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Biomedical subjects

R J Defalque

Publications and source records attributed to R J Defalque.

At least 37 records · Page 2Linked to original sources
PubMed1989

Poststernotomy neuralgia: a new pain syndrome.

Fifty-four patients developed severe intercostal neuralgia a few weeks after sternotomy. Immediate relief afforded by parasternal nerve blocks confirmed that the pain derived from scar-entrapped neuromas of the anterior rami of the first 4-6 intercostal nerves in the upper (and mainly left) interchondral spaces after insertion of the sternal wires. Permanent relief (i.e., over 6 months) followed repeated bupivacaine blocks in 57.4% of the patients, phenol blocks in another 22.2%, and alcohol blocks in a remaining 9%. Treatment was successful in 87% of the patients.

Adult↗
PubMed1983

Spontaneous saphenous neuralgia.

Six patients representing seven cases of spontaneous (nontraumatic) saphenous neuralgia secondary to entrapment of the nerve in the subsartorial canal are presented. All patients complained of medial knee and leg pain. Clinical findings included tenderness over the subsartorial canal and sensory changes in the cutaneous distribution of one or both terminal branches of the saphenous nerve. The diagnosis was confirmed by saphenous nerve block in all cases. All patients were treated operatively, which resulted in symptomatic improvement. All six patients initially underwent external neurolysis; however, three patients required saphenous neurectomy for recurrent symptoms. Saphenous neuralgia should be considered in the differential diagnosis of medial lower extremity pain.

Adult↗
PubMed1982

Painful trigger points in surgical scars.

A group of 69 patients with painful trigger points in operative scars were treated following abdominal, inguinal, lumbar, or extremity surgery. Patients undergoing thoracotomies, neurosurgical procedures, or limb amputations, and patients with neurotic features or seeking secondary gains were excluded. The diagnosis was made by finding one or more definite, consistent, tender trigger points in the scar in which total, transient relief of pain was provided by injection of bupivacaine. Repeated injections of alcohol into the trigger point proved to be a simple, safe, and effective treatment with permanent cure or marked improvement in 63 (91%) patients.

Adult↗
PubMed1980

Cerebrospinal fluid immunoelectrophoresis in multiple sclerosis.

In 95 patients with definite multiple sclerosis (MS) cerebrospinal fluid (CSF) cytomorphology, protein electrophoresis and immunoelectrophoresis using antisera to human serum, Fab fragments of immunoglobulin G(IgG) and to kappa and lambda light chains and the CSF IgG concentration were examined. In the CSF diagnosis of MS, the set of the examinations used is considered to be superior to any individual laboratory technique currently applied in the diagnostic process of MS. In the set of the CSF examinations, CSF immunoelectrophoresis revealed abnormal findings in patients with MS in whom presence of bands (oligoclonal gammopathy) in the gamma-globulin field of the CSF electropherogram and/or increased concentration of CSF IgG were not demonstrated.

Adult↗
PubMedDate not supplied

Neurological complications of central venous cannulation.

The reports of neurological damage after central venous cannulation over the past 20 yrs have been gathered, summarized, and analyzed. We found 59 cases of nerve lesions: 32 serious or even fatal, and 27 light or transient ones. They included: Lesions of the cervical sympathetic chain: needle trauma, compression by hematoma, anesthetic blockade; brachial plexopathies: needle trauma or compression by hematoma; phrenic or recurrent nerve palsies: anesthetic blockade, needle trauma, or compression by hematoma; cerebral damage following venous air embolism, carotid artery embolism or obstruction (thrombosis, compression), or internal jugular vein obstruction (thrombosis or catheter tip); lesions of the IX, X, XI, and XII cranial nerves by hematoma compression or spilling of histotoxic solutions; and, massive lesions of the anterior rami of the cervical nerves by spillage of histotoxic solutions. We believe that the following simple and well-known measures can substantially reduce the incidence of those serious complications. 1. Avoiding the subclavian or jugular central routes in patients with marked anatomical changes, coagulopathies, and carotid artery or lung diseases. 2. Using only small amounts of dilute concentrations of short-acting local anesthetics before the puncture. 3. Using a small gauge "seeking" needle and placing a finger on the carotid artery during a jugular venipuncture to avoid accidental arterial puncture. 4. Using radiopaque catheters long enough to have their tip in midsuperior vena cava. The position of the catheter must be checked radiographically immediately after insertion and even at later periods. The catheter must be meticulously fixed to the skin to avoid its movement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗