Question of the Month – September 2025
A 7-year-old girl, born with microtia (grade III), undergoes an external ear reconstructive surgery. The cartilage for the reconstruction is harvested from 5th to 7th costal cartilages of the right side. Her past medical history is significant for developmental delay and moderate obstructive sleep apnea. For intraoperative pain management, IV ibuprofen and acetaminophen is used. After an uneventful intraoperative period, the patient is transferred to the postoperative area. Two hours later, she begins to experience significant pain over the donor site. She is crying inconsolably and is unable to move. The pain is worsened with deep inspiration. The family has a history of substance use disorder and is very concerned about the use of opioids. Which of the following is most likely the best approach for managing pain in this child?
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?
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