A&A practice
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Complex regional pain syndrome (CRPS) is a chronic condition commonly consisting of allodynia, paresthesias, skin and temperature changes, and motor dysfunction. CRPS is relatively rare and classically develops in a limb after sustaining a traumatic or surgical insult. To date, CRPS developing in a previously uninjured limb after prolonged immobilization has not yet been reported. We describe a 45-year-old man with no known preexisting injury or neuropathy to his upper extremities who developed CRPS of his right wrist and hand after prolonged colorectal surgery.
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Case Reports
Liposomal Bupivacaine for Pediatric Celiac Plexus Block: A Case Report of Refractory Constipation Management.
Liposomal bupivacaine is a long-acting amide local anesthetic with a limited list of indications. At the time of publication, use is limited to field block and surgical wound infiltration and, more recently, interscalene nerve block. ⋯ We present the use of liposomal bupivacaine for pediatric celiac plexus block in a 12-year-old boy suffering from gastrointestinal complications (eg, pain, constipation, and ileus) after bone marrow transplantation. Celiac plexus block utilizing liposomal bupivacaine was successfully used to palliate his pain and to normalize bowel function.
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Vertebral body tethering (VBT) is an innovative surgical technique used to treat juvenile and adolescent idiopathic scoliosis. The optimal anesthetic technique, including the preferred management of postoperative pain, is not known. In this case series, we describe 3 patients with adolescent idiopathic scoliosis who received either continuous erector spinae plane block (ESPB) catheters or intercostal liposomal bupivacaine for postoperative pain management after bilateral VBT via minithoracotomy.
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It remains unclear how epidural pneumatosis affects the efficacy of neuraxial anesthesia. Spontaneous pneumomediastinum (Hamman syndrome) with epidural pneumatosis is rare. ⋯ We present a 19-year-old patient with Hamman syndrome and epidural pneumatosis who required emergency laparotomy. Effective analgesia was obtained using neuraxial anesthesia with a combined spinal-epidural anesthesia technique.
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Peripheral nerve blocks for postoperative pain management in distal radius fracture fixation with volar locking plates can cause undesirable motor paralysis. We performed bilateral ultrasound-guided selective sensory nerve blocks to the lateral cutaneous nerve of the forearm, superficial branch of the radial nerve, and anterior interosseous nerve for a patient undergoing bilateral distal radius fracture fixation with volar locking plates. This case report describes the first successful use of this ultrasound-guided selective sensory nerve block, which provided satisfactory postoperative analgesia and preserved the patient's motor function following distal radius fracture fixation with volar locking plates.