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The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. To highlight some of the great resources, we’ve pulled together some interesting facts about anesthesia from James Hebl and Robert Lennon’s Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade. Get free access to the Mayo Clinic suite for a limited time with this Facebook offer (watch out, it closes today!).

(1) Egyptian pictographs dating back to 3000 BC showing a physician compressing a nerve in the antecubital fossa while an operation is being performed on the hand.

(2) William Halsted, M.D. (1852–1922; Chair, Department of Surgery, Johns Hopkins Hospital), used cocaine as local infiltration as he dissected down toward major nerve trunks. He then injected cocaine around them, performing regional blockade under direct vision.

(3) In Paris in the early 1920s, a new technique for blocking the brachial plexus from an axillary approach was introduced. M. Reding, M.D., studying the anatomy of the axilla, discovered that the nerves of the plexus surround the artery in a fascial sheath. Thus, using the artery as a landmark, Reding found that the fascial compartment could be filled with local anesthetic to result in brachial plexus blockade. Reding blocked the musculocutaneous nerve, which lay outside the sheath, by infiltrating the coracobrachialis muscle.

(4) Paresthesia technique—the long-preferred method of regional anesthesiologists—was slowly replaced during the 1980s as peripheral nerve stimulation began to emerge. During its development, peripheral nerve stimulation was thought to provide superior localization of neural structures compared with blind paresthesia-seeking techniques. Peripheral nerve stimulators transmit a small electric current through a stimulating needle that, when in proximity to neural structures, causes depolarization and muscle contraction.

(5) In contemporary medical practice, regional anesthetic techniques have expanding socioeconomic and clinical implications. For example, studies evaluating patient satisfaction have found that perioperative analgesia and the avoidance of nausea and vomiting are consistently two of the highest concerns among patients.

(6) Ultrasound guidance may represent the 21st century’s version of Halsted’s anatomical dissection down to the brachial plexus.

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade by James Hebl and Robert Lennon is a practical guide for residents-in-training and clinicians to gain greater familiarity with regional anesthesia and acute pain management to the upper and lower extremity. It emphasizes the importance of a detailed knowledge of applied anatomy to safely and successfully performing regional anesthesia. It also provides and overview of the emerging field of ultrasound-guided regional anesthesia, which allows reliable identification of both normal and variant anatomy. Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade contains more than 200 beautifully illustrated anatomic images important to understanding and performing regional anesthesia. Corresponding ultrasound images are provided when applicable.

The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. With full-text titles from Mayo Clinic clinicians and a bank of 3,000 multiple-choice questions, Mayo Clinic Toolkit provides a single location for residents, fellows, and practicing clinicians to undertake the self-testing necessary to prepare for, and pass, the Boards and remain up-to-date. Oxford Medicine Online is an interconnected collection of over 250 online medical resources which cover every stage in a medical career, for medical students and junior doctors, to resources for senior doctors and consultants. Oxford Medicine Online has relaunched with a brand new look and feel and enhanced functionality. Our aim is to ensure that the site continues to deliver the highest quality Oxford content whilst meeting the requirements of the busy student, doctor, or health professional working in a digital world.

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The post Six facts about regional anesthesia appeared first on OUPblog.

Three months to the day before Addison was born, we learned we were getting a little sister. We crowded into the ultrasound room peering expectantly at grainy, elusive images on the monitor waiting for some confirmation. The technician asked if we had any preference, and we were divided. The boys had either been flexible or non-committal until then, but the girls, eight year-old Keilana and I, were decidedly in girl camp. Keilana so she could have a majority and me so I could give Keilana what I never had--a sister. The technician then asked if we had any guesses. Since I had dreamed Addison into being long before she came to be, we all guessed girl. And the woman with the magic wand said, “You got it!” I went straight out and bought the girliest pink shoes I could find, just to make it real, and looked forward to a little sister for my brood. But change is always a bit unnerving. As I left for the hospital on the day Addison arrived, I looked at my two earthside kids, especially Connor, tiny in the middle of a king-sized bed, and wondered how it would work out. I needn’t have worried. After some typical adjustment, Addison became what she was always meant to be: a necessary part of our family. In Ed Young’s My Mei Mei, Antonia longs for a sister until reality trumps fantasy and she’s not so sure. Thankfully, there’s a no refund, no return policy on sisters.
http://www.amazon.com/My-Mei-Ed-Young/dp/0399243399

http://www.embracingthechild.org/Bookspecialyoung.htm

I spent an entire two weeks during the holiday season without working on a single piece of art and so the only new piece of evidence that I'm still around, creating, is a little photo I'd like to share. (18 weeks along - our little baby who's sex I will keep a secret from the blogging world in case my mom gets the chance to read this post)