Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2002
Percutaneous electrode guidance: a noninvasive technique for prelocation of peripheral nerves to facilitate peripheral plexus or nerve block.
Typically, peripheral nerve block is done by approximating nerve location, usually by use of anatomical landmarks. Precise nerve location has been done by needle exploration. A new method, percutaneous electrode guidance (PEG) of the block needle, was performed. A transcutaneous stimulating cylindrical electrode was used to indent the skin, locate the underlying nerve, and guide a block needle near it. ⋯ A smooth, metal-tipped electrically shielded skin electrode probe can be used to comfortably and accurately indent the skin over a desired nerve or plexus, define its anatomical course, and subsequently guide a block needle near it.
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Methadone is an inexpensive and highly effective analgesic when titrated appropriately. Its equianalgesic ratio with other opioids is variable, however. We present a case of conversion from high-dose intrathecal (IT) morphine to oral methadone. ⋯ The conversion from high-dose IT morphine to oral methadone has not been previously described. The case presents higher IT morphine to oral methadone conversion ratio than might be expected based upon conventionally used equianalgesic tables.
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Reg Anesth Pain Med · May 2002
Effectiveness of cervical sympathetic ganglia block on regeneration of the trigeminal nerve following transection in rats.
Stellate ganglion block (SGB) is one treatment option for human trigeminal nerve injury. The aim of this study was to evaluate the effectiveness of cervical sympathetic ganglia blocks (SB) by comparing the recovery of severed nerves in 2 rat models, treated or not treated by SB. ⋯ The findings suggest that cervical sympathetic nerve block may accelerate the recovery and regeneration of severed ION. The clinical correlation in patients with peripheral trigeminal paralysis remains to be established.
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Reg Anesth Pain Med · May 2002
Case ReportsMandibular nerve block treatment for trismus associated with hypoxic-ischemic encephalopathy.
We describe the use of mandibular nerve block for the management of bilateral trismus associated with hypoxic-ischemic encephalopathy. ⋯ Mandibular nerve block may be an effective treatment for patients with bilateral trismus due to ischemic-encephalopathy, even when consciousness is impaired.