Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2014
Multicenter Study Observational StudyThe Short-FormMcGill Pain Questionnaire-Revised to Evaluate Persistent Pain and Surgery-Related Symptoms in Healthy Women Undergoing a Planned Cesarean Delivery.
The incidence of chronic pain after cesarean delivery (CD) has been estimated to range between 0.3% and 18%. This wide range may be explained by differing study methodologies. Furthermore, a comprehensive characterization of pain quality is lacking. The aim of this study was to evaluate persistent pain in a healthy obstetric population undergoing planned CD and to provide a comprehensive description of pain quality. ⋯ The incidence of chronic pain at 12 months after planned CD is low (0.6%) and if present symptoms are mostly mild and not interfering with common daily activities. Using Short-Form McGill Pain Questionnaire-Revised, this study provides a comprehensive evaluation of pain quality that can be used as a basis in future post-CD pain trials.
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A cautionary summary of the benefits and potential risks of perineural dexamethasone.
"...there have been no reports of neurotoxicity or complications of any kind attributed to perineural dexamethasone in the nearly 700 patients who have received it in published studies of peripheral nerve blocks ... We must acknowledge that complications in regional anesthesia are rare, and 700 patients are woefully inadequate to declare dexamethasone safe for routine perineural use." (Noss 2014)
Noss concludes that:
- Perineural dexamethasone is probably safe, though conclusive safety evidence is still lacking.
- Systemic effects from IV dex is unlikely to explain the profound block prolongation.
- Prolongation is not enough on its own.
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Reg Anesth Pain Med · Nov 2014
Anatomical Analysis of Medial Branches of Dorsal Rami of Cervical Nerves for Radiofrequency Thermocoagulation.
Cervical medial branch blocks are used to treat patients with chronic neck pain. The aim of this study was to clarify the anatomical aspects of the cervical medial branches to improve the accuracy and safety of radiofrequency denervation. ⋯ The present anatomical study may help improve accuracy and safety during radiofrequency denervation of the cervical medial branches.