Regional Anesthesia and Pain Medicine back issues from July 2005:
Morphologic Analysis of Bipolar Radiofrequency Lesions: Implications for Treatment of the Sacroiliac Joint
Jul 01, 2005; ... Background and Objectives: Sacroiliac (SI) joint dysfunction is an important cause of mechanical low-back pain. Bipolar radiofrequency ablation has been proposed as a long-lasting treatment for pain in patients with SI dysfunction who report temporary pain relief with local-anesthetic injection ...
Plasma Concentrations and Analgesic Effects of Ropivacaine 3.75 mg/mL During Long-Term Extrapleural Analgesia After Thoracotomy
Jul 01, 2005; ... Background and Objectives: Fourteen patients received long-term extrapleural analgesia with ropivacaine for postoperative pain relief after posterolateral thoracotomy. We determined plasma concentrations of ropivacaine as well as pain scores and opioid consumption to assess the analgesic ...
Scavenging Nanoparticles: An Emerging Treatment for Local Anesthetic Toxicity
Jul 01, 2005; ... A dreaded complication of local anesthetic use in regional anesthesia is systemic toxicity from unintentional intravascular local anesthetic injection. Although systemic toxic reactions are not common after peripheral nerve block, 7.5 to 20 events per 10, 000 in adults,1 they can be ...
Use of Stellate Ganglion Block to Salvage an Ischemic Hand Caused by the Extravasation of Vasopressors
Jul 01, 2005; ... Objective: This case report describes the successful use of early stellate ganglion block to salvage an acutely ischemic hand caused by the extravasation of vasopressors. Case Report: A young man with a gunshot wound to the right inguinal area was brought to the operating room for ...
Systemic Meloxicam Reduces Tactile Allodynia Development After L5 Single Spinal Nerve Injury in Rats
Jul 01, 2005; ... Background: Although recent evidence suggests that cyclooxygenase-2 (COX-2) may contribute to the development and management of neuropathic pain, the efficacy of COX-2 inhibitor against neuropathic pain is still unclear. In this study, we investigated the effects of the systemic administration ...
A Comparison of Four Stimulation Patterns in Axillary Block
Jul 01, 2005; ... Background and Objectives: Insufficient spread of the local anesthetic toward the retroarterial region of the neurovascular space may be responsible for inconsistent anesthesia of the upper limb after single-injection axillary block. We hypothesized that injection of the local anesthetic on a ...
Differential Block of N-Propyl Derivatives of Amitriptyline and Doxepin for Sciatic Nerve Block in Rats
Jul 01, 2005; ... Background and Objectives: The propyl group of ropivacaine (N-propyl-2',6'-pipecoloxylidide hydrochloride) could be responsible for conferring some sensory selectivity to this drug. Thus, adding a propyl group to experimental local anesthetics (LAs) (e.g., the tricyclic antidepressants ...
Sciatic Nerve Block for Total-Knee Replacement: Is it Really Necessary in All Patients?
Jul 01, 2005; ... To the Editor: We have read with great interest the study by PhamDang et al.1 about the value of adding a sciatic block to continuous femoral block for analgesia after total-knee replacement (TKR). Although we agree that some patients have severe pain that originates from the sciatic ...
Ultrasound-Guided Periradicular Injections in the Middle to Lower Cervical Spine: An Imaging Study of a New Approach
Jul 01, 2005; ... Background and Objectives: The objective of this study was to show the efficacy of ultrasound in facilitating the performance of a simulated cervical periradicular injection in cadavers. Methods: A total of 40 ultrasound-guided examinations at 4 levels (C3 to C7) were performed on 4 ...
Effects of Naloxone on Stress-Induced Analgesia After Hemorrhagic Shock
Jul 01, 2005; ... Background and Objectives: To investigate whether endogenous opioids might be involved in the mechanisms that underlie hemorrhagic shock-induced analgesia, formalin tests were performed after hemorrhage and reinfusion in naloxone pretreated and untreated rats. Methods: Twenty-four adult ...
Management of Postoperative Analgesia in Elderly Patients
Jul 01, 2005; ... There is a trend toward an increasingly aging population. By 2050, there are expected to be 31 million American citizens over 80 years of age.1 In the past decade alone, the proportion of the population over 75 has increased from 5.3% to 6.1% in the United States.1 Given that the elderly undergo ...
Bier Block With Steroid for CRPS: Was Bier Block Performed Correctly?/Reply to Dr. Stevens
Jul 01, 2005; ... To the Editor: A study was recently published that showed no beneficial effect achieved by use of intravenous regional anesthesia (IVRA [Bier block]) with lidocaine and methylprednisolone to treat complex regional-pain syndrome (CRPS) type I.1 I am concerned that the lack of beneficial ...
The Lower the Indications, the Higher the Complications/Reply to Dr. Boezaart
Jul 01, 2005; ... To the Editor: With interest, and some concern, we read the case report by Buckenmaier et al.1 Although we congratulate and salute the authors for taking high-quality regional anesthesia, especially continuous regional anesthesia, to our troops in the battlefield, we express concern ...
Ultrasound Imaging of Peripheral Nerves: A Need for a New Trend
Jul 01, 2005; ... Ultrasound imaging is a new technology to localize and block peripheral nerves that offers several potential clinical benefits. It allows clear visualization and localization of nerves, which, thus, helps to define the best possible site for needle insertion.1 It provides real-time guidance for ...
Clinical Evaluation of the Lateral Sagittal Infraclavicular Block Developed by MRI Studies
Jul 01, 2005; ... Background and Objectives: Lateral sagittal infraclavicular block by single injection has a faster performance time and causes less discomfort than does axillary block by multiple injections. This prospective, descriptive, multicenter study assessed block effectiveness, onset time, and incidence ...
The Musculocutaneous Nerve: Ultrasound Appearance for Peripheral Nerve Block
Jul 01, 2005; ... Background and Objectives: To gain complete anesthesia of the forearm, block of the musculocutaneous nerve is necessary. Variations in its course and position make localization of the musculocutaneous nerve problematic. The aim of the study is to describe the ultrasound appearance of the ...
Alberto Gutierrez and the Hanging Drop
Jul 01, 2005; ... In the early twenty-first century, we may have trouble understanding how one person can perform an epidural anesthetic and then proceed to operate on the same patient for a gastrectomy. This double role of surgeon-anesthesiologist was played by Alberto Gutierrez from 1932 to 1945, while he was ...
Continuous Sciatic Nerve Block and Total-Knee Arthroplasty/Reply to Drs. Levesque and Sciard
Jul 01, 2005; ... To the Editor: We read with interest the article by Pham Dang et al.,1 who assessed the value of adding a continuous sciatic nerve block to a continuous femoral nerve block after total-knee arthroplasty. They suggested both continuous femoral and sciatic nerve blocks are required to ...
Continuous, Intra-Articular Infusion of Bupivacaine After Total-Knee Arthroplasty May Lead to Potentially Toxic Serum Levels of Local Anesthetic
Jul 01, 2005; ... To the Editor: Total-knee arthroplasty (TKA) continues to be associated with significant postoperative pain and often requires large doses of opioid for adequate pain control, which results in frequent opioid-related side effects. Multiple, single-dose injection trials of intra-articular ...