Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2005
ReviewLumbar discography: a comprehensive review of outcome studies, diagnostic accuracy, and principles.
Since its advent more than 50 years ago, the use of discography has been mired in controversy. The purpose of this review is to provide a clinical overview of lumbar discography and discogenic back pain, with special emphasis on determining the accuracy of discography and whether or not the procedure improves outcomes for surgery. ⋯ Although discography, especially combined with CT scanning, may be more accurate than other radiologic studies in detecting degenerative disc disease, its ability to improve surgical outcomes has yet to be proven. In the United States and Europe, there are inconsistencies in the use of lumbar discography such that it is routinely used before IDET, yet only occasionally used before spinal fusion.
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Reg Anesth Pain Med · Mar 2005
Review Case ReportsDealing with difficult patients in your pain practice.
Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. ⋯ Issues of comorbid psychopathology, hostility, suicidality, aberrant drug behavior, and chronic noncompliance are discussed. Specific recommendations are also given of the best ways to manage patients with difficult behavior.
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Reg Anesth Pain Med · Mar 2005
Ultrasound-guided musculocutaneous nerve block: a description of a novel technique.
Localizing the musculocutaneous nerve for neural blockade is crucial to providing surgical anesthesia for the distal forearm. We present a novel approach for localizing and anesthetizing the musculocutaneous nerve. ⋯ Ultrasound can facilitate the localization and local anesthetic block of the musculocutaneous nerve.
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Reg Anesth Pain Med · Mar 2005
Letter Case ReportsBacterial meningitis ten days after spinal anesthesia.