Question of the Month – August 2025
A 16-year-old patient presents with a history of severe pain in her R leg that persists several months after twisting her ankle during basketball. She reports pain in her right foot without allodynia, hyperalgesia, temperature or skin changes, but with significant swelling and motor impairment. She is walking with a crutch as she is unable to weight-bear on her right leg. She is seen by the multidisciplinary pain clinic and undergoes a unilateral lumbar sympathetic block under general anesthesia. After receiving the block and waking up from anesthesia, her pain is resolved, but now she states that she can’t feel or move either of her legs. She gets an MRI, is evaluated by neurology, and is diagnosed with Functional Neurological Symptom Disorder. What is the definition of FNSD and how might you describe it to a patient?
Question of the Month – July 2025
A 15-year-old boy is undergoing an ACL reconstruction. He is otherwise healthy and has no
relevant past medical history.
Which of the following block combinations is most likely to provide the most complete
analgesia with minimal motor weakness?
Question of the Month – June 2025
A 12‑year‑old male with a known history of congenital methemoglobinemia presents for bilateral inferior alveolar nerve blocks to facilitate extraction of multiple impacted molars. He has no prior anesthetic history and is otherwise healthy. His preoperative hemoglobin is 14.6 g/dL, and his baseline methemoglobin level ranges from 2 % to 14 %. Which of the following is the most appropriate anesthetic management strategy for this patient?
Question of the Month – May 2025
A 7-year-old boy (24 kg) undergoes extensive bilateral lower-extremity orthopedic surgery. Epidural catheter placement under general anesthesia proves technically difficult, requiring several needle passes before a catheter is threaded. Twenty-four hours later he develops a bifrontal, throbbing headache with vomiting that is immediately relieved when supine and recurs on sitting or standing. Conservative therapy—including IV fluids, oral caffeine citrate, acetaminophen, ketorolac, and continuation of the local anesthetic infusion through the catheter—fails to provide durable relief. The parents are hesitant about further neuraxial procedures and ask whether any less-invasive options exist before proceeding to an epidural blood patch.
Which of the following interventions has documented success in children for aborting PDPH:
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- 2
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