Use of near infrared spectroscopy to detect impaired tissue oxygen saturation in patients with complex regional pain syndrome type 1.

Purpose: Deep tissue hypoxia has been hypothesized in the pathogenesis of complex regional pain syndrome type 1 (CRPS 1) for some patients. The purpose of this study was to determine if near-infrared spectroscopy (NIRS) could detect differences in deep tissue oxygen saturation (StO2) and microcirculatory function in the hands of patients with CRPS 1.

Methods: Tissue oxygen saturation was evaluated at baseline and during an ischemia reperfusion challenge using vascular occlusion testing (VOT) in affected vs unaffected hands of patients with unilateral upper limb CRPS 1.

Randomized controlled trial comparing pudendal nerve block under ultrasound and fluoroscopic guidance.

Background: Although fluoroscopy is an established imaging modality for pudendal nerve block, ultrasound (US) technique allows physicians better visualization of anatomic structures. This study aimed to compare the effectiveness and safety between the US- and fluoroscopy-guided techniques.

Methods: A randomized, single-blind, split-plot design was used to conduct the study.

Duloxetine: a review of its pharmacology and use in chronic pain management.

Duloxetine is a serotonin and norepinephrine reuptake inhibitor that possesses antidepressant and pain-relieving properties. Compared with other antidepressants, it has a high affinity for both norepinephrine and serotonin reuptake transporters, which are relatively balanced. Analgesic onset has been observed within the first week of administration in randomized controlled trials and is likely obtained by enhancing the tone of the descending pain inhibition pathways of the central nervous system.

A low-cost ultrasound phantom of the lumbosacral spine.

Background And Objectives: This report describes the production of a low-cost ultrasound phantom of the lumbosacral spine. The phantom should be a very useful tool to teach the basic skills for ultrasound-guided procedures of the lumbosacral spine.

Methods: A lumbosacral spine model is secured to the bottom of a microwave-safe container and is immersed in a concentrated gelatin solution.

Ultrasound-guided suprascapular nerve block: a correlation with fluoroscopic and cadaveric findings.

Purpose: Previous work on the ultrasound-guided injection technique and the sonoanatomy of the suprascapular region relevant to the suprascapular nerve (SSN) block suggested that the ultrasound scan showed the presence of the suprascapular notch and transverse ligament. The intended target of the ultrasound-guided injection was the notch. The objective of this case report and the subsequent cadaver dissection findings is to reassess the interpretation of the ultrasound images when locating structures for SSN block.

Proximal splenic artery embolization in the management of splenic rupture.

Objective: To report the use of proximal splenic artery embolization for management of spontaneous splenic rupture.

Design: Case report and literature review.

Setting: A tertiary pediatric critical care unit in a university teaching hospital.

Case report: retroperitoneoscopic pheochromocytoma removal in an adult with Eisenmenger's syndrome.

Purpose: Patients with uncorrected or palliated, complex congenital heart lesions requiring surgery can benefit from laparoscopic techniques, but retroperitoneal insufflation may render them hemodynamically unstable. Alterations in cardiopulmonary physiology during retroperitoneal insufflation have been studied, yet there are no cases detailing this approach in patients with congenital heart lesions. We present a case of a pheochromocytoma removal via retroperitoneoscopy in a patient with a palliated, complex heart lesion.