Articles: nerve-block.
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Epidural and spinal anesthesia enjoy wide usage in modern practice, and each can provide reliable and safe anesthesia. Although the techniques appear to the casual observer to require relatively straightforward technical skill, both are fraught with myriad hazards and potential complications. It is the familiarity with and the understanding of these complications that makes for safe and professional practice of these techniques.
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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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A new posterior approach to the sciatic nerve in the subgluteal region was developed. We describe our clinical experiences on 135 consecutive patients. ⋯ The study demonstrated that the sciatic nerve can be easily blocked using this new posterior subgluteal approach, suggesting that it represents a safe and effective alternative to block the sciatic nerve at a proximal level, with the potential for reducing the discomfort experienced by the patient during block placement.
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Neural blockade has been used as the single method to anesthetize a part of the body or used in combination with general anesthesia to lessen perioperative pain. Currently, nerve blocks are used for diagnostic, prognostic, therapeutic and prophylactic proposes for management of chronic, acute and cancer pain in a Pain Clinic. Reviewing the records of the 3,349 patients at Siriraj Pain Clinic, we found 2,662 and 687 cases had chronic and acute pain problems respectively, and only 646 patients were treated with anesthetic interventions during 1990 to 1998. ⋯ This retrospective review showed that 38 per cent of them reported 50 per cent pain relief with temporary effect. 34 per cent experienced good and satisfactory pain relief while 9 per cent reported excellent pain relief. 17 per cent did not gain benefit from any technique of pain relief and about 2 per cent could not be evaluated due to they did not return for follow-up. One serious complication after thoracic sympatholysis was brachial plexus injury. The neural blockade is proven to be one of the useful adjunct in the management of chronic pain but the selection of the technique is subjected to its critical appraisal.