Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2000
Case ReportsComputed tomography-guided pudendal nerve block. A new diagnostic approach to long-term anoperineal pain: a report of two cases.
To show the value of computed tomography (CT) in selectively blocking the pudendal nerve in patients with long-term anogenital pain of uncertain etiology. We report a technique to selectively block the pudendal nerve using CT guidance in 2 patients with long-term anogenital pain. ⋯ The use of CT to guide the procedure allowed precision in performing the procedure and in making a differential diagnosis.
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Reg Anesth Pain Med · Jul 2000
Case ReportsCircumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication.
Dorsal penile nerve block is a common procedure and can provide effective analgesia after penile surgery. Ischemic complications are rare and generally result from trauma or inadvertent administration of vasoconstrictive solutions. ⋯ Theoretical concerns over the vasoconstrictive properties of ropivacaine may be sufficient to avoid its use where the potential for ischemia to end organs is present.
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Reg Anesth Pain Med · May 2000
Clinical TrialEffect of high-dose lidocaine treatment on superoxide dismutase and malon dialdehyde levels in seven diabetic patients.
We report on the use of intravenous (IV) high-dose lidocaine to relieve diabetic neuropathic pain, and the technique's effects on clinical measures of lipid peroxidation. ⋯ High-dose lidocaine treatment lessens MDA levels, a marker of free-radical-mediated cell damage. This suggests that one of lidocaine's mechanism of action may be its effect on oxygen free radicals, which in turn impacts lipid peroxidation.
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Reg Anesth Pain Med · May 2000
Clinical TrialThe minimum effective concentration of opioids: a revisitation with patient controlled analgesia fentanyl.
Whether patients titrate themselves to an individualized blood or plasma opioid concentration (the so-called minimum effective concentration or [MEC]) has been debated extensively. Nevertheless, there is consistent opinion that during patient controlled analgesia (PCA) patients balance acceptable pain relief against unacceptable side effects. This study sought to characterize fentanyl used by PCA with respect to MEC and factors influencing PCA use. ⋯ This study found evidence to support the concepts of an individual MEC and a therapeutic window of fentanyl used with PCA.