Techniques in regional anesthesia & pain management最新文献_第10页

Training on regional anesthesia—From neurostimulation to ultrasound 区域麻醉训练——从神经刺激到超声

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.003

Carlos Tornero Tornero MD , Luis Aliaga Font MD, PhD

引用次数: 3

Is ultrasound essential for regional anesthesia in children? 超声对儿童区域麻醉有必要吗?

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.008

Vicente Roqués Escolar MD , Ana Isabel Sánchez Amador MD , Mari Carmen Martínez-Segovia MD

{"title":"Is ultrasound essential for regional anesthesia in children?","authors":"Vicente Roqués Escolar MD , Ana Isabel Sánchez Amador MD , Mari Carmen Martínez-Segovia MD","doi":"10.1053/j.trap.2013.03.008","DOIUrl":"10.1053/j.trap.2013.03.008","url":null,"abstract":"<div>According to systematic reviews performed on adults, ultrasound provides moderate advantages in latency time reduction and block quality. Whether it really reduces the number of complications at the expense of less vascular puncturing, less diaphragm paralysis, and less pleural puncturing, together with lower doses of local anesthetic used, is a controversial question. Neither is there evidence that ultrasound achieves a higher rate of success than traditional techniques. Pediatric patients have special characteristics that differentiate them from adult patients, so the existing studies and their results should not be extrapolated. Ultrasound has a series of advantages: real-time visualization of our target or infiltration of anatomical plane; a view of the needle performing the puncture; and continuous monitoring of spreading of the local anesthetic. Few techniques satisfy so many requirements for adoption by the medical practice, but trials proving that this is an essential technique for pediatric regional anesthesia are scarce. However, ultrasound has shown to be at least as efficient and as safe as traditional techniques and should therefore be routinely used in pediatric regional anesthesia.</div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.03.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of complications in ultrasound-guided regional anesthesia vs neurostimulation 超声引导下区域麻醉与神经刺激的并发症发展

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.007

Jorge Hernando Sáez MD , Carlos Tornero Tornero MD , Vicente Roqués Escolar MD , Francisco Hernández Méndez MD , Luis Aliaga Font MD, PhD

{"title":"Development of complications in ultrasound-guided regional anesthesia vs neurostimulation","authors":"Jorge Hernando Sáez MD , Carlos Tornero Tornero MD , Vicente Roqués Escolar MD , Francisco Hernández Méndez MD , Luis Aliaga Font MD, PhD","doi":"10.1053/j.trap.2013.03.007","DOIUrl":"10.1053/j.trap.2013.03.007","url":null,"abstract":"<div>The use of peripheral nerve block techniques has significantly increased over the last two decades; as a consequence, development of complications has also increased. Neurostimulation has been the technique of choice for locoregional anesthesia for many years and has even been considered the gold standard. Compared with location by means of paresthesia, this technique reduces the potential risk of postoperative neuropathy, as it limits any direct contact between the needle and the nerve structure. Neurostimulation provides high efficacy with a minimum complication rate; currently, however, as ultrasound provides real time visualization of the nerve, needle and local anesthetic distribution relationship, the use of neurostimulation is less prevalent. Additionally to an apparent improvement of ultrasound-guided peripheral block success rate, there are also many trials available promoting the decrease of neurologic complications. Thus the unavoidable question comes up: is ultrasound the quality gold standard for locoregional anesthesia today? Should we rule out formerly used techniques? The current evidence for maintaining routine and exclusive use of ultrasound over any other peripheral nerve block method is limited. So, why not use all anesthetic techniques available to us, that is neurostimulation, injection pressure control, and ultrasound, to bring the complication rate down?</div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.03.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Future directions in interventional pain management 介入性疼痛管理的未来方向

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.001

Ricardo Vallejo

引用次数: 0

High-frequency spinal cord stimulation: An emerging treatment option for patients with chronic pain 高频脊髓刺激:慢性疼痛患者的一种新兴治疗选择

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2012.12.002

Ricardo Vallejo MD, PhD

{"title":"High-frequency spinal cord stimulation: An emerging treatment option for patients with chronic pain","authors":"Ricardo Vallejo MD, PhD","doi":"10.1053/j.trap.2012.12.002","DOIUrl":"10.1053/j.trap.2012.12.002","url":null,"abstract":"<div>Chronic pain is a complex syndrome estimated to affect over 100 million Americans. Pharmaceutical-based therapy, including the use of opioids, is widely accepted as a primary treatment strategy but is associated with addiction, overdose, and diversion risk. Spinal cord stimulation (SCS) is a well-established, device-based alternative for pain management. Though effective in treating leg pain, traditional SCS has been much less effective at achieving long-term back-pain relief. In addition, stimulation with traditional SCS often leads to tingling sensations and inadvertent postural-related shocks that many patients find unpleasant. A newly developed SCS system (Nevro Corp., Menlo Park, CA) shows promise in addressing these limitations. This new device is similar to traditional SCS systems but is able to stimulate at much higher frequencies, up to 10 kHz. Prospective clinical studies of high-frequency SCS (HF-SCS) suggest improved effectiveness in treating chronic low-back pain and other types of pain that often do not respond well to traditional SCS. In addition, HF-SCS appears capable of delivering pain relief without paresthesia, both simplifying the implant procedure and improving patient satisfaction. The system is currently undergoing study in a multicenter, randomized controlled clinical trial in the United States. If the results are positive, HF-SCS could represent an important advancement in the treatment of chronic pain.</div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2012.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58055325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Injectable spinal cord stimulator system: Pilot study 可注射脊髓刺激系统:初步研究

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.006

Laura Tyler Perryman MS, MBA, Benjamin Speck MS, Carlos Montes Garcia MD, Ralph Rashbaum MD

{"title":"Injectable spinal cord stimulator system: Pilot study","authors":"Laura Tyler Perryman MS, MBA, Benjamin Speck MS, Carlos Montes Garcia MD, Ralph Rashbaum MD","doi":"10.1053/j.trap.2013.02.006","DOIUrl":"10.1053/j.trap.2013.02.006","url":null,"abstract":"<div>Spinal cord stimulation (SCS) is widely used for relief of chronic back and limb pain. However, numerous adverse events pose a hindrance to the widened acceptability of the treatment. A prospective, nonrandomized cohort study was conducted to compare the efficacy of a wirelessly powered SCS novel system with commercial SCS systems. Each of 12 patients were serially implanted with a Medtronic 1 × 8 SCS trial lead and a Stimwave Freedom trial lead for a 1-day evaluation. Patients were asked to report on pain relief, paresthesia coverage, paresthesia intensity, and paresthesia comfort. Ten of the 12 patients successfully underwent the trial whereas the remaining 2 procedures were terminated because of operating-equipment failures. Of the successful patients, all reported good pain relief and paresthesia for each device. The average pain reduction was reported as 80% for the Stimwave system and 66% for the Medtronic system. The average paresthesia coverage was 91% and 77%, respectfully. Differences in the averages reported by patients can be attributed to the fact that no randomization was designed in the study. The study showed that wirelessly powered, injectable SCS systems are just as effective as commercial products at relieving pain and at creating paresthesia coverage for patients who suffer from chronic back and limb pain and have the added advantages of shortened procedure time and elimination of open ports during the trial periods, as well as elimination of the need for tunneling and pocket creation for implantable pulse generators.</div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Minimally invasive treatments for osteoporotic vertebral compression fracture: Current concepts and state-of-the-art technologies 骨质疏松性椎体压缩性骨折的微创治疗:当前概念和最新技术

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.008

Sean M. Tutton MD , Francis R. Facchini MD , Larry E. Miller PhD

{"title":"Minimally invasive treatments for osteoporotic vertebral compression fracture: Current concepts and state-of-the-art technologies","authors":"Sean M. Tutton MD , Francis R. Facchini MD , Larry E. Miller PhD","doi":"10.1053/j.trap.2013.02.008","DOIUrl":"10.1053/j.trap.2013.02.008","url":null,"abstract":"Osteoporotic vertebral compression fractures (VCFs) are common in the elderly and can result in debilitating pain, loss of function, kyphosis with resulting height loss, and reductions in quality of life. Conservative treatment of VCFs is considered the gold standard but has limited effectiveness after the initial 23-week period when the majority of uncomplicated VCFs resolve. Surgical intervention is invasive and associated with morbidity, particularly in the elderly patient with poor bone quality. Percutaneous techniques such as vertebroplasty and vertebral augmentation have revolutionized the treatment of VCFs by filling the treatment gap between conservative care and surgery. A robust series of randomized controlled trials and case series have demonstrated effective pain reduction, function improvement, and acceptable safety with these procedures. However, limitations still exist with these techniques including the need for bipedicular access, inadequate vertebral height restoration, trabecular destruction with balloon-based techniques, inability to precisely control cement delivery, and significant radiation exposure to patients and physicians. New technologies are emerging that retain the clinical advantages of traditional percutaneous vertebroplasty and vertebral augmentation while minimizing these limitations. This review article discusses the history of minimally invasive VCF treatment, summarizes clinical evidence with these therapies, and highlights the most innovative experimental and commercial technologies available today.","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.02.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Advances in biological techniques for treatment of lumbar discogenic pain 生物技术治疗腰椎间盘源性疼痛的进展

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.003

Jeffrey D. Petersohn MD

引用次数: 1

A novel method of neurostimulation of the peripheral nervous system: The StimRouter implantable device 外周神经系统神经刺激的新方法:StimRouter植入式装置

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.007

Timothy R. Deer MD , Jason E. Pope MD , Matthew Kaplan DO

{"title":"A novel method of neurostimulation of the peripheral nervous system: The StimRouter implantable device","authors":"Timothy R. Deer MD , Jason E. Pope MD , Matthew Kaplan DO","doi":"10.1053/j.trap.2013.02.007","DOIUrl":"10.1053/j.trap.2013.02.007","url":null,"abstract":"<div>The nervous system is a dynamic and plastic structure that modulates the transduction and transmission of neuropathic and nociceptive pain. Traditionally, the focus of neuromodulation treatment has been on the central nervous system: spinal cord stimulation, motor cortex stimulation, and deep brain stimulation. Observational experience suggests that peripheral neuromodulatory techniques show promise as peripheral targets, both as stand-alone therapies and as an adjuvant in hybrid systems lead arrays. Currently, there are only a few neuromodulatory devices designed specifically for the periphery. We review one of these novel modalities: the StimRouter. We describe a novel strategy of stimulating named peripheral nerves with the StimRouter. Initial clinical data have shown successful implantation of this novel device and improvement in the acute setting. Currently, a multicenter study is under way to access the success of this novel method of stimulation in the long-term setting. The potential success of the StimRouter could affect peripheral neuromodulatory strategies.</div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.02.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Novel options for patients with lumbar spinal stenosis: Minimally invasive lumbar decompression and other strategies 腰椎管狭窄患者的新选择:微创腰椎减压和其他策略

Techniques in regional anesthesia & pain management Pub Date : 2012-04-01 DOI: 10.1053/j.trap.2013.02.002

Ricardo Vallejo MD, PhD , Ramsin Benyamin MD

引用次数: 1