Use of computed tomography for mandibular nerve block in the treatment of trigeminal neuralgia.
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Biomedical subjects
Publications and source records attributed to T Kitajima.
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BACKGROUND AND OBJECTIVES: The aim of this study is to examine the duration and magnitude of vasodilative effect induced by sympathetic block with the addition of clonidine to mepivacaine. METHODS: We measured mean arterial pressure (MAP), heart rate (HR), and right and left brachial artery blood flow (BABF) before and after stellate ganglion block (SGB) in dogs. The experimental protocol was designed as follows: (1) left SGB using 1.0 mL 0.5% mepivacaine (n = 6) and (2) left SGB using the addition of clonidine 0.5 microg to 1.0 mL 0.5% mepivacaine (n = 6). RESULTS: MAP and HR did not change significantly throughout the study in either group. Left SGB with mepivacaine increased left BABF significantly from 10 minutes through 50 minutes after SGB (baseline, 100%; peak at 10 minutes after SGB, 176% +/- 28%; P <.01). Left SGB with the addition of clonidine to mepivacaine induced a significant increase of left BABF from 10 minutes through 70 minutes after SGB (baseline, 100%; peak at 10 minutes after SGB, 223% +/- 42%; P <.01). The values of left BABF after SGB with the addition of clonidine to mepivacaine were significantly higher than those of SGB with mepivacaine alone from 10 minutes through 80 minutes after SGB (P <.05). Right BABF decreased significantly after SGB throughout the study in both groups. CONCLUSIONS: The addition of clonidine increases both duration and magnitude of the vasodilative effect induced by sympathetic block over that caused by mepivacaine alone.
BACKGROUND AND OBJECTIVES: Prolongation of QT interval and QT dispersion (QTD) may be associated with an increased risk of arrhythmias. This study was designed to investigate the effects of right or left stellate ganglion block (SGB) on RR interval, QT interval, the rate-corrected QT (QTc) interval, QTD and the rate-corrected QTD (QTcD) using computerized measurements. METHODS: Ten healthy volunteers underwent both right and left SGBs using 7 mL 1% mepivacaine with a 7-day interval between the 2 blocks. The measurement from the 12-lead electrocardiogram was performed for 60 minutes after SGB. RESULTS: Right SGB induced a significant decrease of RR interval immediately after the block, and significant increases of QT interval, QTc interval, QTD, and QTcD from immediately through 50 minutes after the block (P <.01). Left SGB induced a significant decrease of RR interval, and significant increases of QTc interval and QTD immediately after the block (P <.01). Left SGB also produced a significant decrease of QT interval from 20 through 50 minutes after the block, and a significant decrease of QTc interval from 30 through 50 minutes after the block (P <.05). CONCLUSIONS: Right SGB induces increases of the QT interval, QTc interval, QTD, and QTcD, and left SGB induces decreases of the QT interval and QTc interval.
A 62-year-old housewife had a metastasis of granular cell ameloblastoma to the third thoracic vertebra. She had suffered at least four local recurrences during the 38-year duration of the right mandibular tumor and was treated by posterior decompression of the spinal cord with instrumentation. Histologically, the granular cells appeared to be of epithelial origin. Ultrastructurally, the granules were identified as lysosomes, including some that were autophagic. Of 45 reported cases of granular cell ameloblastoma, there have been only three cases with pathologically confirmed metastasis. Their characteristics are long duration of the tumor, multiple local recurrences, and predominance in blacks.
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