Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2023
Case ReportsGenicular nerve and fracture site chemical neurolysis for distal femoral fracture: a case report.
Distal femur fractures account for approximately 3%-6% of all femoral fractures. Non-operative management may be an attractive option for the elderly with significant perioperative mortality risk. Adequate pain control is a major barrier to non-operative fracture management. Chemical neurolysis has been described for analgesic management of proximal hip fractures, however no description of interventional management of distal femur fracture exists in literature. We describe a case of phenol chemical neurolysis of genicular nerves in addition to injection at the site of fracture to provide effective analgesia for distal femur fracture. ⋯ We report the successful use of phenol neurolysis of genicular nerves and the fracture site in an elderly patient with a conservatively managed distal femur fracture. These interventions resulted in improved analgesia and achieved prolonged duration of effect.
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Reg Anesth Pain Med · Jul 2023
Comparison of the feasibility and safety of infrazygomatic and suprazygomatic approaches to pterygopalatine fossa using virtual reality.
Injections of local anesthetics into pterygopalatine fossa gained popularity for treating acute and chronic facial pain and headaches. Injury of maxillary artery during pterygopalatine fossa injection can result in pseudoaneurysm formation or acute bleeding. We aimed to identify the optimal approach into pterygopalatine fossa by comparing feasibility and safety of suprazygomatic and two infrazygomatic approaches. ⋯ The suprazygomatic approach proved to be the safest, however not always feasible. The posterior infrazygomatic approach was always feasible and predominantly safe if the needle entry point was just anterior to the condylar process. The anterior infrazygomatic approach was always feasible, however least safe even with an optimal needle entry point just anterior to the coronoid process.
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Reg Anesth Pain Med · Jul 2023
Common street drug names for the anesthesiologist and pain physician.
People who use or sell drugs develop their own in-group terms and language, much like any other group of people with a common experience. Slang terms are derived from a wide variety of sources. These might include the physical appearance and/or type of drug, the place where it originates, the effect it has on users, or how it is packaged for sale. To assist and educate the clinical practitioner who may deal with this nomenclature, we have compiled a list of some of the most common street names and some explanations (when known) of their origins.
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Reg Anesth Pain Med · Jul 2023
Subcostal transversus abdominis plane block for postoperative analgesia in liver transplant recipients: a before-and-after study.
Postoperative pain management after orthotopic liver transplantation is complex due to impaired liver function and frequent acute kidney dysfunction. Subcostal transversus abdominis plane (TAP) block may be of interest in this population. The aim of this study was to evaluate the impact of subcostal TAP block on opioid consumption after liver transplantation. ⋯ Subcostal TAP block appears to have a small opioid reducing effect after orthotopic liver transplantation surgery.