Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1998
Case ReportsInguinal paravascular (lumbar plexus) neurolytic block--description of a catheter technique: case report.
We provided care for a 47-year-old female with a history of lung carcinoma and bony metastases who sustained a pathologic fracture of the right acetabulum causing severe and uncontrolled pain in the right groin. Her pain was rated as 8-10 on a 10-point visual analog scale (VAS). Her terminal disease and poor surgical risk precluded therapeutic operative intervention. Consequently, a neurolytic block of the lumbar plexus was performed as a palliative measure. ⋯ This case report supports the feasibility of placing a catheter via a modified anterior inguinal paravascular block technique and its subsequent use for both local anesthetic infusion and neurolytic block of the lumbar plexus.
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Reg Anesth Pain Med · Mar 1998
Intrafascicular injection of ammonium sulfate and bupivacaine in peripheral nerves of neonatal and juvenile rats.
Regional nerve blocks are often used for the treatment of postoperative pain in children. Ammonium sulfate is a non-narcotic anesthetic agent, which has been reported to provide pain relief lasting days to weeks, with few reported side effects in adult studies. Prior to considering clinical use in children, the neurotoxicity of ammonium sulfate in 4-day and 3-week old rats was assessed and compared with that of bupivacaine. ⋯ Intrafascicular injection of ammonium sulfate was as safe as bupivacaine in this animal model. Further animal studies must be made before human trials are initiated.
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Reg Anesth Pain Med · Mar 1998
Biography Historical ArticleThe Labat Lecture 1997--from Pauchet to today--the French connection.
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Reg Anesth Pain Med · Jan 1998
Randomized Controlled Trial Clinical TrialIncisional morphine has no analgesic effect on postoperative pain following inguinal herniotomy.
Opioids induce antinociceptive effects after peripheral administration in experimental and clinical studies. The results of the clinical studies are conflicting. The objective of this study was to examine a possible analgesic effect of incisionally administered morphine on postoperative pain in patients undergoing inguinal herniotomy during general anesthesia. ⋯ The analgesic effect of a single 5 mg dose of morphine injected in a herniotomy wound is not superior to saline or to morphine given subcutaneously or intravenously.
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Reg Anesth Pain Med · Jan 1998
Randomized Controlled Trial Clinical TrialSphenopalatine ganglion block for the treatment of myofascial pain of the head, neck, and shoulders.
This study examined the effectiveness of sphenopalatine ganglion block (SPGB) for myofascial pain syndrome of the head, neck, and shoulders using a double-blind, placebo-controlled, crossover study design with comparison to an internal standard consisting of trigger point injections (TPI). ⋯ This study suggests that SPGB with 4% lidocaine is no more efficacious than placebo and less efficacious than administration of standard trigger point injections in the treatment of myofascial pain of the head, neck, and shoulders.