Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Apr 2021
Novel fluoroscopic landmark to significantly facilitate the visualization of foramen ovale in treating idiopathic trigeminal neuralgia.
Access through the foramen ovale (FO) is essential in performing trigeminal ganglion injection, glycerol rhizolysis, balloon compression, and radiofrequency thermocoagulation (RFT) to treat idiopathic trigeminal neuralgia (ITN). However, identification of the FO under fluoroscopy can be difficult and time-consuming, and thus exposes patients to increased radiation and procedure risks. Here we present the 'H-figure' as a novel fluoroscopic landmark to quickly visualize the FO. ⋯ The H-figure is an easy fluoroscopic landmark that can help to view the FO with less radiation and procedure time, and the needles placed with this approach can be closer to the target for the RFT treatment of patients with ITN.
-
Reg Anesth Pain Med · Apr 2021
ReviewRegional anesthesia for scapular fracture surgery: an educational review of anatomy and techniques.
Scapular fractures are very rare, and those requiring surgical interventions are even rarer. Most scapula surgeries are done under general anesthesia with or without the regional anesthesia (RA) technique as an adjunct. ⋯ In this review, we are describing an algorithmic "identify-select-combine" approach, which enables the anesthesiologist to understand detailed innervation of the scapula and to obtain a procedure-specific RA technique. Procedure-specific RA would probably be the way forward for defining future RA practices.
-
Reg Anesth Pain Med · Apr 2021
ReviewIntracranial hematoma and abscess after neuraxial analgesia and anesthesia: a review of the literature describing 297 cases.
Besides spinal complications, intracranial hematoma or abscess may occur after neuraxial block. Risk factors and outcome remain unclear. ⋯ Diagnosis of intracranial hematoma is often missed initially, as headache is assumed to be caused by cerebrospinal hypotension due to cerebrospinal fluid leakage, known as PDPH. Prolonged headache without improvement, worsening symptoms despite treatment or epidural blood patch, change of headache from postural to non-postural or new neurological signs should alert physicians to alternative diagnoses.