Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2006
Case ReportsSubcutaneous neuromodulating implant targeted at the site of pain.
Primary afferent stimulation for the control of chronic pain frequently offers the optimal compromise for the control of intractable pain. We describe a new access route directly to the site of pain (target) in the form of subcutaneous targeted neurostimulation (STN) via a percutaneous permanent neurostimulating implant. ⋯ The introduction of an STN directly to painful areas, therefore bypassing the spinal cord and peripheral nerves, is a novel and simple procedure that is effective, in this small series, for control of intractable pain consistent with neuropathic pain.
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Reg Anesth Pain Med · Mar 2006
Comparative StudyHydrodynamics of the spinal epidural space in pigs determined by constant-flow methods.
Impressive quantities of fluid can be infused into the epidural space of the spine without causing dramatic or sustained increases in pressure. The epidural space is considered "leaky," but questions remain about how fluid leaves the epidural space. We used constant-flow infusions of saline to gain insight into the hydrodynamics involved. ⋯ Fluid leaves the porcine spinal epidural space through channels that are open at baseline rather than being recruited as epidural pressure increases. This behavior is inconsistent with the view that the epidural space behaves like a Starling resistor.
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Reg Anesth Pain Med · Mar 2006
Biography Historical ArticleIntroduction to the 2005 Bonica Lecture Award: James C. Eisenach, M.D.