Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2005
ReviewLumbar discography: a comprehensive review of outcome studies, diagnostic accuracy, and principles.
Since its advent more than 50 years ago, the use of discography has been mired in controversy. The purpose of this review is to provide a clinical overview of lumbar discography and discogenic back pain, with special emphasis on determining the accuracy of discography and whether or not the procedure improves outcomes for surgery. ⋯ Although discography, especially combined with CT scanning, may be more accurate than other radiologic studies in detecting degenerative disc disease, its ability to improve surgical outcomes has yet to be proven. In the United States and Europe, there are inconsistencies in the use of lumbar discography such that it is routinely used before IDET, yet only occasionally used before spinal fusion.
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Reg Anesth Pain Med · Mar 2005
Review Case ReportsDealing with difficult patients in your pain practice.
Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. ⋯ Issues of comorbid psychopathology, hostility, suicidality, aberrant drug behavior, and chronic noncompliance are discussed. Specific recommendations are also given of the best ways to manage patients with difficult behavior.
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Reg Anesth Pain Med · Mar 2005
Review Historical ArticlePosterior lumbar plexus block: anatomy, approaches, and techniques.
Lumbar plexus is an effective but underused regional technique that was described nearly 3 decades ago. The original description has been modified several times based on advances in technology, localization, and imaging techniques. This review provides an overview of the history, anatomy, and techniques described to perform this block.
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Reg Anesth Pain Med · Mar 2005
Case ReportsContinuous peripheral nerve block for battlefield anesthesia and evacuation.
Peripheral nerve and continuous peripheral nerve block (CPNB) have the potential to be valuable techniques in combat anesthesia. We describe the first successful application of CPNB in the pain management and surgical management of a combat casualty as he was evacuated from the Iraqi battlefield to the United States.