. The clinic has invested in new computer systems that can track patients in different settings to see how they’re managing their care.

Elsewhere, the clinic is looking to expand its reach by joining forces with Akron General Health System, which will give Cleveland Clinic an even bigger presence in its home state of Ohio. It also became a part of the Midwest Health Collaborative, a group of health systems whose overall goal is to provide better care across the state.

To learn more, click here: Cleveland Clinic Grapples With Changes in Health Care.


Since 1981, Havel’s has offered premium quality ultrasound needles and procedure needles for anesthesia, pain control, radiology and biopsy, as well as sutures and surgical scalpel blades for dentists, oral surgeons, dermatologists, veterinarians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of procedure needles, sutures and surgical scalpel blades, please click here: Havel’s Procedure Needles, Sutures and Surgical Scalpel Blades.


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Gift or Curse: Surgical ‘Black Box’ Could Be Future of Operating Room

Debate over proper use still in question 

Surgical black box could benefit or harm

Researchers in Canada have developed a surgical black box that could track procedures and operations for later analysis. (Photo: Bigstock)

Researchers in Canada are developing a surgical “black box,” like the ones used in airplanes, which could change the face of modern surgery. The hope is that the box could become an tool for surgeons, where operations could be tracked and analyzed, mistakes could be improved upon and complications before, during and after surgery could be significantly reduced.

However, some are wondering if the tool could backfire. If data could be used in court, it could become a potential mess in the malpractice department and ultimately become counterproductive to those it was meant to help.

“We have to ensure the black box is used as an educational tool to help surgeons evaluate their performance and improve,” said Dr. Teodor Grantcharov, a minimally invasive surgeon at St. Michael’s Hospital in Toronto.

For more information, click here: Surgical Black Box Could Reduce Errors.


Since 1981, Havel’s has offered high-quality procedure needles and surgical scalpel blades to doctors, hospitals, veterinarians and other leading medical professionals. To learn more about Havel’s selection of procedure needles and surgical scalpel blades, please click here: Havel’s Procedure Needles and Surgical Scalpel Blades.


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American Academy of Dermatology Wraps Up 2015 Annual Meeting

Topics like health care reform, teledermatology, quality care addressed

The Moscone Center in San Francisco, California

The American Academy of Dermatology’s 73rd Annual Meeting took place at the Moscone Center in San Francisco, California. (Photo: MedPage Today)

The American Academy of Dermatology’s 73rd Annual Meeting took place this past weekend, March 20-24, and throughout the meeting several topics of interests were highlighted. Among them were health care reform and the impact it has on the field of dermatology, maintaining quality care for patients, the growing problem of skin cancer and the role dermatologists have in early diagnosis and the role of teledermatology in the future.

“The future of dermatology and how dermatologists can continue to offer quality patient care remains a key issue for the academy,” said AAD scientific assembly chair Joan Guitart, MD, of Northwestern University in Chicago, as quoted in an article from MedPage Today.

A number of speakers were on hand to discuss a wide variety of topics, including American Medical Association president-elect Steven J. Stack, MD, who spoke on both the challenges and opportunities the dermatology profession faces in the next decade.

Workshop sessions included topics like advanced suture techniques, nail surgery and the use of cosmetic fillers. There were also sessions that focused on late-breaking science and the newest trends in dermatology.

For more information on the AAD’s annual meeting, click here: Future of Dermatology on Display at AAD.

Be sure to visit the AAD’s website for up-to-date news and information.


Since 1981, Havel’s has offered premium quality sutures and surgical scalpel blades for dermatologists, doctors, hospitals and other leading medical professionals. To see Havel’s selection of sutures and surgical scalpel blades, please click here: Havel’s Sutures and Surgical Scalpel Blades.

 

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