Articles: nerve-block.
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Diagnostic blocks are used to obtain information about the source of a patient's pain. As such they differ in principle and in practice from regional anaesthetic blocks. In order to be valid, diagnostic blocks must be precise and target-specific. ⋯ This warns that sympathetic blocks must be controlled in each and every case lest false conclusions be drawn about the response. Medial branch blocks of the lumbar and of the cervical dorsal rami have been extensively investigated in order to establish their validity, diagnostic utility and therapeutic utility. They provide an example and benchmark for how diagnostic blocks can and should be validated.
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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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This paper reviews published data on welfare aspects of stag restraint and velvet antler removal, and prevention of antler growth. Several studies of physical restraint and handling demonstrate behavioural and physiological changes both during and after velvet antler removal. Interpretations vary as to whether the act of velvet antler removal imposes a welfare cost additional to that of handling and restraint alone. ⋯ Post-operative sequelae are uncommon, but include clostridial infection. Antler growth in most stags can be prevented by rubber-band application to the growing pedicle, although behavioural changes after ring application suggest this practice may be painful. The procedures used for velvet antler removal, and whether practices are acceptable on the balance of welfare costs and benefits, should be reviewed on an ongoing basis as science, using an increasing range of techniques and measures, provides more data about the welfare implications of this practice.