Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 1999
Comparative StudyThe endoneurial response to neurolytic agents is highly dependent on the mode of application.
The variability and predictability of neurolytic neural blocks were studied using an experimental rat sciatic nerve model. The goal of the study was to compare endoneurial and clinical responses to commonly used neurolytic agents. ⋯ There were no differences in the effects of clinically used neurolytic agents after intraneural injections. Although the perineurally applied 7% phenol-aqua induced marked endoneural damage, the destructive effect of glycerol and phenol-glycerol injections seemed to be prevented by the perineurium; phenol-glycerol and glycerol treatments induced subperineural damage only after perineural injections. The ability to penetrate the perineurium favors the use of 7% phenol-aqua in peripheral perineural blocks when complete neurolysis is the goal.
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Reg Anesth Pain Med · Jul 1999
Case ReportsLumbar spine pain originating from vertebral osteophytes.
Axial spine pain originates from a number of structures. Putative pain generators include facet joints, intervertebral disks, sacroiliac joints, and myofascial structures. Osteophytes originating from lumbar vertebral bodies in the area of the intervertebral disks may be a source of nociceptive low back pain which may respond to local injection. ⋯ Vertebral osteophytes may be a source of axial spine pain. Injection of painful osteophytes with a local anesthetic and corticosteroid solution may produce pain relief.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRemifentanil versus alfentanil as analgesic adjuncts during placement of ophthalmologic nerve blocks.
Short-acting opioids are often used prior to the placement of ophthalmologic nerve blocks. This study examines whether remifentanil would provide superior analgesia compared with alfentanil, without oversedation or prolonged recovery when given either as a single dose over 30 seconds or as a single dose followed by a continuous infusion, in a dose ratio of 1:7 (remifentanil:alfentanil). ⋯ Remifentanil 1 microg/kg results in superior analgesia compared with alfentanil 7 microg/kg when used during the placement of ophthalmologic nerve blocks. The combination of a single dose of remifentanil followed by a continuous infusion was equally effective but resulted in a higher incidence of respiratory depression.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine for peribulbar anesthesia.
We compared the efficacy of a mixture of ropivacaine and lidocaine with a mixture of bupivacaine and lidocaine for providing peribulbar anesthesia for cataract surgery. We used the time to adequate block for surgery and ocular and eyelid movement scores as clinical end points. ⋯ Ropivacaine 1% is an effective alternative to 0.75% bupivacaine for peribulbar anesthesia, when combined with lidocaine and hyaluronidase.
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Anesthesiologists are increasingly utilizing the Internet for personal and professional purposes. Without guidance, the task of searching the Internet for information may be time-consuming and frustrating. This article includes a basic introduction to the Internet with suggestions and guidelines for accessing information resources. Future articles will address locating articles about human anatomy, regional anesthesia and pain medicine. ⋯ This is the first in an informal series of articles demonstrating and describing information technology. The articles will include nontechnical information and will detail the experiences and wisdom obtained from experienced anesthesiologists. The series is geared toward the computer novice with interest in regional anesthesia and pain medicine. These articles are also available in full text on the American Society of Regional Anesthesia website (www.asra.com) with links to the websites in the article.