Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Aug 2020
CommentCurrent versus revised anatomical targets for genicular nerve blockade and radiofrequency ablation: evidence from a cadaveric model.
Recent studies have proposed revised anatomical targets to improve accuracy of genicular nerve (GN) radiofrequency ablation (RFA). This study aims to compare the accuracy of classical and revised techniques for fluoroscopic-guided GN-RFA in cadaveric models. ⋯ This study demonstrates that the revised targets are more accurate than the current targets for GN-RFA.
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Reg Anesth Pain Med · Aug 2020
Comparison of intravenous lidocaine versus epidural anesthesia for traumatic rib fracture pain: a retrospective cohort study.
Effective analgesia is essential in managing traumatic rib fractures. Intravenous lidocaine (IVL) is effective in treating perioperative pain, acute pain in the emergency department, cancer pain in hospice, and outpatient chronic neuropathic pain. Our study examined the associations between IVL versus epidural analgesia (EA) and pain for the treatment of acute rib fracture in the inpatient setting. ⋯ Our results suggest that IVL is similar to EA in numeric pain score reduction, and that IVL may have an opioid sparing effect when taking neuraxial opioids into account. IVL may be an effective alternative to epidurals for the treatment of rib fracture pain. It should be considered for patients who have contraindications to epidurals or are unable to receive an epidural in a timely manner.
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Reg Anesth Pain Med · Aug 2020
Case ReportsLocal anesthetic resistance in a Crohn's patient undergoing cesarean delivery.
Patient resistance to local anesthetics is rarely considered as the cause of regional anesthesia failure. ⋯ Resistance to local anesthetics may be more common than we think, especially among patients with chronic pain. Providers should consider local anesthetic resistance when regional anesthesia is unsuccessful. Further research is needed to determine if skin wheal tests and/or a different local anesthetic could improve results.
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Reg Anesth Pain Med · Aug 2020
5-HT1A receptor-mediated attenuation of heat hyperalgesia and mechanical allodynia by chrysin in mice with experimental mononeuropathy.
Persistent neuropathic pain poses a health problem, for which effective therapy or antidote is in dire need. This work aimed to investigate the pain-relieving effect of chrysin, a natural flavonoid with monoamine oxidase inhibitory activity, in an experimental model of neuropathic pain and elucidate mechanism(s). ⋯ These findings confirm the antihyperalgesic and antiallodynic efficacies of chrysin, with spinal 5-HT1A receptors being critically engaged.