MSK US Guided Hydrodissection of Interscalene Brachial Plexus with 5% Dextrose without Lidocaine скачать в хорошем качестве

MSK US Guided Hydrodissection of Interscalene Brachial Plexus with 5% Dextrose without Lidocaine

https://doi.org/10.1155/2017/7920438 Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described. Here we describe ultrasound-guided methods for hydrodissection of deep nerve structures in the upper torso, including the stellate ganglion, brachial plexus, cervical nerve roots, and paravertebral spaces. We retrospectively reviewed the outcomes of 100 hydrodissection treatments in 26 consecutive cases with a neuropathic pain duration of months and the mean Numeric Pain Rating Scale (NPRS) 0–10 pain level of .