Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2002
Case ReportsPatient-controlled epidural analgesia for labor and delivery in a parturient with chronic inflammatory demyelinating polyneuropathy.
The anesthetic management of labor and delivery in patients with any form of chronic inflammatory demyelinating polyneuropathy (CIDP) is not well defined. Using patient-controlled epidural analgesia (PCEA), or epidural analgesia, in such a rare clinical situation has not been previously reported. ⋯ PCEA had no apparent detrimental affect on the patient's disease and may be a reasonable option for patients with CIDP presenting for labor and delivery.
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Reg Anesth Pain Med · Mar 2002
Case ReportsForaminal injection of a painful sacral nerve root using an epidural catheter: case report.
Nerve root pain has been treated with steroid injections since the 1970s. We will describe a novel method for nerve root injection using a directed epidural catheter. ⋯ This is a novel approach to treatment of painful nerve roots with a catheter.
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Reg Anesth Pain Med · Mar 2002
Use of a charged lidocaine derivative, tonicaine, for prolonged infiltration anesthesia.
We tested the hypothesis that the duration of cutaneous anesthesia elicited by the permanently charged compound N-phenylethyl lidocaine (tonicaine) would be longer than that elicited by its parent structure, lidocaine, and that it would be less affected by epinephrine (epi), after subcutaneous injection in rats, as a model for infiltration anesthesia. ⋯ Tonicaine is a substantially longer lasting local anesthetic with a delayed onset of action compared with lidocaine and may be useful in situations where long duration of infiltration block is desirable.
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Reg Anesth Pain Med · Mar 2002
Chronic pain with beneficial response to electroconvulsive therapy and regional cerebral blood flow changes assessed by single photon emission computed tomography.
Recent neuroimaging studies suggested that chronic neuropathic pain may be largely sustained by a complex neuronal network involving the thalamus. Although recent studies have demonstrated the efficacy of electroconvulsive therapy (ECT) in the treatment of a variety of types of chronic neuropathic pain, the effects of ECT on regional cerebral blood flow (rCBF) have not been studied. ⋯ The results from the SPECT suggest that ECT increases abnormally decreased thalamus activity in chronic neuropathic pain.