Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · May 2011
Comparative StudyMorphologic study of nerve root and types of needle used in transforaminal injections.
The bevel type and location of the distal orifice of the needle may have relevance for potential complications occurring during transforaminal epidural injection. ⋯ The layer of fat around nerve roots may prevent the contact of the needle tip with axons. The sharp needle tip entered the nerve root cuff more easily than the blunt tip in the cadaveric nerve root samples, measured in a qualitative manner. There is a need for clinical studies to ascertain if blunt needles may be safer than sharp needles for transforaminal injections.
-
Reg Anesth Pain Med · May 2011
Comparative StudyNeurotoxicity of adjuvants used in perineural anesthesia and analgesia in comparison with ropivacaine.
Clonidine, buprenorphine, dexamethasone, and midazolam (C, B, D, M) have been used to prolong perineural local anesthesia in the absence of data on the influence of these adjuvants on local anesthetic-induced neurotoxicity. Therefore, the impact of these adjuvants on ropivacaine (R)-induced death of isolated sensory neurons was assessed. ⋯ Results with R reaffirm the need to identify ways to mitigate local anesthetic-induced neurotoxicity. While having no protective effect on R-induced neurotoxicity in vitro, future research with adjuvants should address if the C + B + D combination can enable reducing R concentrations needed to achieve equianalgesia (and/or provide equal or superior duration, in preclinical in vivo models).
-
Reg Anesth Pain Med · May 2011
Editorial CommentThat bow is perfect, but your shoes are on the wrong feet.