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At least 1,477 records · Page 82Linked to original sources
PubMed1990

[The treatment of patients with the anococcygeal pain syndrome].

Results are reported of a two-year rehabilitative treatment of 17 patients with anococcygeal pain syndrome. The I stage of treatment consisted of intrarectal administration of anti-inflammatory reparative anesthetic aerosols "Olasol" and "Cimesol" in association with phonophoresis on the lumbosacral zone. At the 11 stage prophylaxis of recurrences was carried out by dietary and physiotherapeutic correction of constipation as well as short repeat courses of "soft" aerosols "Livian", "Levovinisol" or "Vinisol" in association with phonophoresis every 4-6 months. The medical and economic efficacy of the method is emphasized. Recurrences were 3.5 times less frequent.

Administration, Rectal↗
PubMed1990

[Peripheral neurofibromatosis and involvement of lumbosacral nerves. Value of imaging].

We report a case of giant plexiform neurofibromatosis revealed by a sensori-motor, axo-myelinic polyneuropathy. Only the lumbar and sacral spinal nerves were involved in this peripheral form of Von Recklinghausen's disease. The polyneuropathy was due to compression of the nervous fibers by the neurofibromatous tumors. Ultrasonography DTPA 99 m Technetium scintigraphy, CT and MRI were the diagnostic procedures. MRI proved superior to CT in demonstrating the extent of the lesions. Biopsy confirmed the diagnosis. This form of neurofibromatosis did not involve the central nervous system, cranial nerves of cervicothoracic spinal nerves and roots; nor was there any visceral involvement, particularly endocrine neoplasia.

Adult↗
PubMedDate not supplied

Preoperative percutaneous ilioinguinal and iliohypogastric nerve block with 0.5% bupivacaine for post-herniorrhaphy pain management in adults.

The safety, effectiveness and duration of a percutaneous ilioinguinal-iliohypogastric nerve block with 10 ml 0.5% bupivacaine, as a method for postoperative analgesia, were studied prospectively in adult patients undergoing unilateral inguinal herniorrhaphy under spinal anesthesia. Group I (n = 20) blocked patients were compared with Group II (n = 25), non-blocked control patients. A blinded observer assessed pain scores and analgesic requirements after surgery. Group I patients had less pain at 3, 6, 24 and 48 hours after surgery and also required less analgesics during the first two postoperative days. This technique appears to be a simple and safe method for providing effective and long-lasting postoperative analgesia following inguinal hernia repair in adults.

Adult↗
PubMedDate not supplied

Plasma concentrations after high doses of mepivacaine with epinephrine in the combined psoas compartment/sciatic nerve block.

A combination of psoas compartment block and sciatic nerve block was performed with a total dose of 731.5 mg mepivacaine (55 ml, 1.33%) with epinephrine (1:600,000) in patients scheduled for orthopedic surgery on one leg. In 20 patients, arterial blood samples were collected at timed intervals over a 6-hour period to determine the mepivacaine plasma concentration. In all patients, good sensory and motor blocks were obtained and no analgesics were required during surgery. Despite the high dose of mepivacaine, the plasma concentrations stayed below 6.0 micrograms/ml, with one exception, although no clinical signs of local anesthetic toxicity were observed. Plasma pharmacokinetic variables of mepivacaine were as follows: Cmax: 4.22 mg.l-1 (SD, 1.28); Tmax: 0.99 hours (SD, 0.76); T1/2: 3.25 hours (SD, 1.12); CL 0.55 1.hour-1.kg-1.

Adult↗
PubMed1990

[Mesenchymal extra-skeletal chondrosarcoma. Apropos of a case].

The authors report a case of extra-skeletal mesenchymal chondrosarcoma in a 22 year old man. This rare tumour developed along the nerve tracts (nerve roots, sciatic nerve and gluteal nerves) with contiguous involvement of muscles and three different bones (vertebra, sacrum, iliac bone). The nature of the tumour could only be determined by histological examination of a large fragment.

Adult↗
PubMedDate not supplied

Sacralization of epidural block with repeated doses of 0.25% bupivacaine during labor.

A descriptive analysis of the progression of epidural block with repeated doses of 0.25% bupivacaine was performed, assessing pain relief (visual analog scoring), dermatomal spread of sensory and motor block, and the associated management and outcome of labor. The influence of epinephrine 1:200,000 on these observations was also assessed by the random assignment of study patients into two groups, one receiving 10 ml of 0.25% bupivacaine plain (n = 28) and another group receiving 10 ml of 0.25% bupivacaine with commercially added epinephrine 1:200,000 (n = 27). Only primigravid patients were studied. Data comparisons were considered significant at p less than 0.05. With repeated doses of 0.25% bupivacaine, administered within fixed dosing intervals of 60-90 minutes, there was an increasing spread of sensory block toward sacral dermatomes while the upper level of sensory block did not change. Sacral sensory analgesia was present in only 3.5% of patients after the first dose of bupivacaine but was evident in 63.2% of patients following the fourth epidural injection. A similar increase in the number of patients with significant motor weakness was also seen as the number of top-up doses increased. A comparison of patients receiving plain solutions and epinephrine containing bupivacaine showed similar demographic profiles between the groups. Both groups received a similar dose of bupivacaine and experienced comparable management and outcome of labor. Epinephrine in a 1:200,000 concentration did not influence the changing characteristics of the epidural block over time. The duration of labor was not significantly different between groups (10.3 +/- 5.2 hours for the plain group and 11.0 +/- 4.7 hours for the epinephrine group).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

The recognition of mechanically induced pelvic pain and organic dysfunction in the low back pain patient.

Mechanical disorders of the lumbar spine have been identified as a cause of pelvic pain and organic dysfunction (PPOD). Categorically, the clinical features indicative of mechanically induced PPOD fall into three areas: the history of the development or onset of pelvic symptomatology attributable to lower sacral nerve root compression (LSNRC), identification of related symptomatology on presentation, and the recognition of clinical findings indicative of mechanically induced PPOD on examination. Characteristic features of each category are presented. The clinical signs that most reliably indicate the presence of PPOD secondary to a mechanical lesion of the low back are of a sensory nature, and the disappearance or lack of improvement of these signs closely parallels the patient's overall response to manipulative treatment. Without a thorough understanding of the salient features of mechanically induced PPOD, the practitioner is likely to overlook this as a diagnostic possibility. As a result, efforts to document chiropractic spinal manipulative therapy in relieving disorders of pelvic organic function may be hampered. The empirical efficacy of chiropractic spinal manipulative therapy for treating disorders of pelvic organic function would be enhanced if more chiropractors were apprised of the salient features indicating the presence of mechanically induced PPOD.

Back Pain↗
PubMed1989

[Clinical, neurophysiologic and therapeutic remarks from anatomic data on the pudendal nerve in some cases of perineal pain].

Clinical observations in patients suffering from positional perineal pain have led us to performing an anatomical study of the pudendal nerve in order to demonstrate compression of this nerve trunk by elements likely to compress it in the sitting position. Thus we observed that the falciform process of the sacrotuberous ligament may act in this way. Besides helping us to understand the clinical symptoms, this anatomical study allowed choosing the technique we found most appropriate for the anatomical conditions observed out of the various neurophysiological examinations described in the literature. Lastly, we describe the surgical technique that allows releasing the trunk of the pudendal nerve under an operating microscope.

Evoked Potentials, Somatosensory↗
PubMed1989

Neuroanatomy and its clinical application.

In years prior, articles concerned with neuroanatomy have stressed just that, the anatomy. It is for this reason that this article was written. The primary intent addresses the clinical aspects of neuroanatomy, and as such, has stressed so-called "anatomic function." An overview of neuroanatomy as well as neural function and deficit is provided. The article is intended for both the student and practitioner in the hopes of taking the labor out of its study and replacing it with a logical approach to the neuroanatomy and its clinical applications.

Humans↗
PubMed1989

[Superior gluteal nerve entrapment neuropathy].

We observed two female patients suffering from chronic gluteal pain of mechanical origin, without paresthesia. In the first case, the muscular pain was associated with weakness of hip abduction and with tenderness of the middle gluteal muscle. An electromyography, a principal examination, confirmed a diagnosis of entrapment of the superior gluteal nerve in one case and of the distal branch in the other. The proposed treatment, as in the case of neuropathic entrapment of the median nerve at the wrist, consists of a local infiltration of corticosteroids. If the symptoms persist, surgical intervention to free the nerve is indicated. For our first patient the clinical and electromyography cure has been completed. The neuropathy by chronic compression of a nerve in the gluteal area seems to be rare, but one has to consider further investigations in the case of chronic gluteal pain.

Adrenal Cortex Hormones↗