Articles: nerve-block.
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Herpes zoster neuralgia and post-zoster neuralgia (PZN) are common disabling pain syndromes. While pain from acute herpes zoster is self-limited in most cases, as pain may disappear without treatment, post-zoster neuralgia is difficult to manage. Pathological findings in acute herpes zoster include infiltration of ganglia, demyelinization and loss of axons; yet the pathogenesis of pain remains largely unknown. ⋯ The same is true for specific zoster hyperimmunoglobulins and non-specific immunoglobulins; however, there are no definite results. In the future, controlled, double-blind studies on the effect of therapeutic measures in preventing postzosteric neuralgia need to be conducted. So far, the positive effect of sympathetic blocks in preventing the late pain complications of herpes zoster can only be suggested and recommended based on subjective experience.
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Journal of anesthesia · Mar 1994
Relief of intractable perineal pain by coccygeal nerve block in anterior sacrococcygeal ligament after surgery for rectal cancer.
Intractable perineal pain often appears in the anal region following abdominoperineal resection for the treatment of rectal cancer. In such cases, a subarachnoid block or transsacral block is generally used to control pain. However, these procedures sometimes cause complications such as dysuria or sensory paralysis of the pudendum. ⋯ Absolute alcohol was injected into this space. It is essential that the neurolytic agent remain localized in this space to avoid complications and to successfully block perineal pain. In all patients, we found that this method was extremely effective in blocking localized perineal pain without any complications.
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Clinical TrialUltrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus.
We prospectively studied 40 patients (ASA grades I-III) undergoing surgery of the forearm and hand, to investigate the use of ultrasonic cannula guidance for supraclavicular brachial plexus block and its effect on success rate and frequency of complications. Patients were randomized into Group S (supraclavicular paravascular approach; n = 20) and Group A (axillary approach; n = 20). Ultrasonographic study of the plexus sheath was done. ⋯ Because of the direct ultrasonic view of the cervical pleura, we had no cases of pneumothorax. An accidental puncture of subclavian or axillary vessels, as well as neurologic damage, was avoided in all cases. An ultrasonography-guided approach for supraclavicular block combines the safety of axillary block with the larger extent of block of the supraclavicular approach.
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Randomized Controlled Trial Clinical Trial
Ketorolac as a component of balanced analgesia after thoracotomy.
Ketorolac 10 mg or 30 mg i.m., 6 hourly or placebo was given to 75 patients who had undergone thoracotomy, in a randomized double-blind study. All subjects were given intercostal nerve blocks with bupivacaine and had access to i.v. patient-controlled morphine. I.m. ketorolac improved the success rate of the analgesic regimen, with fewer patients withdrawing from the study because of inadequate pain relief.