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Anesthesia Clinical Reference Group

Time: Tuesday, July 25, 2023 19:00 - 20:00 UTC / 20:00 - 21:00 UK / 15:00 - 16:00 ET

https://snomed.zoom.us/j/84604407202?pwd=K1gzd0JzRWo4Vkp3ellMcnA2SWV5QT09

Or Telephone:

+1 646 518 9805 (US Toll)
+44 203 481 5237 (GB Toll)
+1 587 328 1099 (CA Toll)

International numbers available: https://snomed.zoom.us/u/avs0qL3Fx

Recording (GoogleDrive)


ItemDescriptionOwnerNotes
1Introductions and Apologies


2

Matters arising from the previous meeting notes

2023-04-04 Anesthesia CRG London F2F Meeting


3SNOMED Update
Business Meeting: Friday Oct 20 - Weds Oct 25
Expo: Weds Oct 25 - Fri Oct 27
IG notes the agenda for Atlanta is in development, Speakers have been arranged. There is lots of discussion regarding the use of specialty registries and of networking them together, Registration is open. PM expects that the Anesthesia group may meet virtually.
4Local Anesthetic question

Longstanding question regardng local anesthetic

Request is to inactivate 265778005 |Local anesthetic nerve block (procedure)| as duplicate of 56333001 |Nerve block (procedure)|

Reference

https://pubmed.ncbi.nlm.nih.gov/35305154/ "The obturator nerve branches into the obturator canal; therefore, local anesthetic spread into the obturator canal predicts the success of the obturator nerve block (ONB)" This paper discusses a nerve block, and clearly assumes it uses a local anesthetic.

https://www.radiologyinfo.org/en/info/nerveblock#:~:text=A%20nerve%20block%20is%20an%20anesthetic%20and%2For%20anti%2Dinflammatory,decrease%20inflammation%20in%20that%20area. "A nerve block is an anesthetic and/or anti-inflammatory injection targeted toward a certain nerve or group of nerves to treat pain. The purpose of the injection is to "turn off" a pain signal coming from a specific location in the body or to decrease inflammation in that area"

This site explains a nerve block as an injection to turn off a pain signal from a specific location in the body. Indeed, how could the effect of blocking a particular nerve not be local, or localized anyway? Obviously the effect can be (quite a bit) downstream, but it's not going to be generic the way an aspirin is. Third piece of evidence: run the ECL query < 265778005 |Local anesthetic nerve block (procedure)| and you find dozens of concepts without local in the FSN, e.g. 764912007 |Obturator nerve block using fluoroscopic guidance (procedure)|. If there is a clear difference, then the modelling is inconsistent.

See also:

5IASP TermiinologyJane Millar has been approached by a member country to discuss the possibility of linking SNOMED to terminology used by the IASP (International Association for the Study of Pain). Definbition of pain by the IASP has recently been modified. Extent of "linkage" and copyright considerations would need to be clarified.
6Work Plan and Outreach (e.g. to SCATA and RCoA)
  • Agree targeted outreach (see 23/04 notes for list of potential organisations)
  • Facilitated discussion to agree focus of workplan
 7

Dates of next meeting

Tuesday September 26, 2023

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