ABPS Interventional Pain Management flashcards
ABPS Interventional Pain Management · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Numeric Rating Scale
- A unidimensional 0-10 pain intensity scale where 0 is no pain and 10 is worst imaginable pain; simple but does not capture functional impact.
- Straight leg raise
- A radiculopathy test positive when ipsilateral leg pain reproduces below the knee between 30 and 70 degrees of hip flexion, suggesting nerve root irritation.
- Red flags in back pain
- Findings such as progressive motor deficit, bowel or bladder dysfunction, saddle anesthesia, fever, or unexplained weight loss that mandate urgent diagnostic workup.
- Brief Pain Inventory
- A multidimensional questionnaire assessing pain intensity and pain-related functional interference across domains such as mood, walking, work, and sleep.
- Acetaminophen ceiling dose
- Generally 3-4 grams per day in healthy adults; the maximum should be lowered with hepatic disease, chronic alcohol use, or malnutrition.
- Tramadol risks
- A weak mu agonist with serotonin-norepinephrine reuptake inhibition that lowers seizure threshold and can precipitate serotonin syndrome with serotonergic drugs.
- Methadone QT risk
- Methadone prolongs the QT interval; ECG monitoring is recommended at higher doses or with other QT-prolonging medications.
- Naloxone use
- An opioid antagonist titrated to restore adequate ventilation rather than full arousal, used to reverse opioid-induced respiratory depression.
- Medial branch block
- A diagnostic injection targeting the medial branch of the dorsal ramus to identify facet joint-mediated pain before considering radiofrequency ablation.
- Provocative discography
- An intradiscal procedure considered positive when concordant pain is reproduced at low pressure with a negative control level.
- Sympathetic block
- Injection anesthetizing sympathetic ganglia (stellate or lumbar) used to diagnose and treat sympathetically maintained pain such as complex regional pain syndrome.
- Transforaminal epidural injection
- A fluoroscopically guided injection of steroid through the intervertebral foramen targeting the nerve root for radicular pain; carries vascular and cord infarction risk.
- Caudal epidural access
- An epidural approach through the sacral hiatus that avoids the interlaminar space and is useful in patients with prior lumbar surgery.
- ASRA anticoagulation guidelines
- Recommendations specifying when to hold anticoagulants and antiplatelets before neuraxial procedures to reduce the risk of spinal hematoma.
- Local anesthetic maximum dose
- Approximate ceilings without epinephrine are 4.5 mg/kg for lidocaine and 2.5 mg/kg for bupivacaine; exceeding them risks systemic toxicity.
- Suprascapular nerve block
- A peripheral block targeting the suprascapular nerve for shoulder pain, often used diagnostically and therapeutically before considering ablation.
- Spinal cord stimulation trial
- A temporary stimulation period before permanent implantation; success is commonly defined as at least 50 percent pain reduction.
- Dorsal root ganglion stimulation
- A neuromodulation approach placing leads near the dorsal root ganglion to target focal dermatomal neuropathic pain with stable coverage.
- Intrathecal drug delivery
- A programmable pump system delivering medication directly into the cerebrospinal fluid for refractory pain or spasticity; requires refill and complication monitoring.
- Radiofrequency ablation
- A thermal technique creating lesions at approximately 80 degrees Celsius for 60-90 seconds to interrupt nociceptive transmission, commonly of medial branches.
- Pulsed radiofrequency
- Delivery of radiofrequency energy in pulses that avoids thermal destruction, used near sensitive neural structures where heat injury is a concern.
- Cryoneurolysis
- Ablation of nerve tissue using cold injury to produce prolonged focal analgesia for neuropathic or postsurgical pain.
- Spinal hematoma
- A rare complication presenting with new back pain, progressive weakness, and bowel or bladder dysfunction after neuraxial procedures; requires emergent decompression.
- Post-dural puncture headache
- A positional headache after dural puncture treated conservatively with caffeine and hydration, or with an epidural blood patch if persistent.
- Local anesthetic systemic toxicity
- A syndrome of perioral numbness, tinnitus, seizures, and cardiac arrest from local anesthetic overdose; treated with lipid emulsion resuscitation.
- Cognitive behavioral therapy
- A psychological treatment targeting maladaptive pain beliefs and catastrophizing, reducing disability and improving coping in chronic pain.
- Pain neuroscience education
- Structured patient education explaining central sensitization and pain mechanisms to reduce fear-avoidance and improve engagement in rehabilitation.
- PDMP review
- Prescription drug monitoring program query required or recommended in many states before prescribing controlled substances to identify risky patterns.
- Medical necessity documentation
- Records supporting diagnosis, failed conservative care, and response to prior interventions that justify interventional procedures for payer approval.
- A-delta versus C fibers
- A-delta fibers are myelinated and conduct sharp fast pain; C fibers are unmyelinated and conduct dull slow pain.
- Central sensitization
- Increased dorsal horn excitability involving NMDA receptor activation and reduced inhibition, producing hyperalgesia and allodynia after injury.
- Descending modulation
- Brainstem pathways using serotonin and norepinephrine to inhibit ascending nociceptive signals; a target of antidepressant analgesics.