Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2001
Clinical TrialVibration sense testing with a 128-Hz tuning fork as a tool to determine recovery from epidural neuraxial block.
Vibration sense testing using a 128-Hz tuning fork is a commonly used test in the diagnosis of dorsal horn dysfunction and polyneuropathy. In this open, prospective study, we tested the hypothesis that vibration sense testing is a sensitive and specific method to assess recovery from epidural block. ⋯ Based on our observations, recovery of vibration sense corresponds with recovery of motor block after epidural anesthesia and may serve as an easy means of documenting recovery with a single test before discharge.
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Reg Anesth Pain Med · Nov 2001
Case ReportsContinuous brachial plexus block at the cervical level using a posterior approach in the management of neuropathic cancer pain.
Neuropathic cancer pain due to tumor growth near the brachial plexus is often treated with a combination of nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, anticonvulsants, and oral or transdermal opioids. We propose placement of a catheter along the brachial plexus using a posterior approach for patients not responding to the above-mentioned treatment. ⋯ Continuous brachial plexus block should be considered in patients with severe neuropathic cancer pain in the arm and shoulder. To achieve sufficient pain relief for prolonged periods of time, a catheter was inserted to block the brachial plexus using a posterior approach. This technique may be a valuable alternative to the interscalene approach because of the improved fixation of the catheter in the muscle sheet of the trapezius, splenius cervicus, and levator scapulae muscles, and the decreased likelihood of catheter dislodgment during neck movements.
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Reg Anesth Pain Med · Nov 2001
Editorial Comment ReviewAxillary plexus block using multiple nerve stimulation: a European view.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialEpidural fentanyl speeds the onset of sensory block during epidural lidocaine anesthesia.
Shortening the onset time of sensory block is a practical goal to improve the quality of epidural anesthesia. The addition of fentanyl to a local anesthetic solution is widely used during epidural anesthesia. This randomized double-blind study examined the onset time of sensory block during epidural lidocaine anesthesia with and without added fentanyl to the epidural solution. ⋯ Epidural injection of the mixture of 100 microg fentanyl and 2% lidocaine solution accelerated the onset of sensory block during epidural lidocaine anesthesia without increased side effects.
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Reg Anesth Pain Med · Nov 2001
Case ReportsPercutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain.
The sensory innervation of the hip joint includes the sensory articular branches of the obturator and femoral nerves. In this report, we retrospectively evaluated 14 cases in which hip joint pain was treated by percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves. ⋯ Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves is an alternative treatment in patients with hip joint pain, especially in those where operation is not applicable.