Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2024
Case ReportsInfraspinatus-teres minor (ITM) interfascial block: a novel approach for combined suprascapular and axillary nerve block.
Combined suprascapular and axillary nerve block could be an analgesic option for shoulder pain control. The current description of this technique requires performing the block procedures at two different sites without consideration for catheter placement. We hypothesized that a single site injection to the interfascial plane between the infraspinatus and teres minor would result in an injectate spread to the suprascapular and axillary nerves. ⋯ Our anatomical and clinical observations demonstrated that an injection to the interfascial plane between the infraspinatus and teres minor consistently achieved injectate spreading to both suprascapular and axillary nerves, which innervate the glenohumeral joint.
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Reg Anesth Pain Med · Jan 2024
Comparison analysis of safety outcomes and the rate of subsequent spinal procedures between interspinous spacer without decompression versus minimally invasive lumbar decompression.
Treatment for degenerative lumbar spinal stenosis (LSS) typically begins with conservative care and progresses to minimally invasive procedures, including interspinous spacer without decompression or fusion (ISD) or minimally invasive lumbar decompression (MILD). This study examined safety outcomes and the rate of subsequent spinal procedures among LSS patients receiving an ISD versus MILD as the first surgical intervention. ⋯ These results showed ISD and MILD procedures have an equivalent safety profile. However, ISDs demonstrated lower rates of open decompression and MILD.
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Reg Anesth Pain Med · Jan 2024
Randomized control trial of a holographic needle guidance technique for thoracic epidural placement.
The Microsoft HoloLens is a head-mounted mixed reality device, which allows for overlaying hologram-like computer-generated elements onto the real world. This technology can be combined with preprocedural ultrasound during thoracic epidural placement to create a visual of the ideal needle angulation and trajectory in the users' field of view. This could result in a technically easier and potentially safer alternative to traditional blind landmark techniques. ⋯ This study shows that thoracic epidural placement may be facilitated by using a guidance hologram and may be more technically efficient.
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Reg Anesth Pain Med · Jan 2024
Parasagittal needle placement approach for lumbar medial branch denervation: a brief technical report.
Radiofrequency denervation of lumbar medial branches is a viable treatment option to manage chronic facetogenic low back pain. Traditionally, lumbar medial branch denervation involves placement of the electrode's active tip at a 20-degree angulation away from the parasagittal plane. ⋯ Currently, there is a lack of clinical data on the effectiveness of the alternative parasagittal needle placement technique. Therefore, in this brief technical report, the parasagittal needle placement technique and the pain relief outcomes in four consecutive patients following treatment with the parasagittal approach are described.