Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2011
Biography Historical ArticleDaniel C. Moore, MD, and the renaissance of regional anesthesia in North America.
While much attention is paid to the early days of organized regional anesthesia in North America under the leadership of Gaston Labat in New York, there was a period of decline in energy and activity in those techniques after the demise of his original American Society of Regional Anesthesia in 1940. In the years after World War II, questions were raised about the safety and utility of regional blockade. ⋯ Moore emerged as a colorful and enthusiastic advocate of regional techniques, effectively leading a renaissance of regional anesthesia interest through his textbook, teaching, and research in Seattle, Washington. His protégés were instrumental in the rebirth of American Society of Regional Anesthesia and the extensive spread of regional anesthesia today.
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Reg Anesth Pain Med · Nov 2011
Ultrasound anatomy of the nerves supplying the cervical zygapophyseal joints: an exploratory study.
Nerve blocks and radiofrequency neurotomy of the nerves supplying the cervical zygapophyseal joints are validated tools for diagnosis and treatment of chronic neck pain, respectively. Unlike fluoroscopy, ultrasound may allow visualization of the target nerves, thereby potentially improving diagnostic accuracy and therapeutic efficacy of the procedures. The aims of this exploratory study were to determine the ultrasound visibility of the target nerves in chronic neck pain patients and to describe the variability of their course in relation to the fluoroscopically used bony landmarks. ⋯ The medial branches and their relation to the fluoroscopically used bony targets were mostly visualized by ultrasound, with the exception of the medial branch of C7 and, to a lesser extent, the bony target of C7. The nerve location may be distant from the fluoroscope's target. These findings justify further studies to investigate the validity of ultrasound guided blocks for invasive diagnosis/treatment of cervical zygapophyseal joint pain.
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Reg Anesth Pain Med · Nov 2011
Comparative StudyInhibition of voltage-gated sodium channels by emulsified isoflurane may contribute to its subarachnoid anesthetic effect in beagle dogs.
Volatile anesthetics, in addition to their general anesthesia action, have been proven to produce regional anesthetic effect in various animal models. The major aim of this study was to examine whether emulsified isoflurane (EI) could also produce subarachnoid anesthesia and to investigate its possible mechanism. ⋯ Emulsified isoflurane produced dose-dependent subarachnoid anesthesia, and this effect might be mediated by inhibition of EI on voltage-gated Na channels in the spinal cord.