Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2015
Ultrasound-Guided Approach for L5 Dorsal Ramus Block and Fluoroscopic Evaluation in Unpreselected Cadavers.
Medial branch blocks are frequently performed to diagnose lumbar facet-joint-mediated pain. Ultrasound guidance can increase practicability and eliminate exposure to ionizing radiation when compared with fluoroscopy. However, ultrasound-guided L5 dorsal ramus block, which, together with L4 medial branch block is necessary to anesthetize the most commonly affected facet joint L5/S1, has not been described so far. The objective of this study was to develop a technique and to evaluate its accuracy with standard fluoroscopy in unpreselected cadavers. ⋯ This is the first study to show that ultrasound-guided L5 dorsal ramus block is accurate and feasible in the absence of significant spondylolisthesis when performed with an oblique out-of-plane technique.
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Reg Anesth Pain Med · Nov 2015
Case ReportsSpinal Anesthesia in a Patient With a History of Systemic Capillary Leak Syndrome (Clarkson Disease).
The aim of this study was to review the relative risks, benefits, and anesthetic considerations of neuraxial, regional, and general anesthesia in a patient with known systemic capillary leak syndrome (SCLS) who presents for elective total knee replacement. ⋯ Spinal anesthesia constitutes a viable option for a patient with a history of SCLS in sustained remission. It remains unclear whether general or neuraxial anesthesia confers the best risk-to-benefit ratio for such patients.