Cousins and Bridenbaugh’s Neural Blockade in Clinical by Michael J. Cousins AM MB BS MD (SYD) FAN, Phillip O.

By Michael J. Cousins AM MB BS MD (SYD) FAN, Phillip O. Bridenbaugh MD, Daniel B. Carr MD DABPM FFPMANZCA(Hon), Terese T. Horlocker MD

This accomplished, authoritative textual content offers the medical foundations and medical perform of neural blockade in either nearby anesthesia and the administration of soreness. The descriptions and illustrations of ache mechanisms are thought of vintage examples. The Fourth variation has been subtle for readability and flows logically from ideas and pharmacology, to options for every anatomic quarter, to purposes. This variation has new co-editors and several other new chapters on themes together with neurologic issues, neural blockade for surgical procedure, therapy of discomfort in older humans, and problems in soreness drugs.

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Extra info for Cousins and Bridenbaugh’s Neural Blockade in Clinical Anesthesia and Pain Medicine

Sample text

And unskilled, seemingly offering little opportunity or incentive for innovative work. In the British quarter of the globe, general anesthesia was administered by physicians and perhaps generated a certain sense of security and a tendency to leave well enough alone. Everywhere, if local anesthesia was the choice, the surgeon did both the choosing and the injecting. It was not until nerve block began to be perceived as an independent diagnostic and therapeutic tool that a demand arose for regional anesthetic skill independent of surgical operation.

Stovaine was less toxic than cocaine but was very slightly irritating and was eventually superseded by procaine. Barker’s stovaine came directly from the laboratory of Billon, in Paris, where it was made up in 5% glucose especially for Barker and packaged in sterile ampules. Barker was a professor of surgery at the University of London, and his article is exceedingly thoughtful, based on some 80 cases. He describes experiments with a glass model of the spinal canal, conforming to the shape seen in a mesial Chapter 1: The History of Regional Anesthesia section of a cadaver and bearing a T-junction in the lumbar region to simulate the injection site.

Fidel Pag´es (1886–1923). found unilateral paravertebral block of selected spinal nerves useful in the differential diagnosis of intra-abdominal disease (93). For example, he observed that a 10-mL injection of 2% procaine at T10 could completely relieve the pain of a severe biliary colic for 3 hours. The use of segmental paravertebral block for the differential diagnosis of painful conditions was ¨ an original idea of Lawen’s. At the suggestion of Pal, it was then tried by Brunn and Mandl in 1924 (94), as a therapeutic measure in the hopes of obtaining pain relief in acute cholecystitis, but without significant success.

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