Hardman, H. David
https://orcid.org/0000-0001-7352-0494
Mayo Clinic
University of North Carolina at Chapel Hill
Citations 2
ASRA Pain Medicine narrative review and expert practice recommendations for gastric point-of-care ultrasound to assess aspiration risk in medically complex patients undergoing regional anesthesia and pain procedures
Haskins, Stephen C. , Ledbetter, Leila , Arzola, Cristián , Hardman, H. David , Panzer, Oliver, Weber, Marissa M, Heinz, Eric , Boublik, Jan , Cubillos, Javier , Hernandez, Nadia , Zimmerman, Joshua , Perlas, Anahi , Arzola, Cristian , Hardman, David , Boublik, Jan , Cubillos, Javier , Perlas, Anahi , Bronshteyn, Yuriy S. , Kalagara, Hari , Weber, Marissa M
Regional Anesthesia & Pain Medicine | April 18, 2025 | Volume: 51 | Issue: 7 | Pages: 723-745
Gastric point-of-care ultrasound (POCUS) may offer clinical value in assessing aspiration risk among medically complex patients undergoing regional anesthesia and pain procedures. While the American Society of Anesthesiologists (ASA) preoperative fasting guidelines primarily apply to healthy individuals, medically complex populations often present with differing gastric emptying and aspiration risk. This narrative review, conducted by the American Society of Regional Anesthesia and Pain Medicine (ASRA-PM), adhered to PRISMA guidelines and was registered with PROSPERO. It focused on seven medically complex patient groups: those who are pregnant, obese, diabetic, have gastroesophageal reflux disease (GERD), are receiving emergency care, are enterally fed, or are taking GLP-1 receptor agonists (GLP-1RA). Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Practice recommendations were developed using an iterative expert consensus process, with final recommendations based on evidence strength, clinical relevance, and expert agreement. Findings support the use of gastric POCUS in patients in active labor, those undergoing urgent cesarean sections, and those with diabetes. Conditional support is given for obesity, emergency care, enteral feeding, and GLP-1RA use. Routine use is not recommended in non-laboring pregnancies, elective cesarean delivery, or GERD. While gastric POCUS may aid with aspiration risk evaluation, its use should complement clinical judgment. Implementation may be limited by practical and training constraints, requiring individualized decision-making. These recommendations serve as a foundation for future research and potential clinical guideline development. PROSPERO registration number: CRD42023445927.
Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project
Lotfy, Ahmed , Atterton, B, Crowe, G, Barratta, Jaime L, Johnson, Mark , Viscusi, Eugene R. , Adhikary, Sanjib Das , Albrecht, Éric , Boretsky, Karen , Boublik, Jan , Breslin, Dara S., Ch’ng, Alan Swee Hock , Chuan, Alwin , Conroy, Patrick , Daniel, Craig O. , Daszkiewicz, Andrzej , Delbos, Alain, Dîrzu, Dan Sebastian , Dmytrіiev, Dmytro , Fennessy, Paul , Frizelle, Henry P., Gadsden, Jeff, Gautier, Philippe , Hardman, H. David , Harrop‐Griffiths, W., Hebbard, Peter , Hernandez, Nadia , Hlásny, Jakub , Iohom, Gabriella , Kalagara, Hari , Kinirons, B., Leng, Jody C. , Lim, Yean Chin , Lobo, Clara , Ludwin, Danielle, Macfarlane, Alan , Machi, Anthony , Mahon, Padraig, Mannion, Stephen , McLeod, David H., Merjavy, Peter , Miščuks, Aleksejs , Mitchell, Christopher H. , Μoka, Εleni , Moran, Peter, Ngui, Ann, Nin, Olga C. , OʼDonnell, Brian D. , Pawa, Amit , Perlas, Anahi , Pozek, John-Paul J., Rebelo, Humberto C, Roqués, V, Schroeder, Kristopher M. , Schwartz, Gary , Shorten, George , Stevens, Markus F. , Turbitt, Lloyd , Valdés-Vilches, Luis Fernando , Webster, Katrina, Wolmarans, Morné , Woodworth, Glenn E. , Worek, Andrew K, Moran, EML , Ahmed, Hassan M , Viscusi, Eugene , Adhikary, Sanjib , Byrne, Kelly , Chuan, Alwin , Dirzu, Dan Sebastian , Dmytriiev, Dmytro , Gupta, Rajnish K , Ip, Vivian H Y , Jeng, Christina L , Johnson, Rebecca L , Lim, Yean Chin , Macfarlane, Alan James Robert , Machi, Anthony T , Merjavy, Peter , Pawa, Amit , Perlas, Anahi , Porter, Steven B , Schwenk, Eric S , Sermeus, Luc , Srinivasan, Karthikeyan , Theodoraki, Kassiani , Volk, Thomas , Wilson, Sylvia H , Woodworth, Glenn , Moran, E M Louise , Kalagara, Hari , Lobo, Clara , Moka, Eleni , Albrecht, Eric , Crowe, Gillian-Genevieve , Ch'ng, Alan, Fischer, H. B. J. , Gupta, Rajnish K. , Gürkan, Yavuz , Ip, Vivian , Johnson, Rebecca L. , Lansdown, Andrew Kenneth, Porter, Steven B. , Schwenk, Eric S. , Volk, Thomas , Webster, Katrina, Wiesmann, Thomas
Regional Anesthesia & Pain Medicine | February 22, 2022 | Volume: 47 | Issue: 5 | Pages: 301-308
Background and objectives Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%–74% agreement. Results Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.