January 2014 - Newsletter

• A Letter from your Editor
• NYSORA Latin America March 14-16 2014
• Techniques - Neuraxial and Perineuraxial Spinal Anesthesia
• Featured Education Video - Ultrasound-Guided Femoral Nerve Block
• Report from NYSORA Boutique Workshops, January 25-26 2014

Dear NYSORA newsletter reader,

In this issue of the NYSORA Newsletter, we share a brief interview with Dr. Pablo Helayel, director of the first NYSORA Latin America program and provide an update on NYSORA educational programs.

NYSORA Latin America Program

NYSORA's first Latin America program became an instant hit in Latin America. There are only relatively few registration spots left for the workshop program that will be presented by some of the most renowned faculty from around the globe. Most importantly, the NYSORA Latin America program is structured as an interactive networking and idea sharing program. The aim is to establish fruitful collaboration and knowledge sharing among the delegates and faculty. Unique to this program are specific sessions on Friday night and at the end of the didactic program on Saturday afternoon. The Friday night program will feature presentations on cutting edge imaging and sharing of new ultrasound-guided regional anesthesia and pain techniques. All presentations will be made by NYSORA’s international faculty, and will include three minute video presentations followed by five minute discussions. The goal is to discuss a number of innovative techniques, establish interactive collaborations and exchange of experience among delegates and faculty. Saturday will feature video presentations for the ultrasound-guided regional anesthesia video competition. This is a unique opportunity to propose your own presentation, take the stage and share with your international colleagues how ultrasound-guided regional anesthesia is practiced in your hospital. For more information or to request a presentation time for yourself in this unique afternoon session, please contact Dr. Pablo Helayel at [email protected].

13th NYSORA Annual New York Symposium

The program for the NYSORA 13th Annual Symposium in New York City, scheduled for September 2014 is almost completed, please visit www.nysora.com for more information. This program is one of the largest gatherings of clinicians with specific interest in Regional Anesthesia and perioperative medicine, as well, as the application of regional anesthesia techniques in clinical practice. Held in NYC and combined with NYSORA signature social programs that stimulate networking, this flagship CME event draws some of the most promising, up and coming speakers from around the world who share the latest, hot off the press data and unique information about their studies. Abstracts of scientific meetings will be accepted for research competition and the top scoring abstracts will be published in a supplement to a peer reviewed journal. NYSORA Annual symposium is a must-be for all interested in RAPM. This newsletter also serves as an invitation to instructors from well recognized ultrasound-guided regional anesthesia programs to participate as instructors in NYSORA's comprehensive workshops. If you would like to be considered as one of the instructors, please send your letter of inquiry and a CV to [email protected]. This is a unique opportunity for aspiring investigators and educators to see and be seen among key opinion leaders and international delegates interested in regional anesthesia.

Sincerely yours,

Tim Peters

The organizing committee of the NYSORA Latin America program would like to invite you to join us in the magnificent Florianópolis, Brazil, from March 14-16th for our collaborative program first Latin America. We have very high expectations for the educational and networking value of this event and we are handling the final details to offer the delegates, top quality educational experience. We look forward to creating new leaders, sharing knowledge and networking in an open and friendly environment. Worldwide top faculty members will be working side by side with Latin-American speakers to create a unique blend of excellence. The scientific program combines cutting edge topics in regional anesthesia and perioperative medicine, comprehensible standardized workshops in regional anesthesia, and an innovative ultrasound video contest. Registrations are coming in from all over Latin America from colleagues who are already planning their stay in Florianópolis. While the education is the center-piece of this event, do not forget to bring your swimming suits and bikinis. After alI, it will be summertime in Brazil, and our tropical south Atlantic island has plenty of leisure attractions, such as beautiful beaches, landscapes, watersports, delicious Brazilian seafood and an intense nightlife.

Come and join us for this one of a kind educational experience!

Carl Koller, an ophthalmologist from Vienna, first described the use of topical cocaine for analgesia of the eye in 1884.[1] William Halsted and Richard Hall, surgeons at Roosevelt Hospital in New York City, took the idea of local anesthesia a step further by injecting cocaine into human tissues and nerves in order to produce anesthesia for surgery.[2] James Leonard Corning, a neurologist in New York City, described the use of cocaine for spinal anesthesia in 1885.[3] Since Corning was a frequent observer at Roosevelt Hospital, the idea of using cocaine in the subarachnoid space may have come from observing Halsted and Hall performing cocaine injections. Corning first injected cocaine intrathecally into a dog and within a few minutes the dog had marked weakness in the hindquarters.[4] Next, Corning injected cocaine into a man at the T11-T12 interspace into what he thought was the subarachnoid space. Since Corning did not notice any effect after 8 min, he repeated the injection. Ten minutes after the second injection, the patient complained of sleepiness in his legs, but was able to stand and walk. Because Corning made no mention of cerebrospinal fluid (CSF) efflux, most likely he inadvertently gave an epidural rather than a spinal injection to the patient.

Dural puncture was described by Essex Wynter in 1891[5] followed shortly by Heinrich Quincke, 6 months later.[6] Augustus Karl Gustav Bier, a German surgeon, used cocaine intrathecally on six patients for lower extremity surgery in 1898.[7,8] In true scientific fashion, Bier decided to experiment on himself and developed a postdural puncture headache (PDPH) for his efforts. His assistant, Dr. Otto Hildebrandt, volunteered to have the procedure performed after Bier was unable to continue due to the PDPH. After injection of spinal cocaine into Hildebrandt, Bier conducted experiments on the lower half of Hildebrandt's body. Bier described needle pricks and cigar burns to the legs, incisions on the thighs, avulsion of pubic hairs, strong blows with an iron hammer to the shins, and torsion of the testicles. Hildebrandt reported minimal to no pain during the experiments; however, afterward he suffered nausea, vomiting, PDPH, and bruising and pain in his legs. Bier attributed the PDPH to loss of CSF and felt the use of small-gauge needles would help prevent the headache.[9]

NYSORA Instructional video