Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2006
Influence of needle position on lumbar segmental nerve root block selectivity.
In patients with chronic low back pain radiating to the leg, segmental nerve root blocks (SNRBs) are performed to predict surgical outcome and identify the putative symptomatic spinal nerve. Epidural spread may lead to false interpretation, affecting clinical decision making. Systematic fluoroscopic analysis of epidural local anesthetic spread and its relationship to needle tip location has not been published to date. Study aims include assessment of epidural local anesthetic spread and its relationship to needle position during fluoroscopy-assisted blocks. ⋯ The findings suggest (P = .06) that the risk of grade 1 and 2 lumbar epidural spread, which results in decreased SNRB selectivity, is greater with medial needle positions in the intervertebral foramen. The variability in anatomic position of the dorsal root ganglion necessitates electrostimulation to guide SNRB in addition to fluoroscopy.
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Reg Anesth Pain Med · Nov 2006
Clinical TrialIncrease in skin temperature after spinal anesthesia in infants.
The relatively stable hemodynamics during spinal anesthesia in infants have been attributed to a less active sympathetic nervous system in comparison with adults. Thus, the authors evaluated sympathetic block primarily by measurement of skin temperature and secondarily by determination of noninvasive blood pressure as an indirect sign of sympatholysis. ⋯ The authors found a significant increase in skin temperature of the feet within 10 minutes as a sign of sympatholysis, whereas trunk temperature remained constant. Blood pressure decreased but remained within the normal range, despite the observed sympatholysis.
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Reg Anesth Pain Med · Nov 2006
Historical ArticleRegional anesthesia and pain medicine after 30 years: A historical perspective.
Regional Anesthesia and Pain Medicine celebrates its 30th anniversary in 2006. What began as a 10-page, industry-sponsored bulletin has evolved into a major anesthesiology and pain journal. This history article chronicles the journal's growth and development over 3 decades.