Der Anaesthesist
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The aim of this prospective study was to evaluate the vertical infraclavicular approach to the brachial plexus for the insertion of a catheter to achieve continuous analgesia in postoperative patients and patients with chronic upper limb pain. ⋯ The placement of an infraclavicular plexus catheter is a suitable method for pain management in the upper limb. This approach may have advantages in patients with severe injuries who cannot abduct the arm. Our results are encouraging in terms of catheterisation time, patient comfort and incidence of complications.
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The use of opioids in the treatment of chronic pain is sometimes accompanied by inadequate pain relief and opioid-specific side-effects. Opioid rotation is a therapeutic approach, that can improve analgesia and provide a more advantageous analgesia and toxicity relationship. This article presents a case report and discusses the mechanisms, indications and possibilities of opioid rotation.