Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Oct 2024
MRI genicular nerve mapping: a novel approach to sagittal genicular nerve localization.
Chronic knee pain, including postarthroplasty knee pain, is a major cause of morbidity. Radiofrequency ablation of genicular nerve branches is a treatment option. The literature to date has demonstrated and recommended consistent rhizotomy targets in the coronal and axial position of the three primary genicular nerve branches (superomedial genicular nerve, superolateral genicular nerve, inferomedial genicular nerve). The debate on genicular nerve positions focuses on the anterior-posterior courses of the nerve branches. ⋯ This study supports updated guidance on genicular rhizotomy targets. Nerve localization studies using MRI data may be a promising avenue in future nerve localization research pertinent to rhizotomy.
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Reg Anesth Pain Med · Oct 2024
Axillary nerve: what anesthesiologists and pain physicians should know.
Innervation of the shoulder joint is complex and remains poorly understood among regional anesthesiologists and chronic pain specialists. Current literature supports the important contribution of the axillary nerve to the total innervation of the shoulder, as well as its blockade for perioperative pain and denervation for chronic shoulder pain. ⋯ We discuss the contribution, extent, and type of innervation the axillary nerve provides to the shoulder joint, which is often misunderstood. Ultimately, this article serves to stimulate thoughts and ideas for future research in an area where literature is scarce.
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Reg Anesth Pain Med · Oct 2024
Social media users' perspectives of spinal cord stimulation: an analysis of data sourced from social media.
To identify Reddit users' viewpoints and inquiries about spinal cord stimulation (SCS) for chronic back pain using Reddit databases. ⋯ Our Reddit analysis identified potential targets for enhanced dialog between physicians and patients around anticipated pain relief, complications, and postoperative care. Reddit and other social media platforms may offer valuable opportunities for healthcare professionals to improve engagement with patients.
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Reg Anesth Pain Med · Oct 2024
Randomized comparison between ultrasound-guided proximal and distal approaches of intercostobrachial nerve block as an adjunct to supraclavicular brachial plexus block for upper arm arteriovenous access procedures.
Ultrasound-guided proximal and distal approaches of the intercostobrachial nerve (ICBN) blocks facilitate analgesia for upper arm and axillary surgery, though success rates vary and lack clinical comparison. This study compared their anesthetic and analgesic efficacy as an adjunct to the supraclavicular brachial plexus block for upper arm arteriovenous access surgery. ⋯ Proximal ICBN block consistently reduced sensation in the medial upper arm and axilla, while one-quarter of distal blocks spared the axilla. Both approaches, in combination with a supraclavicular brachial plexus block, were effective for upper arm arteriovenous access procedures. However, the proximal approach may be preferable for axillary surgery.