Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialA paravenous approach for the saphenous nerve block.
This study assesses a paravenous approach for saphenous nerve block at approximately the level of the tibial tuberosity, and compares it with the conventional technique of blind subcutaneous infiltration between the tibial tuberosity and the gastrocnemius muscle. ⋯ The saphenous nerve can be blocked effectively by a paravenous approach using only 5 mL of local anesthetic solution. This approach is advantageous because of its easily identifiable landmark.
-
Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialEffects of epidural anesthesia on thermal sensation.
Epidural anesthesia decreases the core temperatures triggering vasoconstriction and shivering, presumably by increasing apparent (as opposed to actual) lower-body temperature. We therefore tested the hypothesis that epidural anesthesia also increases the overall perception of warmth. ⋯ Thermal sensation with and without epidural anesthesia was comparable at a lower-body temperature near 34 degrees C, which is a normal leg skin temperature. This suggests that autonomic and behavioral thermoregulatory consequences of epidural anesthesia differ-or that the current explanation for reduced vasoconstriction and shivering thresholds during epidural anesthesia is incorrect.
-
Reg Anesth Pain Med · Nov 2001
Multicenter Study Clinical TrialAnatomic considerations in relation to the maxillary nerve block.
To determine the length of the needle that should be used to reach the maxillary nerve after the lateral pterygoid plate has been contacted. ⋯ The needle should not be advanced by more than approximately 0.25 cm beyond the distance to the pterygoid plate while performing maxillary nerve block by the lateral extraoral approach.
-
Reg Anesth Pain Med · Nov 2001
Case ReportsPercutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain.
The sensory innervation of the hip joint includes the sensory articular branches of the obturator and femoral nerves. In this report, we retrospectively evaluated 14 cases in which hip joint pain was treated by percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves. ⋯ Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves is an alternative treatment in patients with hip joint pain, especially in those where operation is not applicable.
-
Reg Anesth Pain Med · Nov 2001
Case ReportsContinuous brachial plexus block at the cervical level using a posterior approach in the management of neuropathic cancer pain.
Neuropathic cancer pain due to tumor growth near the brachial plexus is often treated with a combination of nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, anticonvulsants, and oral or transdermal opioids. We propose placement of a catheter along the brachial plexus using a posterior approach for patients not responding to the above-mentioned treatment. ⋯ Continuous brachial plexus block should be considered in patients with severe neuropathic cancer pain in the arm and shoulder. To achieve sufficient pain relief for prolonged periods of time, a catheter was inserted to block the brachial plexus using a posterior approach. This technique may be a valuable alternative to the interscalene approach because of the improved fixation of the catheter in the muscle sheet of the trapezius, splenius cervicus, and levator scapulae muscles, and the decreased likelihood of catheter dislodgment during neck movements.