Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2006
Case ReportsThe frozen shoulder syndrome. Description of a new technique and five case reports using the subscapular nerve block and subscapularis trigger point infiltration.
A frozen shoulder is considered by some authors to be a common stage of many disorders affecting the shoulder, while others regard it as an independent idiopatic condition. A consistent finding is that subscapularis muscle trigger points play a key role in the development of the frozen shoulder syndrome. Apart from the conventional treatment, a selective subscapularis fossa nerve block combined with subscapularis trigger points infiltration, may be an effective treatment in preventing chronic pain. ⋯ The results of this block in various painful situations of the shoulder region suggest the importance of subscapularis muscle in the etiology of the frozen shoulder. Using this technique, we could demonstrate that a subscapular nerve block and subscapularis trigger points infiltration have both a diagnostic and therapeutic value for the treatment of the frozen shoulder.
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Acta Anaesthesiol Belg · Jan 2006
A protocol of trauma care in the emergency service including MDCT imaging.
Trauma is the principal cause of young peo ple's death. Care should be appropriate to the severity of the injuries and involves a multidisciplinary team around the clock. In this article, we examine a protocol of care based on ATLS (Advanced Trauma Life Support) recom mendations, including advances in imaging technology, which have greatly increased quality care in our institu tion. ⋯ Multi-detector computed tomogra phy (MDCT) has brought complete and rapid imaging in stable traumas but it shouldn't delay immediate surgical operations. When patients are unstable despite reanima tion, three important x-rays are taken right on the stretch er (pelvis, neck, and chest) before going into surgery. The head of the trauma team makes a decision on the pertinence of such procedure.
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Acta Anaesthesiol Belg · Jan 2006
The effect of hydroxyethylstarch infusion on bupivacaine pharmacokinetics in rats.
Bupivacaine is the agent most often used for labor analgesia. However, the risk of accidental intravascular injection of this drug and consequent acute systemic toxicity is ever-present. Although hydroxyethylstarch (HES) is preferred over crystalloid for prevention of hypotension during regional anesthesia, the pharmacokinetics of bupivacaine during fluid preloading has not been studied. ⋯ Our results suggest that the increased volume of distribution during HES infusion could be counterbalanced by the increased total clearance, resulting in unchanged half-life or elimination rate constant of bupivacaine.