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Category: Nerve Block

Lumbar Epidural Steroid Injection

Lumbar Epidural Steroid Injection

Tiếng Việt >> Indications ESI is most effective for lumbosacral radiculopathy associated with intervertebral disc herniation, bulging, or degeneration. The main criterion for success is the presence of nerve root inflammation that can be relieved by the steroid. ESI also has been used to treat pain from degenerative joint disease, scoliosis, spondylolysis, spondylolisthesis, postlaminectomy syndrome, facet abnormalities, herpes zoster, and postherpetic neuralgia. Techniques After informed consent is obtained, the patient is placed prone, lateral decubitus, or sitting with the back,…

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Celiac Plexus Block

Celiac Plexus Block

Indications Celiac plexus blockade is useful for diagnosing and treating pain of sympathetic origin. This includes pain involving the viscera, abdomen, and pelvis, secondary to cancer, complex regional pain syndrome, and vasospastic disorders. Techniques After informed consent is obtained, the patient is placed in the prone position with a pillow under the abdomen. The inferior edge of the spinous process of the first lumbar vertebra and the lower border of each 12th rib at 7 cm from the spinous process…

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Spinal Nerve Root Block

Spinal Nerve Root Block

Tiếng Việt >> Indications Nerve root blockade is useful in diagnosing and treating pain present in a dermatomal distribution. Techniques After informed consent is obtained, the patient is placed in the prone position, and a line perpendicular to the axis of the spine is drawn across the top of the spinous process. In the lumbar region, a line drawn along the inferior edges of the two transverse processes will intersect the spinous process of the same vertebra at its most…

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Intercostal Nerve Block

Intercostal Nerve Block

Tiếng Việt >> Indications Intercostal blockade is used to treat pain from herpes zoster, rib fractures, and intercostal neuropathies. It is also used to diagnose unusual abdominal or chest wall pain. Techniques After informed consent is obtained, the patient is placed in either the prone or lateral position. In the lateral position, the injection site is along the midaxillary line, which may result in incomplete blockade of the lateral cutaneous branch of the intercostal nerve. In the prone position, the…

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Suprascapular Nerve Block

Suprascapular Nerve Block

Tiếng Việt >> Indication The suprascapular nerve blockade is useful in patients as a therapeutic procedure for pain in the shoulder region. This block is used as an adjuvant to physical therapy in patients with limited range of motion secondary to arthritic shoulder pain, shoulder-hand syndrome, and shoulder pain. Techniques After informed consent is obtained, the patient is placed in the sitting position. The spine of the scapula is divided by a line formed by the bisection of the scapular…

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Cervical Epidural Steroid Injection

Cervical Epidural Steroid Injection

Indications Cervical epidural steroid injection (ESI) is primarily used to treat pain arising from cervical herniated discs or spinal stenosis. Techniques After informed consent is obtained, the patient is placed in the prone, lateral decubitus, or sitting position with the neck flexed. The sitting position, with the head resting on the examination table, provides better stabilization of the neck during the procedure but may be a problem if the patient is prone to light-headedness. The patient is prepared in a…

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Stellate Ganglion Block

Stellate Ganglion Block

Tiếng Việt >> Indication Stellate ganglion blockade is useful for diagnosing and treating pain of sympathetic origin. This includes pain involving the face, head, neck, and upper extremities secondary to complex regional pain syndrome, acute herpes zoster, and phantom limb pain. Techniques After informed consent is obtained, the patient is placed in the supine position with a pillow under the shoulders and the neck extended. The patient is prepared in a standard aseptic fashion over an area large enough to…

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Occipital Nerve Block

Occipital Nerve Block

Tiếng Việt >> Indication The occipital nerve blockade is used both diagnostically and therapeutically in the treatment of occipital neuralgia. Techniques After informed consent is obtained, the patient is placed in the sitting position with the head flexed forward. The occipital nerve is located at the midpoint between the mastoid process and the greater occipital protuberance at the superior nuchal line. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks,…

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Common Nerve Block Techniques

Common Nerve Block Techniques

Tiếng Việt >> General The placement of local anesthetics at various sites along the neural axis is an important tool in the diagnosis and treatment of a variety of pain disorders, such as complex regional pain syndrome and postherpetic neuralgia. Peripheral nerve blocks also can provide muscle relaxation and pain relief to facilitate an active physical therapy program. When the point of injection has been determined, it is best marked with the tip of a retracted ballpoint pen or a…

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Side Effects and Complications of the Injection Procedures

Side Effects and Complications of the Injection Procedures

The injection procedures described here are associated with various side effects, although the risk for significant complications is very low. The physician who performs injection procedures should have the training and education to recognize and treat a wide range of potential complications (Table 67-4). Advanced cardiac life support (ACLS) protocols are used in airway management and cardiorespiratory resuscitation (27). aSympathetic block above T-4 adds cardioaccelerator nerve blockade to the vasodilatation seen with blockade below T-4; total spinal block may have…

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