Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2003
Case ReportsShoulder dislocation after infraclavicular coracoid block.
We report a case of shoulder dislocation after a brachial plexus block with a double-injection technique using the infraclavicular coracoid approach. ⋯ When motor block of the muscles of the shoulder occurs after brachial plexus anesthesia, special care must be taken in patient positioning to avoid shoulder dislocation.
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Reg Anesth Pain Med · Jul 2003
Near-total esophagectomy: the influence of standardized multimodal management and intraoperative fluid restriction.
Esophagectomy can be associated with high morbidity and mortality. We present our experience managing these patients using a standardized multimodal approach that emphasizes intraoperative fluid restriction and early extubation. ⋯ Significant reduction in esophagectomy-related morbidity is possible using a standardized multimodal approach in routine clinical practice. Intraoperative fluid restriction may facilitate early extubation and reduce pulmonary complications without compromising renal function. This preliminary observation warrants further study in a randomized clinical trial.
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Reg Anesth Pain Med · Jul 2003
Case ReportsApplying ultrasound imaging to interscalene brachial plexus block.
Previous studies have examined ultrasound-assisted brachial plexus blocks, but few have applied this imaging technology to the interscalene region. We report a case of interscalene brachial plexus block using ultrasound guidance to show the clinical usefulness of this technology. ⋯ Advanced ultrasound technology is useful for nerve localization and can generate brachial plexus images of high resolution in the interscalene groove, guide block needle placement and advancement in real time to targeted nerves, and assess adequacy of local anesthetic spread at the time of injection. Ultrasound imaging guidance can potentially improve success during interscalene brachial plexus block.
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Reg Anesth Pain Med · Jul 2003
Clinical TrialPostherpetic neuralgia: a descriptive analysis of patients seen in pain clinics.
Postherpetic neuralgia (PHN) is a common ailment that pain specialists must often cope with. The goal of the present survey is to investigate the pain characteristics of 119 PHN patients with persistent pain seen at different pain clinics. Methods information on demographic features, pain characteristics (MPQ-SV, VAS, VRS), and treatment was recorded by means of a standard case report form. ⋯ This study reveals a subset of patients, mostly suffering from long-term PHN, where pain persists. The most frequent qualitative traits of PHN patients are described. Some variables were involved in modulation of pain characteristics in these patients. The effect of study design in interpretation of results is discussed.