Carole Lin

All Publications

• Opioid-Free Tonsillectomy With and Without Adenoidectomy: The Role of Regional Anesthesia in the "New Era". Anesthesia and analgesia Tsui, B. C., Pan, S., Smith, L., Lin, C., Balakrishnan, K. 2021; 133 (1): e7-e9

  View details for DOI 10.1213/ANE.0000000000005567

  View details for PubMedID 34127598

• Droplet evacuation strategy for simulated coughing during aerosol-generating procedures in COVID-19 patients. British journal of anaesthesia Tsui, B. C., Deng, A., Lin, C., Okonski, F., Pan, S. 2020

  View details for DOI 10.1016/j.bja.2020.06.009

  View details for PubMedID 32600805

• Systemic Absorption of Lidocaine from Continuous Erector Spinae Plane Catheters After Congenital Cardiac Surgery: A Retrospective Study. Journal of cardiothoracic and vascular anesthesia Caruso, T. J., Lin, C. n., O'Connell, C. n., Weiss, D. n., Md, G. B., Wu, M. n., Kwiatkowski, D. n., Maeda, K. n., Tsui, B. C. 2020

  Abstract

  To examine postoperative serum lidocaine levels in patients with intermittent lidocaine bolus erector spinae plane block (ESPB) catheters after cardiac surgery with or without cardiopulmonary bypass (CPB).A retrospective study.Single-center pediatric quaternary teaching hospital.Patients who received ESPB catheters after congenital cardiac surgery from April 2018 to March 2019.Postoperative serum lidocaine levels were extracted from the record.Twenty-seven of 40 patients were included in the final analyses (19 with CPB and 8 with no CPB, age 1-47 years, undergoing congenital heart repair). Patients who received ropivacaine or were missing data were excluded. The initial intraoperative bolus of lidocaine ranged from 0- to- 3.72 mg/kg, and the range of postoperative intermittent lidocaine boluses ranged from 0.35- to- 0.83 mg/kg, which were administered every hour. Serum lidocaine levels were measured by the hospital laboratory and ranged from <0.05- to- 3.0 μg/mL in the CPB group and from <0.05- to- 3.2 μg/mL in the no- CPB group. CPB was not associated with differences in lidocaine levels when controlling for time (P = 0.529). Lidocaine concentrations ranged from 0.50- to- 1.68 μg/mL in the CPB group and 0.86- to- 2.07 μg/mL in the no- CPB group. There was a normally distributed overall mean peak level of 1.818 ± standard deviation of 0.624 μg/mL, with 95% confidence interval of 0.57- to- 3.06 μg/mL. No patients had clinical signs of toxicity.Postoperative serum lidocaine concentrations did not appreciably differ due to CPB. Serum lidocaine concentrations did not reach near- toxic doses despite the presence of additional lidocaine in the cardioplegia. The results suggested that lidocaine for ESPBs after cardiac surgery is below systemic toxic range at the doses described.

  View details for DOI 10.1053/j.jvca.2020.05.040

  View details for PubMedID 32622712

• In reply: Regional anesthesia catheter tunnelling: a simpler approach. Canadian journal of anaesthesia = Journal canadien d'anesthesie Reece-Nguyen, T., Lin, C., Tsui, B. C. 2019

  View details for DOI 10.1007/s12630-019-01555-w

  View details for PubMedID 31848982

• Erector spinae plane block for pediatric palliative care. Paediatric anaesthesia Baca, Q., Lin, C., O'Hare, K., Golianu, B., Tsui, B. 2019

  Abstract

  We read with great interest the excellent editorial by Dr.Bosenberg addressing innovative peripheral nerve blocks1 . As highlighted by Dr.Bosenberg, the newly described erector spinae plane (ESP) peripheral nerve block is used across multiple surgical specialties to provide perioperative pain control.2 With patient's father consent, we would like to share our recent experience with using continuous ESP for management of refractory pain in a pediatric patient receiving palliative care. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1111/pan.13607

  View details for PubMedID 30758119

• Toward Opioid-Free Fast Track for Pediatric Congenital Cardiac Surgery. Journal of cardiothoracic and vascular anesthesia Esfahanian, M., Caruso, T. J., Lin, C., Kuan, C., Purkey, N. J., Maeda, K., Tsui, B. C. 2019

  View details for DOI 10.1053/j.jvca.2019.02.003

  View details for PubMedID 30852093

• Practical Regional Anesthesia Guide for Elderly Patients. Drugs & aging Lin, C., Darling, C., Tsui, B. C. 2019

  Abstract

  Ultrasound-guided regional anesthesia is an important part of the practice of anesthesia for the elderly population, the growth of which will continue to outpace that of the younger population due to improvements in lifespan worldwide. The elderly patient is uniquely vulnerable to the effects of systemic anesthetic drugs, and our understanding of the potential toxicities that general anesthetics can have on the elderly brain and body continues to evolve. Aging impacts both the pharmacokinetics and pharmacodynamics of sedative medications and local anesthetics. Alongside the physiologic aging process often comes a myriad of pathologic co-morbidities that can accumulate with age, and result in a great variability of physiologic reserve. This variability in overall functional status is described by a newer concept termed 'frailty,' which is used to evaluate and risk-stratify elderly patients perioperatively. The choice for regional anesthesia is based on a combination of factors such as duration of surgery, pre-existing patient risk factors, and the skill and technique of the anesthesiologist. The utilization of preoperative and intraoperative sedation is now recognized as a key component in maximizing the safety and success rate of regional anesthesia. Excellent pain management with minimal to no sedation during the operation may have benefits that extend far beyond the immediate perioperative setting. Regional anesthesia is increasingly integrated as an important part of multimodal enhanced recovery after surgery (ERAS) protocols, which aim to decrease the cost, enhance safety, and improve the patient's subjective experience during and after hospitalization. Ultrasound-guided techniques, recently developed regional blocks, medications for sedation, and local anesthetics are reviewed in this article.

  View details for PubMedID 30680678

• Moving toward patients being pain- and spasm-free after pediatric scoliosis surgery by using bilateral surgically-placed erector spinae plane catheters. Canadian journal of anaesthesia = Journal canadien d'anesthesie Tsui, B. C., Esfahanian, M. n., Lin, C. n., Policy, J. n., Vorhies, J. n. 2019

  View details for DOI 10.1007/s12630-019-01543-0

  View details for PubMedID 31776896

• A retrograde tunnelling technique for regional anesthesia catheters: how to avoid the skin bridge. Canadian journal of anaesthesia = Journal canadien d'anesthesie Lin, C. n., Reece-Nguyen, T. n., Tsui, B. C. 2019

  View details for DOI 10.1007/s12630-019-01505-6

  View details for PubMedID 31617068

• A Novel and Simple Setup for Positioning the Lower Extremity Using Commonly Accessible Equipment. Regional anesthesia and pain medicine Lin, C., Munshey, F., Tsui, B. C. 2018; 43 (5): 561–62

  View details for PubMedID 29927852