The caudal block: The “no turn” technique

The caudal block is an effective technique that is very common and popular in pediatric regional anesthesia. To perform this block safely, good anatomic knowledge and accurate guidelines about techniques and drugs administration must be followed. The usual approach is well-known and often described, but in some cases is not without risks. The “no turn” technique is a very easy approach that reduces these risks and is useful for teaching hospitals that are minimizing the time of the learning curve. In this article, the technique is shown and the doses of local anesthetics and adjuvants are described. Copyright 2002, Elsevier Science (USA). All rights reserved.     

Editorial Commentary: The Anterolateral Ligament: The Emperor's New Clothes?

In the following editorial commentary, the lateral soft tissues responsible for resisting the pivot shift phenomenon with the anterior cruciate ligament (ACL) are considered. The recent history of the anterolateral ligament (ALL) has led to rapid adoption of surgical techniques that have often not been investigated with scientific due process. A step-by-step approach starts with biomechanical testing to establish the anatomy and biomechanical characteristics of soft tissue structures and questions the importance of the ALL and proposes a more important role for the iliotibial band (ITB) passing between attachments to the distal lateral femur and tibia. Subsequent laboratory testing of various operative options shows superiority of lateral extra-articular tenodeses (LETs) as compared with ALL reconstruction.     

The National Lung Cancer Screening Trial: The Ripple Effect Begins?

Preliminary results of the National Lung Screening Trial were recently announced. The significant implications of this trial for thoracic surgical practice are reviewed.     

The case: your diagnosis? Osteopoikilosis

Enostoses, osteomas, osteopoikilosis, osteopathia striata, and melorheostosis may simulate other diseases. However, the findings on imaging usually are characteristic enough to indicate the correct diagnosis.     

The Historical Narrative: Tales of Professionalism?

The historical narrative is a story told to illustrate a point, however subconsciously. The "giants" of obstetric anesthesia -- Simpson, Snow, Apgar -- and countless other less well-known physicians all contributed to the history of obstetric anesthesia. We remember them by retelling this history to illustrate elements of professionalism and how we as a profession wish to act. The Physician Charter is an excellent first approximation of a workable definition of this quality, which can and does change over time. By using the three principles and 10 professional responsibilities as a template, the past comes alive as a teaching method to each and every obstetric anesthesiologist.