Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2003
Comparative Study Clinical Trial Controlled Clinical TrialRestricted infraclavicular distribution of the local anesthetic solution after infraclavicular brachial plexus block.
The distribution of local anesthetic after different approaches for brachial plexus anesthesia could be responsible for the varying rates of side effects, such as phrenic block, hoarseness, and Horner's syndrome associated with each approach. We compared the distribution of local anesthetic within the neurovascular space in infraclavicular block with that of interscalene and supraclavicular block. ⋯ Spread of the local anesthetic from the infraclavicular space after infraclavicular coracoid block appears to be limited to below the level of the clavicle. Conversely, local anesthetic solution passes below the clavicle in all patients given interscalene or supraclavicular blocks.
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Reg Anesth Pain Med · Jan 2003
Case ReportsSuperior sagittal sinus thrombosis in a patient with postdural puncture headache.
The occurrence of concomitant intracranial pathology in a patient with postdural puncture headache (PDPH) is rare. We present a patient who had a superior sagittal sinus thrombosis in addition to his PDPH. The signs and symptoms of intracranial pathology in patients with dural puncture headache, in addition to their postural headache, are discussed. ⋯ Patients with PDPH have classic postural headache. The occurrence of additional signs and symptoms should alert the clinician to the presence of intracranial pathology. Patients with lymphoblastic lymphoma who had treatment with L-asparaginase and steroid are predisposed to the development of cortical venous thrombosis and may have this syndrome in addition to a dural puncture headache.
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Reg Anesth Pain Med · Jan 2003
Case ReportsSplanchnic neurolysis using carbon dioxide as the contrast agent.
Iodinated contrast agents are usually used to verify correct spread of injectate during splanchnic neurolysis. We performed a splanchnic neurolysis by using carbon dioxide as the contrast agent in a patient who was allergic to iodinated contrast agents. ⋯ Carbon dioxide was useful as the contrast agent to perform splanchnic neurolysis.