Articles: nerve-block.
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J. Perianesth. Nurs. · Dec 2002
ReviewTension pneumothorax: a pulmonary complication secondary to regional anesthesia from brachial plexus interscalene nerve block.
Interscalene brachial plexus anesthesia is often used for surgeries involving the shoulder and upper arm. This method of regional anesthesia decreases pain, nausea, and vomiting associated with general anesthesia. ⋯ Recognition of early signs and symptoms of tension pneumothorax and expeditious treatment for rapid decompression before physiologic decompensation is mandatory. This article discusses the interscalene brachial plexus block procedure leading to the pathogenesis, clinical presentation, diagnosis, and treatment of tension pneumothorax.
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To survey American anesthesiology residency program directors to determine the availability and extent of training in peripheral nerve block techniques. ⋯ Specific peripheral nerve block rotations are not always included in anesthesiology residents' curriculum. In addition, residents in programs with a specific nerve block rotation are exposed to a greater number of peripheral nerve block techniques than those who do not have such a rotation included in their curriculum.
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Facet and sacroiliac joint pathology are not an uncommon cause of back or neck pain. Imaging-guided techniques provide ready access to these synovial joints. Percutaneous injection of the facet or sacroiliac joints yields important diagnostic information as to whether or not the interrogated joint is involved in the patient's pain syndrome. The injection of a steroid-anesthetic mixture into these joints is capable of providing significant, albeit temporary, pain relief.
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This paper reviews published data on welfare aspects of stag restraint and velvet antler removal, and prevention of antler growth. Several studies of physical restraint and handling demonstrate behavioural and physiological changes both during and after velvet antler removal. Interpretations vary as to whether the act of velvet antler removal imposes a welfare cost additional to that of handling and restraint alone. ⋯ Post-operative sequelae are uncommon, but include clostridial infection. Antler growth in most stags can be prevented by rubber-band application to the growing pedicle, although behavioural changes after ring application suggest this practice may be painful. The procedures used for velvet antler removal, and whether practices are acceptable on the balance of welfare costs and benefits, should be reviewed on an ongoing basis as science, using an increasing range of techniques and measures, provides more data about the welfare implications of this practice.