Articles: nerve-block.
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For correction of a shoulder instability (Bankart's operation) in a 33-year-old woman, a combined regional and general anaesthesia was chosen. An interscalene catheter to block the brachial plexus was placed preoperatively without complication. The following day this resulted in an upper extremity almost without motor function and with complete hypoesthesia of the dermatomes C5-C7. ⋯ Stimulation of the three truncs of the brachial plexus was possible and showed electrophysiological signs of recovery of distal parts of the plexus. After 2 years no clinical corresponding recovery could be observed. Despite all investigations (electroneuromyography, evoked potentials, etc.) no clear etiology could be established to explain this adverse outcome.
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Neck pain is considered to be one of the most common chronic pain conditions in modern society. Various structures identified as capable of transmitting pain in the cervical spine include facet joints, intervertebral discs, nerve root dura, ligaments, fascia, and muscles. The prevalence of cervical facet joint pain in patients with chronic pain after whiplash has been determined as 54% to 60%. ⋯ Eighty-one or 70% of the patients (70%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in 81 patients with 64 patients with 60% of the total sample, or 79%, of the lidocaine-positive group reporting definite response with improvement in their pain. Thus, a prevalence rate of facet joint pain in chronic neck pain was determined to be 60% (95% CI, 50%-70%), with a false positive rate of controlled diagnostic blocks of 40% (95% CI, 34%-46%).