Pain practice : the official journal of World Institute of Pain
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Bupivacaine is a long-acting amide local anesthetic that was introduced to clinical practice in the early 1980s. Since then it has been extensively used for both peripheral blocks as well as neuraxial blockade in concentrations varying from 0.125% to 0.75%. Despite the relatively narrow safety margin, bupivacaine has become the most frequently used local anesthetic in obstetric anesthesia. ⋯ Several studies have failed to show TNS after spinal anesthesia using bupivacaine 0.5% or 0.75%. In the literature there is only 1 case report of TNS after spinal anesthesia using bupivacaine and morphine. The following report describes a case of TNS following spinal anesthesia with bupivacaine 0.75%.
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Facet arthropathy is a common cause of spine-related pain. Typically resulting from spondylosis, trauma, including surgical trauma or post surgical stress is also a significant cause. Radiofrequency thermocoagulation or neurolysis may be an effective modality providing long-term improvement. ⋯ In summary, 85% of cervical and 71% of lumbar RFTC cases had at least a 50% improvement in symptoms for extended periods. RFTC of median branches for facet arthropathy is a safe and efficacious modality with the potential for long-term benefit.