Articles: nerve-block.
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Reg Anesth Pain Med · Sep 2002
Successful interscalene block with a nerve stimulator may also result after a pectoralis major motor response.
Interscalene block of the brachial plexus is a well-established anesthetic and analgesia technique for shoulder surgery. The endpoint for successful block using the nerve stimulator has been described by previous authors as a bicep motor response (twitch) and recently by a deltoid motor response. This retrospective observational case study of regular clinical practice examined the efficacy of using the pectoralis major motor response as an endpoint for a successful block. ⋯ This retrospective observational case study of regular clinical practice suggests that a pectoralis major motor response can be a satisfactory endpoint for interscalene block.
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We report a previously undescribed complication of peripheral nerve catheter placement. The catheter was sheared when its stylet was removed with the placement needle still in the tissues. The lost distal fragment was identified with computed tomography scanning.
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Palliative medicine · Sep 2002
Case ReportsPresacral neurolytic block for relief of pain from pelvic cancer: description and use of a CT-guided lateral approach.
A CT guided lateral approach for neurolysis of the presacral plexus is described for treatment of pelvic pain due to advanced cancer. The technique was evaluated in two patients with unrelieved pelvic and perineal pain. Other neurolytic techniques used to treat pelvic pain due to advanced cancer are reviewed with a discussion of benefits and potential side effects of this technique.
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Case Reports
Severe respiratory failure after infraclavicular block with 0.75% ropivacaine: a case report.
Upper extremity surgery is usually performed with an axillary block. There is a risk of pneumothorax and phrenic nerve block when interscalene or supraclavicular block are used in day case surgery, or in patients with chronic obstructive pulmonary disease. ⋯ No clinically relevant respiratory effects have been reported with infraclavicular block. Nonetheless, we report a case of a chronic obstructive pulmonary disease patient who developed severe respiratory failure requiring tracheal intubation after an infraclavicular block.
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Case Reports
[CT guided neurolysis of the sphenopalatine ganglion for management of refractory trigeminal neuralgia].
The authors present the case of a patient with recurrent trigeminal neuralgia, refractory to medical treatment and ablation of the trigeminal ganglion, who underwent three separate CT guided injections for pterygopalatine ganglion ablation over a two year period. Ablation of the pterygopalatine ganglion may be an effective technique for pain management in patients suffering from atypical facial pain syndrome, cluster headache, or neuritis. The technique used for CT guided ablation using alcohol or radiofrequency is described. The advantages and pitfalls of this technique are reviewed.