December 2013 - Newsletter

• A Letter from your Editor
• Interview with Dr. Emine Aysu Salviz
• Upcoming NYSORA Educational Programs
• NYSORA's Philanthropy

Dear NYSORA Readers:

Dr. Emine Ayso Salviz, MD

Dr. Emine Aysu Salviz is an Attending Anesthesiologist in Istanbul University, Medical Faculty of Istanbul, Department of Anesthesiology and Reanimation. She is primarily interested in ultrasound-guided peripheral nerve blocks. Beginning as a research associate at NYSORA, Aysu has been an instructor at NYSORA and NWAC regional anesthesia workshops, and has published articles on a number of ultrasound-guided peripheral nerve blocks, including the interscalene brachial plexus, femoral, saphenous, paravertebral and intercostal nerve blocks. Tim Peters took some time out to interview Dr. Salviz about her recently published research in Anesthesia and Analgesia.

http://www.ncbi.nlm.nih.gov/pubmed/24257398

1. You recently published a paper comparing the analgesia recovery profiles of patients after rotator cuff repair. What were your aims with this reserach?

General anesthesia (GA) and interscalene brachial (ISB) plexus nerve block techniques are both used for outpatient arthroscopic shoulder surgeries. However, the single injection (SISB) and continuous interscalene brachial plexus (CISB) blocks are usually performed in addition to GA for postoperative analgesia. Thus our aim in this research was to perform these modalities as sole anesthesia and analgesia techniques, and to evaluate their effects on the patient's short term recovery profile, especially for pain during the first postoperative week.

2. What were the main findings?

None of the 63 patients who interscalene blocks reported an NRS score ≥1 or required any analgesics while in the PACU., Time to first pain report was longer in the CISB group, and NRS scores were lower for patients in the CISB group than in the SISB and GA groups on postoperative days 1 and 2, and subsequently lower for patients in the CISB group than in the SISB group by the end of the study week. The CISB group also used less narcotics (doses ≥1) until postoperative day 3. By the end of the study week, most patients in the CISB group (74%) reported NRS scores

Nearly all patients in the CISB and SISB groups, but none of the patients in the GA group, were fast-tracked to ambulatory PACU discharge, and in fact, were discharged home far sooner. Length of stay in the PACU and time-to-discharge home were both significantly shorter for the CISB and SISB groups. Patients who received CISB slept significantly longer than patients who received SISB or GA during the first 48 hours postoperatively.

3. How were your findings best extrapolated to clinical care?

According to the results we obtained, CISB is a peripheral nerve block technique for patients undergoing arthroscopic shoulder surgery that appears to offer most value to the patients - best analgesic benefits, shorter length of stay in the PACU and in the hospital, fewer occurrences of PONV, and longer sleep periods.

4. Having done this study, what anesthetic technique would you have done if you yourself needed rotator cuff repair?

Frankly, I would prefer CISB if I needed rotator cuff repair. I saw my patients in much less pain and more comfortable overall. While single injection blocks are also powerful anesthetic and analgesic techniques, their limited duration limits their overall value. Longer acting local anesthetics that have recently became commercially available, but not introduced in clinical practice yet, may provide the solution without the use of catheters.

5. Where do you practice now?

I work as a full-time attending anesthesiologist at Istanbul University, Medical Faculty of Istanbul.

Dr. Emine Aysu Salviz and her colleagues at a departmental function in Istanbul

6. What are your current research projects?

We are currently working on several projects. One study compares electric stimulation thresholds, opening injection pressures, and efficacy of the femoral and popliteal sciatic nerve blocks (tibial and common peroneal nerves, separately) in diabetic and non-diabetic patients. The other compares sciatic nerve block onset times and duration in diabetic and non-diabetic rats using somatosensory evoked potentials (SSEP).

7. What were your experiences during your research fellowship at NYSORA?

NYSORA is a top Education Center where one can improve in all aspects of Regional Anesthesia - theoretically, practically and academically. It also provided me with an opportunity to share practical and theoretical knowledge with other anesthesiologists in NYSORA symposiums and NWAC meetings. Networking, sharing, studying and working together in a friendly environment are the main themes.

Dr. Emine Aysu Salviz collaborating with colligues

Delegates attending NYSORA boutique wokshops will be taught standardized techniques and protocols endorsed by 26 participating NYSORA key opinion leaders worldwide. Faculty selected for teh workshops are some of the best instructors and clinicians, recognized for their expertise in regional anesthesia. They will adhere to a NYSORA's didactic format that offers the clearest possible instruction.

1. NYSORA boutique workshop materials, including a DVD, posters, and a standard NYSORA textbook.

2. New skills are learned in an organized manner. The didactic courses are immediately followed by hands-on sessions, instructor assisted scanning, nerve block simulations, hand eye coordination sessions, injection monitoring sessions, and a pre and post knowledge assessment test.

All sessions and sequences are taught based on a NYSORA format that has proven to offer the utmost educational value during the 2 day package.

Make sure to reserve your spot if you are serious about jumpstarting the use of ultrasound in your practice as the attendance is limited!

For more information visit the event website

Author: Caroline Vloka

In the midst of the holiday season, it is the time for giving. Beyond its international educational outreach, NYSORA is also actively involved in philanthropic activities with various organizations. One such organization is the Jacob Riis Senior Citizen's Center in Queens, NY. On Friday December 6, Stacy Atkinson and Caroline Vloka, two members of the NYSORA philanthropy team, joined by volunteer Lyone Hall, traveled to the Center in Queensbridge to spread some NYSORA holiday cheer.

NYSORA Regional Director Stacy Atkinson with presents for the members of the Jacob Riis Senior Citizen’s Center

The three ladies visited the senior citizens with a jovial energy and gifts. Robert Madison, the director of the center, and two organizers Robbin Davis and Richard Williams, greeted the volunteers and helped set up the visit.

The senior citizens enjoying some snacks and receiving their tickets for the raffle

With the help of the regular staff, the NYSORA team handed out some food and drinks to the senior citizens. To add some suspense to the event, a bingo game and a raffle was also organized. The bingo winners were rewarded with a prize, and the raffle was used to determine the order in which the presents were presented. The members of the center received clothing and puzzle books to keep them warm and busy during the chilly New York City winter. The night was a great success, with both the senior citizens and the volunteers having a fun and friendly time.

The senior citizens pose for a group photo after the holiday party.

An Invitation to a Conference in Conzumel, Mexico

Dr. Wojciech Reiss, MD

Dear Colleagues,

We are very excited to announce the second "Anesthesiology Today" conference in Cozumel, Mexico. You are cordially invited to join us at this beautiful location from April 7 - 11, 2014. The conference will feature lectures presented by world experts in topics of regional and obstetric anesthesia, management of the difficult airway, and postoperative pain management.

We will also present two workshops on ultrasound guided regional anesthesia, and pain medicine procedures.

Please visit our website: anesthesiology-today.com