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Jose De Andrés

Publications and source records attributed to Jose De Andrés.

4 recordsLinked to original sources
PubMed2005

Nerve stimulation in regional anesthesia: theory and practice.

There is now an accumulation of extensive and varied experience with the use of electrical stimulation for verifying the close approximation of needle and nerve, and for increasing the corresponding success rate. The application of this experience has been of proven benefit in the teaching of regional anesthetic techniques, in the performing of difficult nerve blocks, and in the use of novel accesses, resulting in decreased morbidity and a reduced requirement for local anesthetic. Nerve stimulation can also be used in uncooperative patients and in anesthetized individuals or patients under the effects of CNS depressors, although the risk of intraneural injection of local anesthetic is not eliminated in such cases. Putting the accummulated knowledge into practice is not simply a question of using electrical stimulation to elicite an artificial muscle contraction. Sound knowledge of the anatomy of the area to be blocked, the muscle territory subsidiary to the nerve in question, the applied neurophysiology, and the pharmacology of the local anesthetic used are needed. This chapter reviews the most important aspects, from nerve anatomy and physiology, to electrical features of the needle, and devices used for the updated clinical application of nerve stimulation in the practice of plexus regional anesthesia.

Anesthesia, Conduction↗
PubMed2004

Image-guided techniques for peripheral nerve blocks.

PURPOSE OF REVIEW: Success of plexus nerve block is most dependent upon the correct positioning of the local anaesthetic solution within proximity to the corresponding nerve trunk. With the aim of verifying the close approximation of needle and nerve, and increasing the corresponding success rate, in the course of the history of regional anaesthesia, and in addition to the classical methods like seeking of paraesthesia, different mechanical aids have been used for nerve detection. In the last two decades, important medical diagnostic and therapeutic advances in imaging technology have been presented. In this review we will analyse the role such imaging diagnostic procedures will play in regional anaesthesia practice. RECENT FINDINGS: Last developments in the field have produced increased interest in the application of imaging techniques in regional anaesthesia. Of special interest are ultrasound and low radiation x-ray techniques for location of the needle in relation with neural structures. SUMMARY: In this paper we will analyse which imaging techniques are of relevance to anaesthesia in terms of clinical outcome, research and teaching of regional anaesthetic techniques, and the clinical impact of such imaging techniques upon anaesthesia practice.

Journal Article↗
PubMed2003

Coccygodynia: a proposal for an algorithm for treatment.

Coccygodynia (coccydynia, coccygalgia) or coccygeal pain is a well-known but rarely studied painful syndrome affecting the coccyx region. Its etiology is not well understood. Symptoms include development of pericoccygeal soft tissues, pelvic floor muscle spasms, referred pain from lumbar pathology, arachnoiditis of the lower sacral nerve roots, local post-traumatic lesions, and somatization. In spite of advances in the treatment of other pain conditions, coccygodynia remains in a position for which therapeutic options are not clearly designed. On the basis of an anatomic review, proposed pathogenesis of coccygodynia, and the number of treatment approaches that have been proposed, we propose an algorithm for therapeutic decision making in the treatment of this syndrome.

Algorithms↗