Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2007
Ultrasound-guided and CT-navigation-assisted periradicular and facet joint injections in the lumbar and cervical spine: a new teaching tool to recognize the sonoanatomic pattern.
The aim of this study is to provide a teaching tool to facilitate the acquirement of periradicular and facet-joint infiltration techniques in the cervical and lumbar spine. ⋯ This teaching tool provides immediate CT-verification of sonographically identified structures and helps in the identification of bony landmarks, which are necessary for facet-joint and periradicular injections.
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Reg Anesth Pain Med · May 2007
Altered blood flow in terminal vessels after local application of ropivacaine and prilocaine.
Ropivacaine is primarily a local anesthetic, but it also acts as a vasoactive agent. Case reports have described a critical reduction in blood flow when higher concentrations of ropivacaine were used for peripheral-nerve blocks. One hypothesis is that local application of ropivacaine in tissues supplied by end arteries reduces tissue blood flow because of arterial vasoconstriction. ⋯ The application of ropivacaine directly to a rat's tail artery diminished blood flow and lowered regional skin temperature. These effects were dose related. The use of ropivacaine at higher concentrations can, therefore, not be recommended if tissues supplied by end arteries might be affected.
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Reg Anesth Pain Med · May 2007
Chronic intrathecal infusion of minocycline prevents the development of spinal-nerve ligation-induced pain in rats.
Minocycline is a second-generation tetracycline with multiple biological effects, including inhibition of microglial activation. Recently, microglial activation has been implicated in the development of nerve injury-induced neuropathic pain. In this study, the authors examined the effects of continuous intrathecal minocycline on the development of neuropathic pain and microglial activation induced by L5/6 spinal-nerve ligation in rats. ⋯ In this study, the authors demonstrate the preventive effect of continuous intrathecal minocycline on the development of nociceptive behaviors induced by L5/6 spinal-nerve ligation in rats. Further studies are required to examine if continuous intrathecal minocycline could be used safely in the clinical setting.