Techniques in regional anesthesia & pain management最新文献_第9页

Pain management in areas of military conflict 军事冲突地区的疼痛管理

Techniques in regional anesthesia & pain management Pub Date : 2012-10-01 DOI: 10.1053/j.trap.2013.08.006

Scott R. Griffith MD , David E. Jamison MD , Steven P. Cohen MD

{"title":"Pain management in areas of military conflict","authors":"Scott R. Griffith MD , David E. Jamison MD , Steven P. Cohen MD","doi":"10.1053/j.trap.2013.08.006","DOIUrl":"10.1053/j.trap.2013.08.006","url":null,"abstract":"<div><p><span><span>Acute and chronic pain conditions are an inescapable by-product of the conduct of war, and have been so throughout the recorded history. The field of pain management within the war zone has evolved during the Global War on Terrorism, spurred in part by increased survival rates from improved vehicle and personal armor, improved surgical lifesaving techniques and hastened evacuation. A result of these improvements is that wounds that were once fatal are now survivable, but may be a cause for significant pain. In this article, we discuss acute and </span>chronic pain management<span><span> during war, and describe important changes that have occurred during the course of the Global War on Terrorism. Advances in acute pain treatment include multimodal pain regimens from point of injury through air transport from theater. The role of technologies, such as </span>nerve stimulation, </span></span>ultrasound imaging, and medication pumps, suitable for field use is explored. Chronic pain interventions that have been provided in theater are discussed, as well as the effect that early treatment in theater has on return-to-duty rates. An increasing operational effect from pain management is postulated as military forces become smaller, more specialized, and older.</p></div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057101","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

Pain in patients with spinal cord injury: An A to Z approach 脊髓损伤患者的疼痛:A - Z入路

Techniques in regional anesthesia & pain management Pub Date : 2012-10-01 DOI: 10.1053/j.trap.2013.08.003

Tatiana Mayungo MD, BsSc

引用次数: 2

Battlefield regional anesthesia: Evolution and future concepts 战场区域麻醉:演变与未来概念

Techniques in regional anesthesia & pain management Pub Date : 2012-10-01 DOI: 10.1053/j.trap.2013.08.004

Michael L. Kent MD , Chester C. Buckenmaier III MD

{"title":"Battlefield regional anesthesia: Evolution and future concepts","authors":"Michael L. Kent MD , Chester C. Buckenmaier III MD","doi":"10.1053/j.trap.2013.08.004","DOIUrl":"10.1053/j.trap.2013.08.004","url":null,"abstract":"<div><p><span>Owing to advanced protective technologies, many servicemembers are returning home with injuries that proved fatal in previous conflicts. However, such severe injuries provide numerous challenges for acute pain physicians. Advanced regional anesthetic techniques provide an essential multimodal tool that optimizes pain and minimizes opioid use. Utilization of such techniques in current conflicts has progressed from a rare occurrence owing to limited equipment and personnel to a widely use array of techniques utilized on the battlefield and continued throughout transport stateside. Such an evolution has enhanced the development of acute pain medicine services within the military that deliver such techniques along with noninterventional techniques. Further, such acute pain medicine services are well received in a combat theater and may serve as an optimal model in future conflicts. Preliminary experience within the last decade has described the interplay of such techniques with </span>anticoagulation<span><span><span> regimens in such trauma patients, incidence of infection, levels of serum local anesthetics </span>in patients with multiple catheters, and the utility of such techniques in patients who may be at risk for </span>compartment syndrome but must bear with a long transport chain back home. Looking forward, future training of personnel and tracking of outcomes are essential in optimizing the utility of such techniques in forward environments, but the collection of accurate outcome data will also determine if prolonged benefits can be realized in addition to the obvious benefit downrange.</span></p></div>","PeriodicalId":93817,"journal":{"name":"Techniques in regional anesthesia & pain management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.trap.2013.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057210","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: 4

Posttraumatic stress disorder and chronic pain 创伤后应激障碍和慢性疼痛

Techniques in regional anesthesia & pain management Pub Date : 2012-10-01 DOI: 10.1053/j.trap.2013.08.005

Carolina Palacio MHSc , Alicia Krikorian PhD , Nora Saldarriaga MD , John Jairo Vargas MD

引用次数: 12

Is neurostimulation in regional anesthesia still worth knowing? 区域麻醉中的神经刺激还值得了解吗?

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.004

Josep Masdeu Castellví MD, PhD

引用次数: 2

Far lower volumes of local anesthetic: What for? 低得多的局部麻醉剂：为什么？

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.006

Josep Lluis Aguilar Sánchez MD, PhD, DESA, MBA , Javier Carbayo Lázaro MD , Paula Delgado García MD , Carlos Castro Arranz MD , Ma Vega Reyes García MD , Silvia López Márquez MD, DESA

{"title":"Far lower volumes of local anesthetic: What for?","authors":"Josep Lluis Aguilar Sánchez MD, PhD, DESA, MBA , Javier Carbayo Lázaro MD , Paula Delgado García MD , Carlos Castro Arranz MD , Ma Vega Reyes García MD , Silvia López Márquez MD, DESA","doi":"10.1053/j.trap.2013.03.006","DOIUrl":"10.1053/j.trap.2013.03.006","url":null,"abstract":"<div><p><span><span>One of the advantages attributed to the use of ultrasounds in regional anesthesia is the possibility of applying low volumes of </span>local anesthetic. Some studies report the efficient use of extremely low volumes in certain types of blocks. Those results are not easy to extrapolate to general practice because of, among other reasons, the big differences in technical skills among professionals (which are crucial to the ability to reduce the volume used). However, the term “intraneural injection” is currently being redefined based on histology, </span>anatomy, physiology, and on clinical and experimental results. The possibility and advisability of using intraneural-extrafascicular injections to obtain efficient and safe blocks with minimum volumes is now widely studied and debated, as well as the idea that it could be safe in certain selected locations (mainly at the popliteal sciatic level). The purpose of this article is to present the current status of this topic and to share our opinion and elicit debate on the true repercussions and usefulness of a hypothetical reduction of the local anesthetic volumes to their minimum, based on both the reports published and our own clinical experience.</p></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.2013.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056577","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

Ultrasound can guide new regional blocks 超声可以引导新的区域块

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.009

María Martínez-Segovia MD , Carlos Tornero Tornero MD , Manuel Montero MD , Vicente Roqués Escolar MD

引用次数: 0

Can ultrasound-guided regional anesthesia be improved with the combined use of nerve stimulation techniques? 超声引导下的局部麻醉是否可以与神经刺激技术相结合?

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.005

Luis Fernando Valdés-Vilches MD , Manuel Jesús Sánchez-del Águila MD, FCARCSI , Manuel Llácer-Pérez MD , Francisco José Martos-Fernández de Córdoba MD , Pedro Alonso-Atienza MD

{"title":"Can ultrasound-guided regional anesthesia be improved with the combined use of nerve stimulation techniques?","authors":"Luis Fernando Valdés-Vilches MD , Manuel Jesús Sánchez-del Águila MD, FCARCSI , Manuel Llácer-Pérez MD , Francisco José Martos-Fernández de Córdoba MD , Pedro Alonso-Atienza MD","doi":"10.1053/j.trap.2013.03.005","DOIUrl":"10.1053/j.trap.2013.03.005","url":null,"abstract":"<div><p>Currently, the most commonly used techniques to perform peripheral nerve<span><span> blockade are ultrasound-guided regional anesthesia (UGRA) and </span>nerve stimulation<span> (NS). Since its introduction in the 1990s, the use of ultrasound has gained popularity. In the beginning, it was used together with NS to confirm identification of nerve structures, once the learning curve has reached its end, there is a trend to use UGRA alone. In this article, we discuss the pros and cons of performing RA procedures with NS, UGRA, or a combination of both, which we call stimulated and ultrasound-guided regional anesthesia (SUGRA). Even though the use of SUGRA does not seem to improve the success rate of the nerve blocks, does not shorten the time to perform them, and does not shorten the onset time, it does help to avoid intraneural injection without increasing patient's discomfort. The use of SUGRA with low-intensity current and without a generation of motor response, would allow positioning of the needle tip close to the nerve avoiding intraneural injection and nerve damage.</span></span></p></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.2013.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58056546","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

Regional anesthesia: Neurostimulation and ultrasonography. A critical review 区域麻醉:神经刺激和超声检查。批评性评论

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.001

Carlos Tornero Tornero MD

引用次数: 0

Effect of regional anesthesia on pain sensitization after surgery: New concepts 区域麻醉对术后疼痛致敏的影响:新概念

Techniques in regional anesthesia & pain management Pub Date : 2012-07-01 DOI: 10.1053/j.trap.2013.03.002

Laurent Bollag MD, Philippe Richebé MD, PhD

引用次数: 0