Evaluation of paravertebral blocks in improving post-procedural pain and decreasing hospital admission after microwave ablation of liver tumors.

Although ablations are performed with conscious sedation or general anesthesia, microwave ablations can be painful post procedure. Newer analgesic modalities, including regional blocks, have promoted the proliferation of less invasive anesthesia care for ablative procedures. This study evaluates whether bilateral paravertebral blocks reduce the need for additional analgesics in comparison to unilateral blocks in microwave ablations. In this retrospective study, individuals undergoing microwave ablation who underwent unilateral versus bilateral nerve blocks at a single institution from 2017 to 2019 were compared. Categorical variables were analyzed using Pearson's chi-squared tests. Comparisons of means were completed using multiple T-tests corrected using the Holm-Sidak method with α = 0.05. Regression modeling was used to identify factors related to increased MME (milligram morphine equivalent) usage and post-procedure admission rates. A total of 106 patients undergoing 112 liver MWA procedures were included in this analysis, with patients receiving either a bilateral or unilateral block. Pre-procedural characteristics demonstrated no significant differences in age or gender. Bilateral blocks were associated with decreased usage of gabapentin (14% vs. 0%, p = 0.01) and a lower rate of post-procedure admissions (OR 0.23, p = 0.003). Therefore, when using paravertebral blocks, bilateral blocks are superior to unilateral blocks, as demonstrated by decreased rates of hospital admission and reduced use of systemic neuropathic pain medication. Additionally, reducing post-procedural MME may reduce the rate of admission to the hospital.

Gender-Based Survey Analysis of Research and Mentoring in Interventional Radiology.

PURPOSE: This study sought to define gender-related differences in attitudes, perceptions, and aspirations among trainees interested in interventional radiology (IR) and to analyze their experiences in research and mentorship. MATERIALS AND METHODS: A cross-sectional survey study was conducted among the members of the Society of Interventional Radiology Resident, Fellow, and Student section and Medical Student section in the summer of 2020. The anonymous, internally validated 27-item survey assessed demographics, research attitudes and experiences, mentorship, and career aspirations. Descriptive statistics were calculated using Fisher exact analyses and Student t-tests. The institutional review board approved the protocols for this study. RESULTS: Of 105 respondents who indicated their gender, 30% were women and 70% were men. Although both genders reported similar levels of research experience, female trainees were less likely to feel valued and encouraged by their institution to engage in research (2.79 out of 4 vs 3.16 out of 4, P = .02) and were less likely to indicate that their program required them to participate in research (2.47 vs 3.06, P = .01). Female residents and fellows reported more difficulty in finding a mentor (2.88 vs 3.28, P = .04) and received less mentorship relating to IR education (29% vs 64%, P = .002). CONCLUSIONS: This work provides a perspective on the perceived obstacles faced by female trainees in pursuing research and finding effective mentorship in the field of IR. These data may guide future interventions to boost interest and engagement in IR research and residency programs in a way that promotes gender diversity and equity in the field.