Abstract:
BACKGROUND AND OBJECTIVES:Glomangiomas are rare, vascular tumors consisting of an afferent artery, arteriovenous canal, neuro-reticular elements, collagen, and efferent veins, and are most often located in the soft tissue of the upper extremities. We describe how the use of ultrasound-guided nerve blockade altered the anesthetic management of a patient with multiple glomangiomatosis undergoing elective forearm surgery. ULTRASOUND FINDINGS:A 32-year-old man was scheduled for excision of painful glomangiomas from the ulnar aspect of his right wrist, with exploration of his ulnar nerve. The anesthetic concerns included (1) morbid obesity, (2) chronic pain syndrome and opioid intolerance, (3) a potentially difficult airway, and (4) obstructive sleep apnea. Ultrasound-guided supraclavicular blockade was the proposed anesthetic of choice. Ultrasound scan of the supraclavicular fossa revealed numerous vascular lesions surrounding the divisions of the brachial plexus. Color Doppler imaging confirmed these pulsatile lesions to be vascular in origin. Even under two-dimensional ultrasound guidance, we believed that the risk of vascular puncture and unintentional intravascular injection of local anesthetic was high, and therefore we abandoned the supraclavicular approach. A successful ultrasound-guided axillary brachial plexus blockade was performed uneventfully. CONCLUSIONS:Although multiple glomangiomatosis is a rare disease, this case illustrates the invaluable contribution that ultrasound has made to modern, regional anesthetic practice, especially for patients with aberrant anatomy in whom traditional nerve-localization techniques could result in serious complications.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Duggan E,Brull R,Lai J,Abbas Sdoi
10.1016/j.rapm.2007.10.003subject
Has Abstractpub_date
2008-01-01 00:00:00pages
70-3issue
1eissn
1098-7339issn
1532-8651pii
S1098-7339(07)00710-9journal_volume
33pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:0.1% bupivacaine for obstetric epidural analgesia is given by infusion, using a loading dose of a higher concentration alone or in combination with opioid analgesics. A single dose of 0.1% without any additive for relief of first-stage labor pain has not yet been documented. METHODS:Fifty-eig...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00115550-199823020-00004
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The benefit of adding sciatic nerve block (SNB) to femoral nerve block to improve analgesia after total knee arthroplasty (TKA) is uncertain. We hypothesized that the effective duration of single-injection SNB is too short to improve postoperative analgesia and that this contributes to conflic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000076
更新日期:2014-05-01 00:00:00
abstract::This article provides a brief overview of earlier work of our group on the peripheral signaling of pain, summarizes more recent studies on the role of opioids in chronic neuropathic pain, and speculates on the future of gene-based therapies as novel strategies to enhance the peripheral modulation of pain. Neurophysiol...
journal_title:Regional anesthesia and pain medicine
pub_type:
doi:10.1097/AAP.0b013e31823b145f
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Morphine may elicit potent antinociceptive effects by binding and activating peripheral opioid receptors. However, the results in clinical studies have varied. We examined the postoperative analgesic effects of incisional morphine in patients undergoing lumpectomies and axillary node dissectio...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(99)90075-5
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We h...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000764
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Given the readily increasing membership of the pain physician community, efforts toward correcting notable gender disparities are instrumental. The under-representation of women is particularly prevalent within leadership roles in academic medicine, thought to be driven largely by diminished research efforts...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100806
更新日期:2019-11-02 00:00:00
abstract:BACKGROUND:The perception of high resistance during injection of a local anesthetic during regional anesthesia may indicate intraneural injection. Anesthetists' ability to detect high resistance by "syringe feel" has been questioned in the past. The aim of our study was to investigate the anesthetist's ability to detec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181ac7f38
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this ma...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3181a34345
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the c...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000007
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripherally administered opioids, e.g., intra-articular morphine, exert their analgesic action on local opioid receptors. The present study investigated the safety and efficacy of intrabursal oxycodone and bupivacaine in comparison with bupivacaine infiltration and interscalene brachial plexu...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(98)90030-x
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Adenosine is an endogenous compound that may have analgesic effects. Results from clinical trials are not consistent, however, and there is a need for large-scale, randomized, placebo-controlled studies to clarify the role of adenosine in the treatment of pain states, including acute nocicepti...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2001.22256a
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective, randomized, double-blind study compared the effects of the ultrasound-guided popliteal sciatic nerve block performed by either intraneural or subparaneural approach followed by an electrophysiological evaluation. We hypothesized that intraneural injection provides a faster on...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000413
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultrasound-guided infiltration of the interspace between the popliteal artery and capsule of the knee (iPACK) block, a new regional analgesic technique, is believed to relieve posterior knee pain, after total knee arthroplasty, by targeting the articular branches innervating posterior aspect o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100355
更新日期:2019-05-06 00:00:00
abstract::The introduction of ultrasound guidance for regional anesthesia has resulted in an explosion of interest in its use for postoperative analgesia, particularly for orthopedic surgery. Regional anesthesia demonstrates unequivocal superiority compared with systemic opioids with respect to analgesia, reduced opioid consump...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318295d973
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the i...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(03)00393-6
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Although uncommon, residual effects from contrast agents used more than 2 decades ago are possible. This case report is to alert clinicians to the implications of residual oil-based ionic contrast agents in the intrathecal space. CASE REPORT:A 70-year-old female with evidence of degenerative disc disease und...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2005.07.193
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to investigate the possible local neurotoxicity of a number of lipid-depot formulations of local anesthetics in relation to their duration of action in sciatic-nerve block. METHODS:Formulations that contain 2%, 4%, 8%, 16%, 32%, or 64% of a mixture of bupivacaine and...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.05.008
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Conflicting definitions concerning the exact location of the lumbar plexus have been proposed. The present study was carried out to detect anatomical variants regarding the topographical relation between the lumbar plexus and the psoas major muscle as well as lumbar plexus anatomy at the L4-L5...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.07.016
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Anesthesia and analgesia with paravertebral block are reportedly variable. Existence of an endothoracic fascia has been proposed as one of the possible mechanisms leading to variability. We undertook an electron-microscopy imaging study to investigate the endothoracic fascia in the thoracic pa...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e31824451cb
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Cervical medial branch blocks are used to treat patients with chronic neck pain. The aim of this study was to clarify the anatomical aspects of the cervical medial branches to improve the accuracy and safety of radiofrequency denervation. METHODS:Twenty cervical specimens were harvested from ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000175
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:No study has compared cervical interlaminar epidural steroid injection (CIESI) with epidural catheter advancement to the side and level of pathology versus standard C7-T1 CIESI. This study investigated whether cervical radicular pain is more effectively treated by CIESI with a targeted epidura...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000521
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:We wished to determine which long-acting local anesthetic would produce the least pain on injection for treatment of myofascial pain disorders. We compared the pain on intramuscular injection of bupivacaine, ropivacaine, bupivacaine with dexamethasone, ropivacaine with dexamethasone, and needl...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2000.8933
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. METHODS:In thi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000496
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:We present a case of intense herpes zoster-related pain and itching in the ophthalmic division of the trigeminal nerve (V1). Successful pain and itch management was achieved after insertion of a high thoracic epidural catheter with a continuous infusion of bupivacaine and clonidine. CASE REPORT:A 73-year-old...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(03)00182-2
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Local anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma. CASE REPORT:We managed ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(99)90015-9
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Accurate needle control during ultrasound (US)-guided nerve blocks may be an elusive goal for the anesthesiologist. Despite modifications to increase echogenicity, needle visibility still requires precise alignment within the transducer beam. In this study, we evaluated a magnetically guided u...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000390
更新日期:2016-05-01 00:00:00
abstract::As anesthesiologists and acute pain medicine specialists, we will care for patients in the perioperative period who use cannabinoids for chronic pain and/or marijuana recreationally. We will have to address difficult questions from patients regarding the potential applications for cannabinoids in acute pain management...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101475
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Postoperative pain is the expected but nonetheless undesirable byproduct of all surgical procedures. Humanitarian concerns and recent quasi-governmental regulations have heightened awareness about the importance of treating postoperative pain. This guideline builds upon the foundation created ...
journal_title:Regional anesthesia and pain medicine
pub_type: 指南,杂志文章
doi:10.1016/s1098-7339(03)00035-x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter e...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AAP.0000000000000253
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The typical blind insertion of a catheter into the epidural space risks catheter misplacement into the intrathecal space. The epidural stimulation test is designed to confirm the correct epidural location of a catheter but may also detect unintended intrathecal catheter placement by evaluating...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181bfbe1e
更新日期:2009-11-01 00:00:00