Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2005
Ultrasound-guided periradicular injections in the middle to lower cervical spine: an imaging study of a new approach.
The objective of this study was to show the efficacy of ultrasound in facilitating the performance of a simulated cervical periradicular injection in cadavers. ⋯ This preclinical study suggests that ultrasound is a useful guiding tool for periradicular injections in the cervical spine.
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Reg Anesth Pain Med · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of four stimulation patterns in axillary block.
Insufficient spread of the local anesthetic toward the retroarterial region of the neurovascular space may be responsible for inconsistent anesthesia of the upper limb after single-injection axillary block. We hypothesized that injection of the local anesthetic on a single radial-nerve stimulation would produce the same extent of anesthesia as either a single median-nerve stimulation, a double-stimulation technique (radial and musculocutaneous nerves), or a triple-stimulation technique (radial, musculocutaneous, and median nerves). ⋯ Musculocutaneous-nerve stimulation and radial-nerve stimulation play predominant roles in the success of axillary brachial plexus block, although a triple-nerve stimulation technique is still required to produce complete anesthesia of the upper limb.
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Reg Anesth Pain Med · Jul 2005
Systemic meloxicam reduces tactile allodynia development after L5 single spinal nerve injury in rats.
Although recent evidence suggests that cyclooxygenase-2 (COX-2) may contribute to the development and management of neuropathic pain, the efficacy of COX-2 inhibitor against neuropathic pain is still unclear. In this study, we investigated the effects of the systemic administration of the selective COX-2 inhibitor meloxicam at an early stage after nerve injury on the development of tactile allodynia in L5 single spinal-nerve injury in rats. ⋯ Systemic administration of 2 mg/kg and 4 mg/kg of meloxicam at an early stage after nerve injury attenuated the development of tactile allodynia. These results suggest that COX-2 may be at least in part involved in the development of tactile allodynia in an L5 single spinal-nerve injury model.
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Reg Anesth Pain Med · Jul 2005
Plasma concentrations and analgesic effects of ropivacaine 3.75 mg/ml during long-term extrapleural analgesia after thoracotomy.
Fourteen patients received long-term extrapleural analgesia with ropivacaine for postoperative pain relief after posterolateral thoracotomy. We determined plasma concentrations of ropivacaine as well as pain scores and opioid consumption to assess the analgesic effect. ⋯ A dose of 0.375 mg/kg/h of ropivacaine can safely be administered for long-term extrapleural analgesia after thoracotomy.
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Reg Anesth Pain Med · Jul 2005
Morphologic analysis of bipolar radiofrequency lesions: implications for treatment of the sacroiliac joint.
Sacroiliac (SI) joint dysfunction is an important cause of mechanical low-back pain. Bipolar radiofrequency ablation has been proposed as a long-lasting treatment for pain in patients with SI dysfunction who report temporary pain relief with local-anesthetic injection into the joint. No data are available to guide the technical aspects of bipolar radiofrequency lesion creation. This study documents the optimal spacing of cannulae and time required to produce bipolar lesions by use of radiofrequency technology. ⋯ Bipolar radiofrequency treatment creates continuous "strip" lesions proportional in size to the distance between the probes when the distance between cannulae is 6 mm or less. Spacing the cannulae 4 to 6 mm apart and treating at 90 degrees C for 120 to 150 seconds maximizes the surface area of the lesion.