Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2000
Case ReportsComputed tomography-guided pudendal nerve block. A new diagnostic approach to long-term anoperineal pain: a report of two cases.
To show the value of computed tomography (CT) in selectively blocking the pudendal nerve in patients with long-term anogenital pain of uncertain etiology. We report a technique to selectively block the pudendal nerve using CT guidance in 2 patients with long-term anogenital pain. ⋯ The use of CT to guide the procedure allowed precision in performing the procedure and in making a differential diagnosis.
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Reg Anesth Pain Med · Jul 2000
Case ReportsCircumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication.
Dorsal penile nerve block is a common procedure and can provide effective analgesia after penile surgery. Ischemic complications are rare and generally result from trauma or inadvertent administration of vasoconstrictive solutions. ⋯ Theoretical concerns over the vasoconstrictive properties of ropivacaine may be sufficient to avoid its use where the potential for ischemia to end organs is present.
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Reg Anesth Pain Med · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialProcaine compared with lidocaine for incidence of transient neurologic symptoms.
Transient neurologic symptoms (TNS) have been reported to occur after 16% to 40% of ambulatory lidocaine spinal anesthetics. Patient discomfort and the possibility of underlying lidocaine neurotoxicity have prompted a search for alternative local anesthetic agents. We compared the incidence of TNS with procaine or lidocaine spinal anesthesia in a 2:1 dose ratio. ⋯ The incidence of TNS was substantially lower with procaine than with lidocaine. However, procaine resulted in a lower overall quality of anesthesia and a prolonged average discharge time. If the shortfalls of procaine as studied can be overcome, it may provide a suitable alternative to lidocaine for outpatient spinal anesthesia to minimize the risk of TNS.
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Reg Anesth Pain Med · May 2000
Case ReportsLateral cervical epidural catheter placement for continuous unilateral upper extremity analgesia and sympathetic block.
The use of the laterally directed cervical epidural catheter for the treatment of acute and chronic pain has not been previously described. We have used this technique in a series of 30 patients to produce unilateral upper extremity analgesia and sympathetic block. We present a case report of a patient treated with this technique and a description of the technique and results from the series. ⋯ This case report shows results typical of this series of 30 patients. In this series, the laterally directed cervical epidural catheter was an effective technique to produce continuous unilateral analgesia and sympathetic block. Key Words: Analgesia (epidural), Autonomic nerve block, Reflex sympathetic dystrophy, Postoperative pain.