Regional Anesthesia and Pain Medicine back issues from November 2007:
Which Actions of Local Anesthetics Are Relevant to the Medical Care of Humans?
Nov 01, 2007; ... For every complex problem there is a solution that is simple, neat and wrong. - H. L. Mencken (1880-1956) Some of the things that doctors do have simple, neat molecular explanations; most do not. We all know the dogma for the mechanism of peripheral nerve block. If one ...
Local Anesthetics Have Different Mechanisms and Sites of Action at Recombinant 5-HT^sub 3^ Receptors
Nov 01, 2007; ... Background and Objectives: In addition to their blockade of voltage-dependent sodium channels, the action of local anesthetics at 5-hydroxytryptamine-3 (5-HT^sub 3^) receptors may be clinically relevant. Because local anesthetics have different clinical properties, we have tested the hypothesis ...
Effect of Lumbar Flexion on the Extent of Epidural Blockade
Nov 01, 2007; ... Background and Objectives: This study examined the effect of lumbar flexion on the extent of the epidural block during lumbar epidural anesthesia. Methods: The epidural catheter was introduced at the L3-4 interspace with the patient in the lateral decubitus position with the surgical ...
Postoperative Epidural Analgesia After Total Knee Arthroplasty With Sufentanil 1 µg/mL Combined With Ropivacaine 0.2%, Ropivacaine 0.125%, or Levobupivacaine 0.125%: A Randomized, Double-Blind Comparison
Nov 01, 2007; ... Background and Objectives: Total knee replacement is associated with severe postoperative pain that, if treated insufficiently, interferes with early rehabilitation. The purpose of the present study is to compare the efficacy of ropivacaine (0.2% and 0.125%) and levobupivacaine (0.125%), all in ...
Skin Temperature After Interscalene Brachial Plexus Blockade
Nov 01, 2007; ... Background and Objectives: In neuraxial anesthesia, increase of skin temperature is an early sign of successful block. Yet, during peripheral nerve block of the lower extremity, increase in skin temperature is a highly sensitive, but late sign of a successful block. We hypothesized that after ...
Modified Lateral Block of the Suprascapular Nerve: A Safe Approach and How Much to Inject? A Morphological Study
Nov 01, 2007; ... Background and Objectives: This paper presents an evaluation of a modified lateral suprascapular nerve block with easy orientation, low risk of displacement of the needle, and with an assessment of 2 different volumes to propose an ideal volume for a successful block. Methods: Both ...
Factors Predicting Success and Failure for Cervical Facet Radiofrequency Denervation: A Multi-Center Analysis
Nov 01, 2007; ... Background and Objectives: The concept of radiofrequency denervation has recently come under question in light of several studies showing minimal to no benefit. One possibility proposed for these negative outcomes is poor selection criteria. Unlike virtually all other spine interventions, the ...
Carl Koller Gold Medal Award to Paolo Busoni at the Silver Anniversary ESRA Annual Congress, Monte Carlo, Monaco, September 6-9, 2006
Nov 01, 2007; ... The European Society of Regional Anaesthesia and Pain Therapy (ESRA) instituted the Carl Koller Award in 1984, one hundred years after Carl Koller administered cocaine around the eye to achieve regional anesthesia. It is the tradition of ESRA that this award is given to anesthesiologists who ...
Difficulties in Controlling Pain in Children
Nov 01, 2007; ... Why Is It Difficult to Control Pain in Children? There are many ways pain can manifest its presence: acute pain, chronic pain, recurring pain, procedure-related pain, and pain associated with terminal illness. Acute pain can be mathematically measured (linked to a number), which cannot ...
Celiac Plexus Blockade in Children Using a Three-Dimensional Fluoroscopic Reconstruction Technique: Case Reports
Nov 01, 2007; ... Background and Objectives: We present three cases wherein a new radiologic technique was used to facilitate performance of retrocrural celiac plexus blockade. Three patients presented to our institution for performance of celiac plexus block for relief of intractable upper abdominal pain. One ...
Three-Dimensional, Multiplanar, Ultrasound-Guided, Radial Nerve Block
Nov 01, 2007; ... Objective: We describe the use of 3-dimensional, multiplanar ultrasound imaging for peripheral nerve block. Case Report: To illustrate the potential usefulness of the technique, we present a case in which real-time 3-dimensional, multiplanar ultrasound was used to assist in the ...
Posterior Lumbar Plexus Block in Children: A New Anatomical Landmark
Nov 01, 2007; ... Background and Objectives: Posterior lumbar plexus block is a well established anesthetic technique for lower limb surgeries. Both magnetic resonance imaging and clinical prospective studies were performed to verify if a new palpable landmark could be used for lumbar plexus block in pediatric ...
Stimulating Catheter as a Tool to Evaluate Peripheral Nerve Function During Hip Rotationplasty
Nov 01, 2007; ... Objective: Stimulating catheters have been introduced into clinical practice to confirm perineural localization of the catheters. The muscular twitch induced over the catheter may be used to evaluate nerve function intraoperatively. Therefore, the function of the sciatic nerve was evaluated ...
Bee Stings-A Remedy for Postherpetic Neuralgia? A Case Report
Nov 01, 2007; ... Objective: This case report describes the effects of bee stings on painful postherpetic neuralgia in a 51-year-old man. Case Report: The patient was stung by 3 bees in the distribution in which he had been experiencing postherpetic neuralgia. One day after the bee stings, the patient's ...
Erratum
Nov 01, 2007; ... In a letter to the editor by Krombach and Gray entitled "Sonography for Saphenous Nerve Block Near the Adductor Canal" published in the July-August 2007 issue (Regional Anesthesia and Pain Medicine 2007;32: ...
Imaging in Anesthesia: The Role of 4 MHz to 7 MHz Sector Array Ultrasound Probe in the Identification of the Sciatic Nerve at Different Anatomic Locations
Nov 01, 2007; ... To the Editor: Few studies have examined the use of ultrasound for sciatic nerve identification or blockade and thus the clinical utility of such is still being determined.1·4 Additionally, linear probes are used to identify the sciatic nerve at the popliteal1 and the posterior part of ...
A New Look at the Paravertebral Block: A Percutaneous Video-Assisted Technique
Nov 01, 2007; ... To the Editor: How to provide adequate postoperative analgesia after thoracic video-assisted surgery (VATS) is still a matter of debate.1 Parenteral analgesics and/or opioids are widely used but are sometimes inadequate. Thoracic epidural analgesia is judged by many to be excessively ...
Rediscovery of Ganglion Impar Block via Coccygeal Joints
Nov 01, 2007; ... To the Edltor: The modified approach to the ganglion of impar via a transcoccygeal approach was rediscovered by Drs. Foye, Hong, and Jang (2006).12 In his letter to the editor Dr. Foye states that he was the first to perform a transcoccygeal approach and that Drs. Hong and Jang were the ...
Obturator Nerve Anatomy and Ultrasound Imaging
Nov 01, 2007; ... To the Editor: We read with extreme interest the study by Helayel and colleagues1 in which they describe the block of the obturator nerve with the aid of ultrasound. Even though their study has high clinical significance, there are some basic aspects concerning the anatomy of the ...
Comparison of Two 3.5 Inch Hustead Needles
Nov 01, 2007; ... To the Editor: The Department of Anesthesiology at New York-Presbyterian Hospital performs more than 7,000 regional anesthetics annually. Recently we noticed an increase in the number of failed combined spinal epidurals (CSEs) in the general Operating Rooms and the Labor and Delivery ...
High Thoracic Epidural Plus Suprascapular Nerve Block Analgesia for Thoracoscapular Fusion
Nov 01, 2007; ... To the Editor: An 18-year-old female with facioscapular muscular dystrophy presented for right thoracoscapular athrodesis. This skeletal muscle disorder causes progressive weakness of the muscles stabilizing the scapula, resulting in an unstable base for glenohumeral articulation with ...
Ultrasound, Paresthesia, and Motor Response/Reply to Drs. Bollini and Cacheiro/Reply to Drs. Joshi, Kehlet, and Rawal
Nov 01, 2007; ... To the Editor: We read with great interest the article by Perlas et al.1 and would like to respectfully make some comments. Studies conducted by Urmey and Stanton2 at the interscalene level and by Choyce et al.3 at the axillary level suggest a low motor response rate after ...
Seeds, Trees, and Shade-Personal Experience in Research Career Development
Nov 01, 2007; ... To the Editor: With respect to formal research training in our subspecialty, as discussed in the recent editorial of Ilfeld et al.,1 we are at a critical point where more seeds (or any seeds) need to be planted. Regional anesthesia fellowship directors, I believe, are responsible for the ...
Ultrasound and Regional Anesthesia Techniques-Is There Any Limitation?
Nov 01, 2007; ... To the Editor: We present a case underlining a possible limitation in the implementation of ultrasound alone for nerve localization. An 88-year-old female patient with ankle fracture and chronic myositis was scheduled for ankle fracture repair under lateral sciatic nerve block with ...
Unintentional Transient Sciatic Nerve Block After Knee Infiltration With Local Anesthetics
Nov 01, 2007; ... To the Editor: A 27-year-old, American Society of Anesthesiologists class I man underwent a right anterior cruciate ligament reconstruction under spinal anesthesia. To provide post-operative analgesia, a wound infiltration was performed at the end of the 45-minute surgery. The surgeon ...
Saphenous Nerve Block Technique With Neurostimulation
Nov 01, 2007; ... To the Editor: Many approaches to the saphenous nerve block have been described.1 Because this is a sensory nerve, most techniques that have been described use anatomical landmarks as guides to determine the site of local anesthetic injection.2-3 For many other peripheral nerve blocks, ...
ASRA Continuing Education Calendar
Nov 01, 2007; ... For information contact: ASRA, 520 N. Northwest Highway, Park Ridge, IL 60068, U.S.A. telephone 847/825-7246, fax 847/825-5658 E-mail g.hoormann@asahq.org http://www.asra.com 2007 November 15-18, 2007 ASRA 2007 ...