Dr. Karla Espinoza Morales

2023:
Master's Degree in Pain. TECH University. Spain.
Master's Degree in Palliative Care. TECH University. Spain.

2021:
Specialist in Anesthesiology and Recovery. University of Costa Rica

• August 2021 to January 2025:
  • Specialist in Anesthesiology and Recovery. San Juan de Dios Hospital and CAIS of Puriscal
  • Private medical practice. Private clinics and hospitals.
• August 2017 to July 2021:
  • Resident in Anesthesiology and Recovery. CCSS Hospitals.

• Safe sedation
• Pediatric pain
• Adult pain
• Orofacial pain
• Trigeminal neuralgia
• Post-herpetic neuralgia (pain after shingles)
• Fibromyalgia (blockage of the stellate ganglion)
• Lumbago (lower back pain, back pain)
• Osteoarthritis (wear and tear of joints) Omalgia (shoulder pain)
• Preoperative assessments
• Sedation for procedures outside the operating room
• Sedation for uncomfortable procedures for autistic children or children with special conditions. Children / adults with a special condition
• Sedation for dental procedures (including dental cleanings)
• Sedation for dental procedures for children
• Sedation for maxillofacial surgery (wisdom teeth, implant placement, among others)
• Sedation for tattooing
• Sedation for MRI and gastroenterology
• Placement of vascular access for patients with difficult peripheral veins (difficult veins and need for long-term intravenous medication)
• Platelet-rich plasma regenerative medicine
• Hyaluronic acid injection for knees/hips
• Prolotherapy injections
• Phenol injections
• Infiltrations with steroids
• Infiltration of the spine
• Infiltration of joints
• Trigger point infiltration
• Trigeminal ganglion infiltration in trigeminal neuralgia
• Infiltration of nerves in neuropathic pain Botox injection in orofacial pain (face and mouth)
• Button injection into peripheral nerves to reduce pain, depression, anxiety and insomnia (stellate ganglion block)
• Improve quality of life in chronic pain/palliative care patients
• 24-hour availability for sedation (call to check availability)

List of procedures under sedation according to medical specialty:

• Gastroenterology: Upper gastrointestinal endoscopy, gastroscopy, colonoscopy, ERCP, placement of intragastric balloon.
• Cardiology: electrical cardioversion, catheterization.
• Dentistry and Maxillofacial Surgery: extraction of wisdom teeth, placement of dental prostheses, breast lift.
• Pulmonology: bronchoscopy, thoracentesis
• Interventional Radiology: image-guided biopsies, tumor ablation, radiofrequency tumor treatment and cryotherapy
• Urology: prostate biopsy, vasectomy, diagnostic cystoscopy, circumcision
• General Surgery: abscess/infection drainage, percutaneous gastrectomy placement, small umbilical hernias, lymph node biopsies
• Pediatrics: painful procedures, neonatal circumcision, lumbar puncture, dental procedures
• Gynecology: insertion of intrauterine devices (IUDs), insertion of Mirena.
• Traumatology and Orthopedics: reduction of fractures and dislocations.
• Dermatology: laser procedures, Mohs surgeries, for the insertion of tension threads.
• Administration of intrathecal chemotherapy, lumbar punctures with chemotherapy
• Otolaryngology: nasal or laryngeal endoscopy, biopsies of head and neck lesions, placement of tympanic tubes
• Ophthalmology: chalazion surgery
• Neurology/Neurosurgery: lumbar punctures.
• Plastic and Reconstructive Surgery: blepharoplasty, radiofrequency
• Rheumatology: joint infiltrations
• Orthopedics: carpal tunnels, trigger fingers, Kishner's wire removal, fracture reduction
• Otorhinolaryngology: placement of tympanic tubes, nasal fracture reduction

• Association of Anesthesiologists of Costa Rica.

• 2024:
  • Multimodal Anesthesia. Jiménez Díaz Foundation University Hospital. Spain.
  • Face-to-face Regional Anesthesia Ultrafest. Mexico.
  • Regional Anesthesia Teacher. Face-to-face Spain. IBERECO Autonomous University of Madrid.
  • Ultradissection Group Regional Anesthesia. Virtual Cardiothoracic Surgery in Pediatrics. Spain.
  • Virtual Lumbar Plexus Block. Ultradissection Group. Spain.
  • PVI for Virtual Hip Surgery. Ultradissection Group. Spain.
  • Virtual peripheral nerve approach of the foot. Ultradissection Group. Spain.
  • Virtual intradural opioids. Ultradissection Group. Spain.
• 2023:
  • PVI for shoulder surgery. Ultradissection Group. Spain.
  • Nerve blocks to prevent the patient from moving the leg. Ultradissection Group. Spain.
  • PVI for knee surgery. Ultradissection Group Spain.
  • Chronic pain training. Ultradissection Group
  • Echoanatomy applied to cadavers and real patients. Autonomous University of Madrid, Spain.
  • Approach to the ulnar nerve from its origin to its end. Ultradissection Group. Spain.
  • When does anatomy fail? Ultradissection Group. Spain.
  • Vessels that are always there. Ultradissection Group. Spain.
  • Regional Anesthesia for Thoracic Limb Disarticulation. Ultradissection Group. Spain.
  • Local Anesthetic Intoxication. Ultradissection Group. Spain.
  • Peripheral Nerve Approach. Ultradissection Group. Spain.
  • Infraclavicular approach to the brachial plexus. Ultradissection Group. Spain.
  • Interescalene approach to the brachial plexus. Ultradissection Group. Spain.
  • Supraclavicular approach to the brachial plexus. Ultradissection Group. Spain.
  • Musculoskeletal ultrasound. Spain and Italy.
• 2022:
  • Regional Anesthesia. Autonomous University of Madrid.
  • Echofluoroscopy and Echoanatomy applied to Chronic Pain Procedures. Ultradissection Group. Spain.
  • Basic Nerve Blocks that every Anesthetist should master. Ultradissection Group. Spain.
  • Regional Anesthesia for Hip Fractures. Ultradissection Group. Spain.
  • Training in Echoanatomy for Breast Surgery. Ultradissection Group. Spain.
  • Regional Anesthesia Diploma in Regional Anesthesia. Mexico
  • Masterclass in Anatomy Applied to Regional Anesthesia In-person. Hispanoamericana University

Publications:

2024:

• Mario Fajardo Pérez, Karla Espinosa Morales, Andrés Rocha-Romero, Felice Galluccio, Ece Yamak-Altinpulluk, Rodrigo Díez Tafur, Carlos H. Salazar Zamorano, Pablo Oliver-Fornies, Ricardo Aguilar Ureña, Alaa Abd-Elsayed Angel Juarez- Lemus. “Novel ultrasound-guided supraclavicular stellate ganglion block”. Pain Practice / Early View 2024;00: 1–7. January 22, 2024. DOI: 10.1111/papr.13350
• Dexter Kerry Salazar Flores, Carlos H Salazar Zamorano, Luis Humberto Reyes Esparza, Karla Espinoza Morales, Ece Yamak Altinpulluk, Ruth Liceth Jara Pacheco, Radu Podaru, Mario Fajardo Pérez. “The anterior axillary nerve approach: A novel technical for shoulder surgery”. Agri Pain. Agri 2024;36(1):77–78. January 2024. doi: 10.14744/agri.2023.90197

2023:

• Perez Herrero MA*, Morales KE, Galluccio F and Perez MF. “Interfascial Pec's Block Success or Intramuscular Injection? Magnetic Resonance Imaging (MRI)”. FEA Anesthesiology and Resuscitation, University Clinical Hospital of Valladolid, Spain. Clinical Image. Published: Aug. 16, 2023.
• Mario Fajardo Perez, Karla Espinoza Morales, Jose Fabio Rodriguez Sojo, Yaneth Prada Castellanos, Felice Galluccio “A Novel Two-Step Ultrasound-Guided Technique for Anesthesia and Postsurgery Analgesia in Gluteal Augmentation Surgery.” Aug 15, 2023;15(8):e43546. PMID: 37593073 PMCID: PMC10427781 DOI: 10.7759/cureus.43546.
• María del Pilar Ascensio Mercado, Marilina Susana Olea, Ana Teles Rodrigues, Karla Espinoza Morales, Diego García Simon, Juan Jose Llavador Ros, Ece Yamak Altinpulluk, Carlos H. Salazar Zamorano, Fellice Galluccio, Mario Fajardo-Pérez. “Intraneural injection of Botulinum Toxin-A in Palliative Cere and Unresponsive Neuropathic Pain”. Asia Pacific Journal of Pain; 預刊⽂章 2023 / 02 / 13 , P1 – 6 English DOI:10.29760/APJP.202302/PP.0001
• Maria Pérez Herrero. Ece Yamak Altinpulluk. Felice Galluccio. Karla Espinoza Morales. Ruth Licea Jara Pacheco. Mario Fajardo. “Correspondence on Percutaneous cervical sympathetic block to treat cerebral vasospasm and delays
  in cerebral ischemia: a review of the evidence by Bombardieri et al” J NeuroIntervent Surg 2023; 0:1–2. doi:10.1136/jnis-2023-020449

2022:

• María Fernanda Avendaño MD. Andrés Rocha Romero MD. Ricardo Aguilar Ureña MD. Mario Fajardo Pérez MD. Rodrigo Benavides Cordero MD. Karla Espinoza Morales MD. “Effect of Triamcinolone in Regional Anesthesia for Fast-Track Knee Replacement. Case Series”. https://doi.org/10.25237/revchilanestv5128121711

2021

• Pablo Oliver-Fornies, Karla Espinoza Morales, Mario Fajardo-Pérez, Carlos H. Salazar-Zamorano, Ece Yamak-Altinpulluk, Luis Valdes Vilches, Ricardo Aguilar Ureña, Cristian Aragón-Benedí, Irene Lopez Arribas, Alejandro Centeno-Perez, Juan Jose Llavador, Felice Galluccio. “Modified supraclavicular approach to brachial plexus block"https://doi.org/10.1016/j.jclinane.2021.110585
• Andrés Rocha Romero, María Ascensio Mercado, Ece Yamak Altinpulluk, Pablo Oliver Fornies, Karla Espinoza, Carlos Salazar, Marilina Susana Olea, Nelson Roque Gomez, Ana Sofía Teles, Ricardo Aguilar Ureña, Mario Fajardo Pérez. “Proposal of a Clinical Approach to Perioperative Visceral Pain”. Regional Anesthesia and Pain Medicine. September 2021, Vol 0 No 0. http://dx.doi.org/ 10.1136/rapm-2021-103071
• Ana Sofia Teles, Ece Yamak Altinpulluk, Rajendra Sahoo, Felice Galluccio, Diego García Simón, Ilker Ince, Marilina S. Olea, Emilio González-Arnay, Carlos Salazar, Karla Espinoza, Mario Fajardo Pérez. “Beyond the Pericapsular Nerve Group (PENG) Block”: Narrative Review. 2021
• Ece Yamak Altinpulluk, María del Pilar Ascensio Mercado, Susana Marilina Olea, Diego García Simón, Carlos H. Salazar-Zamorano, Felice Galluccio, Karla Espinoza, Ana Teles Rodrigues, Juan Jose Llavador Ross, Mario Fajardo Perez. “Sub-epineural injection of Botulinum Toxin-A in patients with persistent neuropathic pain: a report of three cases”

Presentation of clinical cases:

2021:

• Irene López Arribas, Alejandro Centeno Pérez, Karla Espinoza Morales, Miguel Lucas Maiza Cortés, Juan José Llavador Ros, Mario Fajardo Pérez MD.
• “Palliative Spinal Neurolysis in a Patient with Incoercible Pain”. 17th Congress of the Spanish Pain Society. Bilbao, October 2021.

Books:

2024:

• Co-author of the book ‘Musculocutaneous Nerve: Applied Echoanatomy’ www.amazon.com
• Co-author of the book “Dorsal scapular nerve: Applied echoanatomy” https://amzn.to/3OpmFF6
• Co-author of the book “Axillary nerve: Ultrasound-guided approach” https://amazon.com/dp/B0CTJDS6G8
• Co-author of the book “Supra-scapular Nerve: Applied Echo-anatomy” https://www.amazon.com/dp/B0CTJBV2CJ
• Co-author of the book “Infraclavicular Approach to the Brachial Plexus: Topographic and Descriptive Echo-anatomy Applied to Regional Anaesthesia” http://amzn.to/3SjEBSu
• Co-author of the book “Applied Echo Anatomy of the Upper Trunk (Plexus Brachialis Approaches No. 1)” https://amzn.to.3Omsx1T
• Co-author of the book “Supraclavicular Brachial Plexus Approach (Topographic and Descriptive Echo Anatomy Applied to Regional Anesthesia” https://eu/d/5kes9VO
• Co-author of the book “Ecoanatomía de la región axilar (Ecoanatomía topográfica y descriptiva aplicada a la anestesia regional” https://a.co/d/7yxLgqu
• 2023: Co-author of the book “Plexo Braquial. Anatomía aplicada del espacio interscalénico: un bloqueo que puede matar” https://amzn.to/3KVV2S

• Not available