Articles: nerve-block.
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Osteoarthrosis of the zygapophyseal joint (Z-joint) is a potential cause of chronic cervical pain. The diagnosis of thirty patients, with pain of more than 12 months duration and with no history of trauma, was confirmed with intra-articular fluoroscopy-guided infiltration of anesthetic. ⋯ The mean time for relapse of 50 percent of the pre-injection level of pain was 12.47 +/- 1.89 weeks, significantly longer than 3 days as reported in patients similarly treated following whiplash neck injury. At this point selective blockade of Z-joints may be offered as an adjunct for diagnostic and therapeutic purposes for patients with chronic neck pain due to facet osteoarthrosis in the ambulatory setup.
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The anesthetic of a patient who presented for vascular access under axillary block is described. After physical examination and ultrasound study, the patient was found to have a bifid axillary artery. Because of neurologic anomalies associated with this vascular variation, an interscalene block was chosen for the procedure. The clinical implications of a bifid axillary artery when an axillary block is contemplated are discussed.