Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2011
Case ReportsRecognition of an incidental abscess and a hematoma during ultrasound-guided femoral nerve block.
Ultrasound guidance for femoral nerve blockade allows visualization of normal and abnormal anatomy. Two cases of femoral nerve blockade under ultrasound guidance are presented where a major perineural pathologic lesion was incidentally revealed. ⋯ We review and discuss incidental pathologic lesions that can be found in the femoral region. Identification of these 2 pathologic lesions facilitated our perioperative management strategies in two separate cases.
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Reg Anesth Pain Med · Jul 2011
Comparative StudyDo diagnostic blocks have beneficial effects on pain processing?
Diagnostic blocks of cervical zygapophysial joints have been used as part of the management strategy for patients with chronic neck pain. Little information is available regarding the sensory processing changes that occur after these common procedures. In a hypothesis-generating prospective study, the pressure-pain thresholds, electrical pain thresholds, and descending inhibitory modulation response using the conditioned pain modulation paradigm are described for 9 patients with cervical zygapophysial joint pain that underwent successful comparative diagnostic blocks. ⋯ Our preliminary evidence suggests that the perturbations to the sensory processing system from effective diagnostic blocks affect the tonic inhibitory system in a positive manner. Conditioned pain modulation, however, needs to be interpreted in the context of altered pain thresholds, and future studies should aim to investigate the shift in the nociceptive balance between facilitatory and inhibitory control after therapeutic interventions.
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Reg Anesth Pain Med · Jul 2011
Comparative StudyAnatomy and clinical implications of the ultrasound-guided subsartorial saphenous nerve block.
We evaluated the anatomic basis and the clinical results of an ultrasound-guided saphenous nerve block close to the level of the nerve's exit from the inferior foramina of the adductor canal. ⋯ Ultrasound-guided injection directly caudally from the inferior foramina of the adductor canal, between the sartorius muscle and the femoral artery, seems to be an effective approach for saphenous nerve block.