Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Sep 2004
Comparative StudyThe use of magnetic resonance imaging to evaluate the accuracy of a handheld ultrasound machine in localizing the sciatic nerve in the popliteal fossa.
Ultrasound has become an increasingly popular modality in facilitating the performance of peripheral nerve blocks. There is a paucity of data describing techniques of ultrasound-guided sciatic nerve blocks. By using magnetic resonance imaging (MRI) as a gold standard, the objective of this study was to describe the ability of a handheld ultrasound machine to accurately locate the sciatic nerve. ⋯ The data presented here suggest that the specific ultrasound machine evaluated in this study can accurately localize the sciatic nerve in the popliteal fossa.
-
Reg Anesth Pain Med · Sep 2004
Randomized Controlled Trial Clinical TrialPeripheral opioid analgesia in laparoscopic cholecystectomy.
Recent research has revealed that opioids can act directly on the peripheral terminals of afferent nerves to mediate antinociception. The aim of this study was to assess the influence of peripheral morphine administration on the nociception process in the postoperative period. ⋯ Results of the study confirm the possibility of modifying the nociception process in the postoperative period through peripheral opioid administration.
-
Headache is a common symptom caused by a wide variety of diseases. Primary headaches include migraine, cluster headache, tension-type headache, and other less common diseases. It is important to differentiate these headaches from secondary headaches caused by vascular, neoplastic, infectious, metabolic, or toxic disorders. ⋯ Detoxification from the offending drug is essential for headache improvement. Cervicogenic headache is common and needs to be diagnosed correctly since it may require specific therapy. Nerve blocks are useful for some patients with primary, as well as secondary, headaches.
-
Reg Anesth Pain Med · Sep 2004
Comparative StudyIntrathecal mepivacaine and prilocaine are less neurotoxic than lidocaine in a rat intrathecal model.
Histologic evidence of the comparative neurotoxicity of lidocaine, mepivacaine, and prilocaine is incomplete. We compared the intrathecal neurotoxicity in rats among these 3 drugs based on morphologic and neurofunctional findings. ⋯ It is suggested that intrathecal mepivacaine and prilocaine are less neurotoxic than highly concentrated lidocaine in a rat intrathecal model.
-
Reg Anesth Pain Med · Sep 2004
Case ReportsParalysis after transforaminal epidural injection and previous spinal surgery.
This case discusses a rare but devastating complication of transforaminal epidural injection. Elements in the patient's history that may be risk factors are discussed. ⋯ This case report is part of a new and growing body of literature that demonstrates the potential risk of transforaminal injection. Further study is necessary to ensure that spinal vascular injuries can be kept to an acceptably rare level.