By Steven D. Waldman MD JD
This atlas, a better half to the preferred INTERVENTIONAL discomfort administration, presents step by step full-color illustrations demonstrating interventional soreness administration strategies. Over 2 hundred computer-generated figures offer a vivid and colourful technique to view soreness administration equipment in a nearly 3-D strategy. The textual content bargains concise info on anatomy, symptoms, approach, and issues in an easy, bulleted layout.
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Extra resources for Atlas of interventional pain management
The supraorbital nerve sends fibers all the way to the vertex of the scalp and provides sensory inner- 36 upper eyelid, and anterior - TECHNIQUE The patient is placed in a supine position. A total of 3 mL of local anesthetic is drawn up in a lO-mL sterile syringe. When treating supraorbital neuralgia, acute herpes zoster, postherpetic neuralgia, or other painful conditions involving the supraorbital nerve, a total of 80 mg of depot-steroid is added to the local anesthetic with the first block and 40 mg of depot-steroid is added with subsequent blocks.
This technique may be used as a part of the diagnostic evaluation of facial pain when the pain management specialist is trying to determine whether a patient's pain is somatic or sympathetic in origin. In addition to its use in anatomic differential neural blockade, trigeminal nerve block via the coronoid approach allows for selective blockade of the maxillary and mandibular divisions to allow the technique to be used in a prognostic manner prior to neurodestruction of these nerves. Trigeminal nerve block via the coronoid approach may also be used in the acute setting to provide palliation of acute pain emergencies, including trigeminal neuralgia, facial trauma, and cancer pain, while waiting for pharmacologic and antiblastic agents to become effective.
This pressure should be maintained after the procedure to avoid periorbital hematoma and ecchymosis. After gentle aspiration, 3 mL of solution is injected in a fanlike distribu tion. 45 • 46 See t ion 1: HEAD - SIDE EFFECTSAND COMPLICATIONS The face is highly vascular, and the pain specialist should carefully calculate the total milligram dosage of local anesthetic that may be safely given, especially if bilateral nerve blocks are being performed. This vascularity gives rise to an increased incidence of post-block ecchymosis and hematoma formation.