Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1998
Case ReportsAsymptomatic profound oxyhemoglobin desaturation following interscalene block in a geriatric patient.
Interscalene block can be chosen for complete anesthesia for shoulder surgery. Phrenic nerve block occurs with almost all interscalene blocks, but is well tolerated in most patients. This may not be the case in selected geriatric patients. ⋯ Ipsilateral phrenic nerve paralysis caused significant respiratory compromise in an elderly patient without known significant pulmonary disease.
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Reg Anesth Pain Med · Mar 1998
Biography Historical ArticleThe Labat Lecture 1997--from Pauchet to today--the French connection.
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Reg Anesth Pain Med · Mar 1998
Comparative StudyPain evaluation in the intensive care unit: observer-reported faces scale compared with self-reported visual analog scale.
The visual analog scale (VAS) is a simple and sensitive mean of pain assessment. The faces scale is also a simple, self-reporting method for children. Facial signs of pain have not been used to assess pain in postoperative adult patients in the intensive care unit (ICU). ⋯ The faces scale may be useful for pain evaluation in the ICU.
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Reg Anesth Pain Med · Mar 1998
Case ReportsInguinal paravascular (lumbar plexus) neurolytic block--description of a catheter technique: case report.
We provided care for a 47-year-old female with a history of lung carcinoma and bony metastases who sustained a pathologic fracture of the right acetabulum causing severe and uncontrolled pain in the right groin. Her pain was rated as 8-10 on a 10-point visual analog scale (VAS). Her terminal disease and poor surgical risk precluded therapeutic operative intervention. Consequently, a neurolytic block of the lumbar plexus was performed as a palliative measure. ⋯ This case report supports the feasibility of placing a catheter via a modified anterior inguinal paravascular block technique and its subsequent use for both local anesthetic infusion and neurolytic block of the lumbar plexus.
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Reg Anesth Pain Med · Mar 1998
Intrafascicular injection of ammonium sulfate and bupivacaine in peripheral nerves of neonatal and juvenile rats.
Regional nerve blocks are often used for the treatment of postoperative pain in children. Ammonium sulfate is a non-narcotic anesthetic agent, which has been reported to provide pain relief lasting days to weeks, with few reported side effects in adult studies. Prior to considering clinical use in children, the neurotoxicity of ammonium sulfate in 4-day and 3-week old rats was assessed and compared with that of bupivacaine. ⋯ Intrafascicular injection of ammonium sulfate was as safe as bupivacaine in this animal model. Further animal studies must be made before human trials are initiated.