Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Nov 2007
Posterior lumbar plexus block in children: a new anatomical landmark.
Posterior lumbar plexus block is a well established anesthetic technique for lower limb surgeries. Both magnetic resonance imaging and clinical prospective studies were performed to verify if a new palpable landmark could be used for lumbar plexus block in pediatric patients. ⋯ The sulcus formed by the division between the longissimus and the iliocostal muscles is a simple, direct, and easy-to-identify landmark for posterior lumbar plexus block in children.
-
Reg Anesth Pain Med · Nov 2007
Case ReportsBee stings--a remedy for postherpetic neuralgia? A case report.
This case report describes the effects of bee stings on painful postherpetic neuralgia in a 51-year-old man. ⋯ Bee venom and bee sting therapy have been shown to have both antinociceptive and anti-inflammatory properties, which may explain why the bee stings relieved the patient's postherpetic neuralgia. Bee sting or bee venom therapy should be further investigated as a potential treatment modality for postherpetic neuralgia.
-
Reg Anesth Pain Med · Nov 2007
Local anesthetics have different mechanisms and sites of action at recombinant 5-HT3 receptors.
In addition to their blockade of voltage-dependent sodium channels, the action of local anesthetics at 5-hydroxytryptamine-3 (5-HT3) receptors may be clinically relevant. Because local anesthetics have different clinical properties, we have tested the hypothesis that differences in interactions at the 5-HT3 receptor may be clinically relevant by investigating the effects of 4 local anesthetics on recombinant wild-type and 4 mutant 5-HT3A receptors. ⋯ The ester type local anesthetics, procaine and tetracaine, may act at a different site on the 5-HT(3A) receptor and with a different mechanism than the amide-type local anesthetics. Clinical differences between local anesthetics may be at least partially due to differences in interactions at the 5-HT3A receptor.
-
In neuraxial anesthesia, increase of skin temperature is an early sign of successful block. Yet, during peripheral nerve block of the lower extremity, increase in skin temperature is a highly sensitive, but late sign of a successful block. We hypothesized that after interscalene brachial plexus block, a rise in skin temperature follows impairment of sensation during successful nerve block and occurs only distally, as observed in the lower extremity. ⋯ Assessment of skin temperature cannot predict the success of an interscalene brachial plexus block of the axillary and musculocutaneous nerve. Distally, the increase of skin temperature has a high sensitivity and specificity but occurs later than the loss of sensory and motor functions. Therefore, the measurement of skin temperature during interscalene blockade is of limited clinical value.
-
Reg Anesth Pain Med · Nov 2007
Case ReportsThree-dimensional, multiplanar, ultrasound-guided, radial nerve block.
We describe the use of 3-dimensional, multiplanar ultrasound imaging for peripheral nerve block. ⋯ Three-dimensional, multiplanar ultrasound in real-time has the potential to improve nerve identification and accuracy of needle placement in regional anesthesia.