Invitees:
Andrew Marchant Steven Dain Patrick McCormick Martin Hurrell Maria Hendrickson Terri Monk Monica Harry Ian Green Jane Millar Zac Whitewood-Moores Ellen Torres Jeremy Rogers Steven Dain Sander Mertens Ingrid MertensChristine Spisla Grant Forrest Charles Gutteridge Krista Lilly
Apologies: Monica Harry Jane Millar
Present:
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
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International numbers available: https://snomed.zoom.us/u/avs0qL3Fx
Recording (GoogleDrive)
| Item | Description | Owner | Notes |
|---|---|---|---|
| 1 | Introductions and Apologies | ||
| 2 | Matters arising from the previous meeting notes | ||
| 3 | SNOMED 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. | |
| 4 | Local Anesthetic question | Longstanding question regardng local anesthetic Is concept 265778005 |Local anesthetic nerve block (procedure)| a 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:
Comments from PM: Agree with Steven that "nerve block" can mean inactivation of the nerve through methods other than local anesthesia. However, in the context of my anesthesiology procedures and anesthesiology research, "nerve block" always refers to a "local anesthesia nerve block." Among, say, pain specialists or interventional radiologists "nerve block" can refer to cryo, RF, phenol, or other means of nerve inactivation. "cryo nerve block" on google brings up links to several healthcare institutions discussing cryoablation of nerves. Wikipedia definition: "Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief." Article has subheadings for "local anesthetic nerve block", "Neurolytic block", "Neurectomy", and "Regional blocks". After discussion Noted that arrangement of concepts is not very logical "Nerve block" is not a duplicate of "local anesthesia nerve block" | |
| 5 | IASP Termiinology | Jane 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. The Revised IASP definition of pain: concepts, challenges, and compromises - PMC (nih.gov) | |
| 6 | Work Plan and Outreach (e.g. to SCATA and RCoA) |
| |
| 7 | Dates of next meeting | Tuesday September 26, 2023 |