Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2019
Randomized comparison between epidural waveform analysis through the needle versus the catheter for thoracic epidural blocks.
Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for loss of resistance (LOR): when the needle/catheter tip is correctly positioned inside the epidural space, pressure measurement results in a pulsatile waveform. Epidural waveform analysis can be carried out through the tip of the needle (EWA-N) or the catheter (EWA-C). In this randomized trial, we compared the two methods. We hypothesized that, compared with EWA-C, EWA-N would result in a shorter performance time. ⋯ EWA can be carried out through the needle or through the catheter with similar efficiency (performance time) and efficacy (success rate, postoperative analgesia).
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Reg Anesth Pain Med · May 2019
Pulsed radiofrequency to the dorsal root ganglion or the sciatic nerve reduces neuropathic pain behavior, decreases peripheral pro-inflammatory cytokines and spinal β-catenin in chronic constriction injury rats.
Pulsed radiofrequency (PRF) is a minimal neurodestructive interventional pain therapy. However, its analgesic mechanism remains largely unclear. We aimed to investigate the peripheral and spinal mechanisms of PRF applied either adjacent to the ipsilateral L5 dorsal root ganglion (PRF-DRG) or PRF to the sciatic nerve (PRF-SN) in the neuropathic pain behavior induced by chronic constriction injury (CCI) in rats. ⋯ PRF treatment either to DRG or to sciatic nerve reduced neuropathic pain behavior, and reduced peripheral levels of pro-inflammatory cytokines and spinal β-catenin expression in CCI rats. PRF to DRG has a better analgesic effect than PRF to the nerve.
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Reg Anesth Pain Med · May 2019
Indented intrathecal drug delivery system with loss of reservoir volume.
We report two patients who underwent elective revision surgery were found to have reduced reservoir volumes and indented bottom shield of intrathecal drug delivery system (IDDS). ⋯ Inability to refill the medication to full capacity should be an indication to investigate device deformation. Information about exposure to hyperbaric therapy or local trauma should be obtained.