Yury Khelemsky

Icahn School of Medicine at Mount Sinai, Borough of Manhattan, New York, United States

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Publications (5)4.26 Total impact

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    Jason Siefferman, Yury Khelemsky
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    ABSTRACT: While undergoing full thickness tissue harvest from the posterior scalp, a 72-year-old man experienced immediate severe pain in the right occiput and was unable to complete the procedure. The pain was constant "sharp" and "shocking" with numbness in the distribution of the lesser occipital nerve, exacerbated by physical activity, and local anesthetic blocks provided temporary complete relief. After numerous treatments over several years, including oral analgesics, botulinum toxin injections, and acupuncture, proved ineffective, pulsed radiofrequency neuromodulation provided greater than 80% relief for 5 months.
    01/2015; 2015:428413. DOI:10.1155/2015/428413
  • Joshua Hamburger, Ira S Hofer, Yury Khelemsky
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    ABSTRACT: A patient with a drug-eluting stent placed 18 months earlier received a thoracic epidural for perioperative analgesic control as part of her thoracotomy. Postoperatively, the patient was started on clopidogrel for secondary prevention. After consultation with the Hematology service and a platelet function assay, the patient was transfused two pools of platelets and the epidural catheter was removed on postoperative day 4. The patient then underwent hourly neurologic checks for 24 hours and was discharged several days later without any negative sequelae. If neuraxial techniques and the need for clopidogrel prophylaxis come into direct conflict, vigilance is necessary for warning signs of epidural hematoma and platelet transfusion should be considered to reverse the effects of the drug. Copyright © 2014 Elsevier Inc. All rights reserved.
    Journal of Clinical Anesthesia 11/2014; 26(7):577-80. DOI:10.1016/j.jclinane.2014.05.008 · 1.21 Impact Factor
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    ABSTRACT: This article reviews the current evidence for multimodal analgesic options for common surgical procedures. As perioperative physicians, we have come a long way from using only opioids for postoperative pain to combinations of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), selective Cyclo-oxygenase (COX-2) inhibitors, local anesthetics, N-methyl-d-aspartate (NMDA) receptor antagonists, and regional anesthetics. As discussed in this article, many of these agents have decreased narcotic requirements, improved patient satisfaction, and decreased postanesthesia care unit (PACU) times, as well as morbidity in the perioperative period.
    03/2014; 28(1):59-79. DOI:10.1016/j.bpa.2014.03.001
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    Yury Khelemsky, Christopher J Noto
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    ABSTRACT: This article provides a concise overview of post-thoracotomy pain syndrome, describes anesthetic and surgical factors that have been investigated to reduce the incidence of the syndrome, and explores the effectiveness of various treatments for this condition. Although some interventions (both procedural and pharmacologic) have been investigated in both preventing and treating post-thoracotomy pain syndrome, definitive studies are lacking and firm conclusions regarding the benefit of any intervention cannot be drawn. The problem is compounded further by our lack of understanding of the pathophysiologic mechanisms underlying the development of chronic pain after surgery. Going forward, it will be important to elucidate these mechanisms and conduct well-designed trials involving novel therapeutic agents for both prevention and treatment of post-thoracotomy pain syndrome.
    Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 01/2012; 79(1):133-9. DOI:10.1002/msj.21286 · 1.56 Impact Factor
  • Michael Mazzeffi, Yury Khelemsky
    Journal of cardiothoracic and vascular anesthesia 09/2011; 25(6):1163-78. DOI:10.1053/j.jvca.2011.08.001 · 1.48 Impact Factor