I've gotten multiple calls from other surgeons that say, sometimes my blocks don't work and invariably, It's a surgeon using a single lumen tube, doing the block too far anteriorly because they can't get posterior to that anterior axillary line.
I've gotten multiple calls from other surgeons that say, sometimes my blocks don't work and invariably, It's a surgeon using a single lumen tube, doing the block too far anteriorly because they can't get posterior to that anterior axillary line.
Update Course Rewind: Cryoanalgesia in Pectus Cases 2024
▶Ep 46 · 1:11
quoteI'm going to go through our technique at the clinic. We use a double lumen tube in all patients.↗
▶Ep 46 · 1:11
quoteI'm going to go through our technique at the clinic. We use a double lumen tube in all patients.↗
▶Ep 46 · 1:39
quoteWe go from T3 to T8, although most of the literature is just to T7.↗
▶Ep 46 · 1:39
clinicalDoctor De Fiori performs cryoanalgesia from T3 to T8, although most of the literature is just to T7.↗
▶Ep 46 · 1:39
quoteWe go from T3 to T8, although most of the literature is just to T7.↗
▶Ep 46 · 1:39
clinicalDoctor De Fiori performs cryoanalgesia from T3 to T8, although most of the literature is just to T7.↗
▶Ep 46 · 1:44
quoteAfter cryo, we do intercostal nerve blocks with subpleural injections.↗
▶Ep 46 · 1:44
quoteAfter cryo, we do intercostal nerve blocks with subpleural injections.↗
▶Ep 46 · 2:16
quoteYou can see the exposure that we get from the double lumin endotracheal tube, which is exceptional. It's very quick and easy to do, and it, and you know that you're getting it right, right on the nerve.↗
▶Ep 46 · 2:16
quoteYou can see the exposure that we get from the double lumin endotracheal tube, which is exceptional. It's very quick and easy to do, and it, and you know that you're getting it right, right on the nerve.↗
▶Ep 46 · 2:43
quoteA lot of people hesitate because of the time involved, so I'm gonna talk just very briefly about that for people who are already using cryo.↗
▶Ep 46 · 2:43
quoteA lot of people hesitate because of the time involved, so I'm gonna talk just very briefly about that for people who are already using cryo.↗
▶Ep 46 · 2:59
quoteThe tip now gets down to temperature about 20 seconds faster. The freeze cycle is 90 seconds instead of 2 minutes. It's 15 seconds less to thaw back to the temperature.↗
▶Ep 46 · 2:59
clinicalThe new probe tip gets down to temperature about 20 seconds faster, the freeze cycle is 90 seconds instead of 2 minutes, and it's 15 seconds less to thaw back to temperature.↗
▶Ep 46 · 2:59
quoteThe tip now gets down to temperature about 20 seconds faster. The freeze cycle is 90 seconds instead of 2 minutes. It's 15 seconds less to thaw back to the temperature.↗
▶Ep 46 · 2:59
clinicalThe new probe tip gets down to temperature about 20 seconds faster, the freeze cycle is 90 seconds instead of 2 minutes, and it's 15 seconds less to thaw back to temperature.↗
▶Ep 46 · 3:17
quoteThat's particularly important for people who are not using a double lumen tube where they're crossing the mediastinum and have the lung as an issue.↗
▶Ep 46 · 3:17
quoteThat's particularly important for people who are not using a double lumen tube where they're crossing the mediastinum and have the lung as an issue.↗
▶Ep 46 · 3:38
host_summaryA Chicago paper showed that a 1 minute freeze cycle instead of a 2 minute freeze cycle had nerve blocks that were just as effective.↗
▶Ep 46 · 3:38
clinicalA Chicago paper showed that a 1 minute freeze cycle instead of a 2 minute freeze cycle had nerve blocks that were just as effective.↗
▶Ep 46 · 3:58
clinicalA new 10 millimeter probe with a 60-second freeze cycle that gets down quicker is coming out on October 1st.↗
▶Ep 46 · 3:58
clinicalA new 10 millimeter probe with a 60-second freeze cycle that gets down quicker is coming out on October 1st.↗
▶Ep 46 · 4:27
opinionDoctor De Fiori uses double lumen tube in all cases because the exposure of the intercostal nerves is exceptional and it ensures that the block is applied posterior enough to get the lateral cutaneous branch.↗
▶Ep 46 · 4:27
quoteI use it in all cases. The exposure of the intercostal nerves is exceptional, and it ensures that you're applying it posterior enough, so you get the lateral cutaneous branch, and I'm gonna show you a diagram.↗
▶Ep 46 · 4:27
quoteI use it in all cases. The exposure of the intercostal nerves is exceptional, and it ensures that you're applying it posterior enough, so you get the lateral cutaneous branch, and I'm gonna show you a diagram.↗
▶Ep 46 · 4:27
opinionDoctor De Fiori uses double lumen tube in all cases because the exposure of the intercostal nerves is exceptional and it ensures that the block is applied posterior enough to get the lateral cutaneous branch.↗
▶Ep 46 · 4:50
quoteI've gotten multiple calls from other surgeons that say, sometimes my blocks don't work and invariably, It's a surgeon using a single lumen tube, doing the block too far anteriorly because they can't get posterior to that anterior axillary line.↗
▶Ep 46 · 4:50
quoteI've gotten multiple calls from other surgeons that say, sometimes my blocks don't work and invariably, It's a surgeon using a single lumen tube, doing the block too far anteriorly because they can't get posterior to that anterior axillary line.↗
▶Ep 46 · 4:50
clinicalDoctor De Fiori has gotten multiple calls from other surgeons saying sometimes their blocks don't work, and invariably it's a surgeon using a single lumen tube doing the block too far anteriorly because they can't get posterior to the anterior axillary line.↗
▶Ep 46 · 4:50
clinicalDoctor De Fiori has gotten multiple calls from other surgeons saying sometimes their blocks don't work, and invariably it's a surgeon using a single lumen tube doing the block too far anteriorly because they can't get posterior to the anterior axillary line.↗
▶Ep 46 · 5:09
quoteWe're really trying to make sure that we cover that lateral cutaneous branch.↗
▶Ep 46 · 5:09
quoteWe're really trying to make sure that we cover that lateral cutaneous branch.↗
▶Ep 46 · 5:23
clinicalIf you don't get posterior enough with the cryoprobe, that's when you get blocks that are ineffective.↗
▶Ep 46 · 5:23
quoteIf you don't get posterior enough, that's when you get blocks that are ineffective. So, a double lumen tube greatly facilitates that.↗
▶Ep 46 · 5:23
clinicalIf you don't get posterior enough with the cryoprobe, that's when you get blocks that are ineffective.↗
▶Ep 46 · 5:23
quoteIf you don't get posterior enough, that's when you get blocks that are ineffective. So, a double lumen tube greatly facilitates that.↗
▶Ep 46 · 5:46
host_summaryDoctor Kim showed in the study that there is a large collateral branch of the intercostal nerve that runs along the top of the nerve, separate from the main intercostal branch on the bottom of the nerve.↗
▶Ep 46 · 5:46
clinicalDoctor Kim showed in the study that there is a large collateral branch of the intercostal nerve that runs along the top of the nerve, separate from the main intercostal branch on the bottom of the nerve.↗
▶Ep 46 · 6:17
clinicalDoctor De Fiori has done the double freeze technique (main nerve and collateral branch) in 20 patients, and peak pain scores have dropped from about 5 to about 3.↗
▶Ep 46 · 6:17
clinicalDoctor De Fiori has done the double freeze technique (main nerve and collateral branch) in 20 patients, and peak pain scores have dropped from about 5 to about 3.↗
▶Ep 46 · 6:22
quoteThe peak pain scores have dropped from about 5 to about 3. It hasn't affected our length of stay because 98% of our patients go home the next day anyway.↗
▶Ep 46 · 6:22
quoteThe peak pain scores have dropped from about 5 to about 3. It hasn't affected our length of stay because 98% of our patients go home the next day anyway.↗
▶Ep 46 · 6:26
clinicalThe double freeze technique hasn't affected Doctor De Fiori's length of stay because 98% of his patients go home the next day anyway.↗
▶Ep 46 · 6:26
clinicalThe double freeze technique hasn't affected Doctor De Fiori's length of stay because 98% of his patients go home the next day anyway.↗
▶Ep 46 · 6:48
quoteAgain, this is a new thing, but it's very easy to do. The probe takes half the amount of time, and now I'm doing double the number of blocks.↗
▶Ep 46 · 6:48
quoteAgain, this is a new thing, but it's very easy to do. The probe takes half the amount of time, and now I'm doing double the number of blocks.↗
▶Ep 46 · 6:51
clinicalThe new probe takes half the amount of time, and Doctor De Fiori is now doing double the number of blocks.↗
▶Ep 46 · 6:51
clinicalThe new probe takes half the amount of time, and Doctor De Fiori is now doing double the number of blocks.↗
