Articles: nerve-block.
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To review the current recommendations and literature on training in regional anesthesia and suggest an improved model to prepare graduating residents better in the practice of regional anesthesia. ⋯ A structured regional anesthesia rotation, a dedicated team of mentors with training in regional anesthesia, and adequate clinical volume are a pre-requisite for adequate training, but they may not be available in many anesthesia residency training programs. As the demand for regional anesthesia continues to increase in the years to come, it is imperative to ensure adequate education of graduating residents to meet this demand. In order to achieve this goal, the present recommendations should be re-evaluated, and perhaps a proficiency in a core group of widely applicable and relatively simple nerve blocks should be mastered by all graduates.
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J. Perianesth. Nurs. · Dec 2002
ReviewTension pneumothorax: a pulmonary complication secondary to regional anesthesia from brachial plexus interscalene nerve block.
Interscalene brachial plexus anesthesia is often used for surgeries involving the shoulder and upper arm. This method of regional anesthesia decreases pain, nausea, and vomiting associated with general anesthesia. ⋯ Recognition of early signs and symptoms of tension pneumothorax and expeditious treatment for rapid decompression before physiologic decompensation is mandatory. This article discusses the interscalene brachial plexus block procedure leading to the pathogenesis, clinical presentation, diagnosis, and treatment of tension pneumothorax.
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Selective nerve root blocks are an effective way of diagnosing and treating radicular pain in many patients. Although traditionally performed under fluoroscopic guidance, computed tomography (CT) and CT fluoroscopy have been increasingly used to direct needle placement. This article discusses the indications and technique of selective nerve root blocks in the cervical, thoracic, and lumbar spine, as well as the evidence supporting their use in the treatment of patients with radiculopathy and/or back pain.
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Anesthesia and analgesia · Dec 2002
Case ReportsContinuous sacral nerve root block in the management of neuropathic cancer pain.
Neuropathic cancer pain caused by tumor infiltration in the sacral plexus is primarily treated by nonsteroidal antiinflammatory drugs, antidepressants, anticonvulsants, and opioids. In one patient with severe pain despite pharmacotherapy, a catheter for the continuous administration of local anesthetics was inserted along the first sacral root, resulting in markedly improved analgesia.