A&A practice
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The use of local anesthetics for improved pain management is well established. However, significant morbidity may be caused by local anesthetic systemic toxicity (LAST) from inadvertent intravascular injection or excessive dosing of local anesthetics. Despite incomplete understanding of the mechanism of action of intravenous lipid emulsions (ILE), their use has become a first-line therapy for treating LAST. We present a case report of LAST, successfully treated with ILE with a secondary effect of complete reversal of a successful peripheral nerve block as quickly as the LAST symptoms resolved.
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Case Reports
Ultrasound-Guided Hydrodissection for Baxter's Neuropathy Secondary to Plantar Fasciitis: A Case Report.
Plantar heel pain is a common pain condition encountered in clinical practice. The common etiologies include plantar fasciitis, calcaneal spur, calcaneus stress fracture, systemic causes, and trauma. ⋯ In this case report, we describe a patient with severe heel pain, presenting with overlapping features of plantar fasciitis and neuropathic pain. Magnetic resonance imaging suggested Baxter's nerve entrapment, and a subsequent ultrasound-guided hydrodissection of Baxter's nerve provided long-lasting pain relief.
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Spinal cord stimulation (SCS) is a minimally invasive procedure used for a broad spectrum of chronic pain conditions. Unfortunately, complications can occur that may lead to device explantation. ⋯ To our knowledge, salvage therapy with high-frequency SCS for LoE with burst SCS has not been previously described. We present a case of salvage therapy utilizing 10 kHz SCS for LoE with a passive recharge burst SCS.