This issue of Anesthesiology Clinics focuses on Pain Management.Topics will include: The Pain Treatment Imperative: Developments in the 21st Century, Imaging Pain, The Opioid Conundrum, Advancing the Pain Agenda in the Veteran Population ,Interventional Treatments of Cancer Pain, Integrating Pain Care into the Peri-Operative Surgical Home, Pain Care in the ED, Sleep and Pain, Can Chronic Pain be Prevented?, The Use of Outcome Data to Improve Patient Outcomes, and Impact of State-based Pain Legislation on Patient Outcomes.

This issue brings the anesthesiologist up to date on current essential topics in regional analgesia and acute pain management, including the latest state-of-the-art techniques and drugs. Subjects covered include prevention and treatment of local anesthetic systemic and neurotoxicity; complications of RA and pain management (medicolegal issues including anticoagulation, infection, etc.); assessment and treatment of post block neurologic injury (history, physical, investigations, EMG, NCS); new ultrasound guided techniques for peripheral nerve blocks and evidence based outcome review; emerging techniques and drugs for neuraxial and paravertebral blocks; local infiltration analgesia (for a variety of surgical procedures, wound infusions, infusion devices); continuous PNB in hospital and at home; recent advances in multimodal analgesia (new drugs & strategies, such as capsaisin, long acting opioid and local anesthetics); challenges in acute pain management (including the opioid tolerant patient, patients with comorbidities such as MS, DM and renal failure); economics and practice management issues associated with acute pain management; pediatric pain management; new concepts of acute pain management (including strategies to prevent chronic pain, opioid induced hyperalgesia, and more).

This issue of Anesthesiology Clinics brings the reader up to date on the most important advances in surgical palliative care for anesthesiology intensivists. Topics covered include recent trends and developments, palliative care of patients on high doses of narcotics, trauma in the surgical ICU, care of family in the surgical ICU, communication skills in palliative surgery, surgical palliative care in Haiti, and much more.

In this issue of Anesthesiology Clinics, guest editors Drs. Ronald G. Pearl and Sean Mackey bring their considerable expertise to the topic of Pain/Palliative Care. Top experts in the field cover key topics such as psychological approaches for migraine management; ketamine in chronic pain management; spinal cord stimulation for treatment of chronic pain: history and transition to novel waveforms; blinded pain cocktails; transitional pain services; and more. - Contains 11 relevant, practice-oriented topics including the emerging field of potential biased opioid agonists; update on treatments for facial pain; disparities in pain medicine; ultrasound-guided procedures in the management of chronic pain; and more. - Provides in-depth clinical reviews on pain and palliative care, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This issue of Anesthesiology Clinics, edited by Dr. Nabil Elkassabany and Dr. Edward Mariano, focuses on Regional Anesthesia, with topics including: Current evidence related to regional analgesia and hip surgery; Updates on billing and coding and establishing an acute pain service in private practice; Establishing a home catheter program for orthopedic surgery in pediatric patients or more broadly: updates on regional anesthesia for pediatric orthopedic surgery; Enhanced recovery after shoulder arthroplasty; Perioperative management of patient on opioid agonist antagonist therapy; Outcome metrics to be considered for regional anesthesia and acute pain medicine; Updates on multimodal analgesia (intransal ketorolac, IV acetmenophen, newer NSAIDS) for orthopedic surgery; Updates in enhanced recovery pathway for knee replacement versus updates outpatient knee replacement; Updates on new technology for regional anesthesia (peripheral nerve stimulators and cryotherapy); and Regional anesthesia and analgesia for the poly trauma patients.

The volume of elderly patients requiring anesthesia and surgery is growing rapidly. Thirty-five percent of surgeries are performed on patients older than 65 years, and in general, these patients have higher morbidity and mortality rates after anesthesia compared with their younger counterparts. One of the major challenges of treating elderly patients is the heterogeneity of the geriatric population—and the need to individualize care for each patient to provide the best outcome.

This issue will cover novel approaches to demonstrating value by anesthesiologists. Articles will include Value from the Patient and Payer Perspectives, Perioperative Surgical Home, Demonstrating Value: A British perspective, Demonstrating value: A case study of enhanced recovery, Acute Pain Management/Regional, Measuring Outcomes as Demonstrating Value and many more!

This issue of Clinics in Perinatology will carry the reader through the perinatal period and examine pain management throughout that continuum. Beginning with the genetics of obstetrical pain and opioid use in pregnancy, the discussion moves to the provision of anesthesia to the mother and fetus during fetal surgery - an area of intense concern and interest in many centers. There is an extensive discussion of both pharmacologic and non-pharmacologic management of pain during delivery. A discussion of regional anesthetic techniques is increasingly relevant in light of increasing evidence of adverse neurodevelopmental consequences of fetal exposure to general anesthetics and sedatives. Pain, its implications and management, are extensively covered including discussions of how to assess neonatal pain and how best to provide sedation and non-pharmacologic pain management, systemic pharmacologic, or regional techniques. Of particular interest are the reviews of the potential neurodevelopmental impact of both the treatment and the failure to adequately treat pain in the newborn. This topic is receiving an enormous amount of attention from all those who care for children as well as government and the media.

Ambulatory anesthesia is used for surgical procedures where the patient does not need to stay overnight in the hospital. The same anesthetics that are used in the operating room setting are used in the ambulatory setting, including general, regional and local anesthetics. Sedation anesthetics are also given in the ambulatory setting. This issue will cover best practices and procedures for perioperative care, regional anesthesia, pediatric anesthesia, administering office anesthesia, and more.

Guest editors Nabil M. Elkassabany and Edward R. Mariano have assembled an expert team of authors on the topic of Orthopedic Anesthesia. Articles include: Evidence-Based Medicine for Ultrasound-Guided Regional Anesthesia,Role of Regional Anesthesia in Orthopedic Trauma, Which Outcomes Related to Regional Anesthesia Are Most Important for Orthopedic Surgery Patients?,Optimizing Perioperative Care for Patients with Hip Fracture, Regional Anesthesia-Analgesia: Relationship to Cancer Recurrence and Infection, Developing a Multidisciplinary Fall Reduction Program for Lower-Extremity Joint Arthroplasty Patients, Optimizing Perioperative Management of Total Joint Arthroplasty, and more!