Category Archives: Pain Management

Median Nerve Block

Introduction Median nerve blocks at the wrist, either alone or in combination with blockade of the ulnar and radial nerves, are useful emergency department (ED) procedures. Compared to local anesthesia, nerve blocks provide greater efficacy and coverage of anesthesia useful for more complicated wounds or procedures involving the hand. In general, adequate anesthesia is a […]

Topical Anesthesia

Topical Anesthesia

Overview Many options to deliver anesthesia have developed over the last several decades. Administration of topical anesthetics to control pain associated with procedures such as laceration repair may avoid the need for infiltrative local anesthesia injections and associated pain from the injections. Topical anesthesia also avoids the risk of wound margin distortion that exists with […]

Digital nerve blocks

Introduction Digital nerve blocks are important tools for the emergency medicine clinician. Injuries or infections of the digits are extremely common. Adequate analgesia is essential to properly address the presenting condition and to minimize the patient's discomfort. Digital blocks are useful in many scenarios in which local infiltration of an anesthetic would require several injections […]



Anesthesia Local anesthetics are classified into 2 groups: the ester group and the amide group. The classification is based on the chemical structure of the intermediate chain. This structural difference affects the pathway by which local anesthetics are metabolized and the allergic potential. Ester anesthetics are listed in the Table below. They are metabolized by hydrolysis, […]

Local and Regional Anesthesia

Local And Regional Anesthesia

Introduction Local anesthetics provide a reversible regional loss of sensation. Local anesthetics reduce pain, thereby facilitating surgical procedures. Delivery techniques broaden the clinical applicability of local anesthetics. These techniques include topical anesthesia, infiltrative anesthesia, ring blocks, and peripheral nerve blocks. Local anesthetics are safer than general or systemic anesthetics; therefore, they are used whenever possible. […]

Corticosteroid Injections of Joints and Soft Tissues

Corticosteroid Injections Of Joints And Soft Tissues

Introduction Use of cortisone injections in the treatment of muscle and joint inflammatory reactions is becoming increasingly popular. First popularized by Janet Travell, MD, muscle injections are a remarkably effective adjunct to pharmacologic and physical therapies and are safe and easy to perform. Joint injections, while technically more difficult to perform, also can be of […]

Pain relief ladder

Tiếng Việt >> 1. WHO’s pain ladder The World Health Organization has developed a three-step ladder for cancer pain relief. On the WHO website they write: “If a pain occurs, there should be a prompt oral administration of drugs in the following order: non-opioids (aspirin or paracetamol); then, as necessary, mild opioids (codeine); or the strong […]

Pain Management and Bioelectric Therapy

Pain Management And Bioelectric Therapy

Bioelectric therapy is a safe, drug-free treatment option for people in pain. It is used to treat some chronic pain and acute pain conditions. It relieves pain by blocking pain messages to the brain. When you are injured, pain receptors send a message to the central nervous system (the brain and spinal cord). The message […]