Regional anesthesia
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Regional anesthesia · May 1997
Case ReportsThermal grill illusion and complex regional pain syndrome type I (reflex sympathetic dystrophy).
In normal humans, placing a hand on a thermal grill containing warm elements separated by cool ones produces a burning sensation. In this case report, responses to a thermal grill in a patient with neuropathic pain were examined. ⋯ The thermal grill may be a useful a tool to help understand the pathophysiology of complex regional pain syndrome type I.
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The clinical utility of a new parasacral approach for conduction block of the sciatic nerve was investigated, with critical examination of onset, extent, and success rates when this block was used for surgical procedures below the knee. ⋯ The parasacral approach to the sciatic nerve exhibits a high success rate, resulting in anesthesia of the entire sacral plexus and generally in motor block of the obturator nerve was an interesting observation.
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Regional anesthesia · May 1997
Case ReportsPhantom pain with probable reflex sympathetic dystrophy: efficacy of fentanyl infiltration of the stellate ganglion.
The stellate ganglion can alleviate phantom pain of the upper extremity, possibly because of the presence in it of enkephalin receptors, as has been suggested by experimental and clinical reports. A case is reported in which fentanyl, instead of local anesthetic, was used for stellate ganglion block. ⋯ Fentanyl infiltration of the stellate ganglion proved to be successful in the management of the pain and temperature sensation changes in the stump and phantom upper extremity.
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Regional anesthesia · May 1997
Comparative StudyComparison of accuracy and cost of disposable, nonmechanical pumps used for epidural infusions.
Temporary epidural catheter pumps are used to infuse analgesics in patients with chronic intractable pain. Three brands of disposable, nonmechanical pumps adapted for epidural infusion were tested to determine their flow rate efficacy and their cost effectiveness. ⋯ All three units deviated considerably from the claimed flow rate of 2-mL/h, both at the beginning and at the end of the infusion. Presumably, the decreasing flow rates are responsible for the diminishing pain relief often experienced by patients over the course of the infusion. The Homepump unit appeared to be the most cost-effective and the easiest to handle and maintained an acceptable infusion rate for the greatest percentage of the infusion period. The considerable cost benefit of using a nonmechanical disposable pump as opposed to a costly but more reliable computerized pump appears to warrant further product improvement and development.
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Regional anesthesia · May 1997
Case ReportsSurvey of regional anesthetic practice among French residents at time of certification.
A survey of anesthesia practice was conducted among French residents in anesthesia at the end of their training. This study was performed mainly to evaluate the residents' experience in peripheral nerve blocks. ⋯ French residents in anesthesiology at time of certification are better trained for peripheral nerve blocks of the upper extremity than for those of the lower extremity. Axillary plexus and femoral nerve block are the most widely used blocks, probably reflecting the techniques the most mastered among teachers. Finally, the extensive use of a peripheral nerve stimulator by residents is probably the result of the widespread use of this device by teachers in France.