Articles: nerve-block.
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(1) To determine the prevalence of cervical zygapophyseal joint pain in a specialist clinical setting; (2) to review the number of diagnostic blocks needed to identify the segmental level of the symptomatic joints; and (3) to determine the distribution of segmental levels of cervical zygapophyseal joint pain in a clinical setting. ⋯ The prevalence of cervical zygapophyseal joint pain estimated in this clinical study is lower than that found in previous research setting studies, but our requirement for confirmation by a repeat block (which many patients declined) makes our estimate conservative; it is likely that the true prevalence is higher. Zygapophyseal joints are clearly a common source of pain in patients presenting with chronic neck pain, with or without headache. Cervical zygapophyseal joint pain is readily diagnosable, enabling patients to seek further, targeted treatment.
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Swiss medical weekly · Feb 2001
Therapeutic efficacy of selective nerve root blocks in the treatment of lumbar radicular leg pain.
The objective of this study was to investigate the clinical effectiveness of nerve root blocks (i.e., periradicular injection of bupivacaine and triamcinolone) for lumbar monoradiculopathy in patients with a mild neurological deficit. We have retrospectively analysed 30 patients (29-82 years) with a minor sensory/motor deficit and an unequivocal MRI finding (20 disc herniations, 10 foraminal stenoses) treated with a selective nerve root block. ⋯ Twenty-six patients (87%) had rapid (1-4 days) and substantial regression of pain, five required a repeat injection. 60% of the patients with disc herniation or foraminal stenosis had permanent resolution of pain, so that an operation was avoided over an average of 16 months (6-23 months) follow-up. Nerve root blocks are very effective in the non-operative treatment of minor monoradiculopathy and should be recommended as the initial treatment of choice for this condition.
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Am. J. Gastroenterol. · Feb 2001
Role of differential neuroaxial blockade in the evaluation and management of pain in chronic pancreatitis.
Chronic pancreatic pain is difficult to treat. Surgical and medical therapies directed at reducing pain have met with little long-term success. In addition, there are no reliable predictors of response including pancreatic duct diameter. A differential neuroaxial blockade allows characterization of chronic abdominal pain into visceral and nonvisceral pain origins and may be useful as a guide to the treatment. Pain from an inflamed, and scarred pancreas should be visceral in origin. The purpose of our study was to determine the frequency with which patients with chronic pancreatitis have visceral pain and whether our modified differential neuroaxial blockade technique using thoracic epidural analgesia can accurately predict which patients will respond to medical or surgical therapy. ⋯ Surprisingly, patients with chronic pancreatitis commonly have nonvisceral pain. Differential neuroaxial blockade can predict which patients will respond to therapy.