Textbook of Regional Anesthesia 2003 EDITION P. PRITHVI RAJ MD Professor of Anesthesiology Co-Director of Pain Services International Pain Institute Texas Tech University Health Sciences Center School of Medicine Lubbock, Texas CHURCHILL LIVINGSTONE An imprint of Elsevier Science New York•Edinburgh•London•Melbourne•Tokyo Volume CHURCHILL LIVINGSTONE An imprint of Elsevier Science The Curtis Center Independence Square West Philadelphia, Pennsylvania 19106 NOTICE Anesthesiology is an ever-changing field. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the treating physician, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the Publisher nor the editor assumes any liability for any injury and/or damage to persons or property arising from this publication. T P HE UBLISHER Library of Congress Cataloging-in-Publication Data Raj, P. Prithvi. Textbook of regional anesthesia/P. Prithvi Raj. p. ; cm. ISBN 0–443–06569–1 1. Conduction anesthesia. I. Title. [DNLM: 1. Anesthesia, Conduction—methods. WO 300 R161t 2002] RD84 .R35 2002 617.9′64—dc21 2001037149 Acquisitions Editor: Allan Ross Project Manager: Robin E. Davis Senior Editorial Assistant: Josh Hawkins TEXTBOOK OF REGIONAL ANESTHESIA ISBN 0–443–06569–1 Copyright © 2002 Elsevier Science (USA). All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. CHURCHILL LIVINGSTONE and the Sail Boat Design are registered trademarks. Printed in the United States of America. Last digit is the print number: 9 8 7 6 5 4 3 2 1 II Contributors ELI ALON MD Professor of Anesthesiology, University of Zurich, Zurich, Switzerland; Chairman, Department of Anesthesiology, Ospedale Civico and Ospedale Italiano, Lugano, Switzerland Efficacy Outcome of Regional Anesthesia Techniques in Obstetrics SUSAN R. ANDERSON MD Assistant Professor, Director of Education, Advanced Pain Centers of Alaska, Anchorage, Alaska Drugs Used in Regional Anesthesia: Chemical Neurolytic Agents; Continuous Regional Analgesia; Epiduroscopy; Discography and Intradiscal Electrothermal Annuloplasty; Vertebroplasty JOSE DE ANDRÉS MD Associate Professor of Anesthesia, Valencia University Medical School; Director, Pain Management Center, Department of Anesthesiology and Critical Care, Valencia University General Hospital, Valencia, Spain Aids to Localization of Peripheral Nerves; Common Techniques for Regional Anesthesia: Subarachnoid and Epidural Anesthesia DOUGLAS R. BACON MD Associate Professor of Anesthesiology, Mayo Medical School; Senior Associate Consultant, Mayo Clinic Rochester Minnesota Beyond Blocks: The History of the Development of Techniques in Regional Anesthesia III RONALD BANISTER MD Resident, Department of Anesthesiology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas Aids to Localization of Peripheral Nerves ALDO BARBATI MD Staff Anesthesiologist, Department of Anesthesia and Intensive Care, Cardarelli Hospital, Naples, Italy Equipment and Techniques SHAUNA BAUGHCUM CPC Business Manager, International Pain Institute, Texas Tech University Health Sciences, Center School of Medicine Lubbock Texas Appendix A: Selected Pain Management Billing Codes; Appendix B: Selected Diagnoses for Pain Management DIEGO BELTRUTTI MD Head, Department of Anesthesia and Resuscitation, Pain Control Center, Santo Spirito Hospital, Bra, Italy Organization of Chronic Pain Services; Organization of Palliative Care Services JAY B. BENDER MD Pain Fellow, Department of Anesthesiology, University of Texas M.D. Anderson Cancer Center, Houston, Texas Chronic Pain: Outcomes Using Procedures for Nociceptive Pain HONORIO T. BENZON MD Professor of Anesthesiology, Northwestern University Medical School; Chief Division of Pain Medicine, Northwestern Memorial Hospital Chicago, Illinois Acute Situations: Trauma IV HEMMO A. BOSSCHER MD Assistant Professor of Anesthesiology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas Epidural Steroids CHRISTOPHER M. BURKLE MD Instructor in Anesthesiology, Mayo Medical School; Senior Associate Consultant in Anesthesiology, Mayo Clinic, Rochester, Minnesota Beyond Blocks: The History of the Development of Techniques in Regional Anesthesia ALLEN W. BURTON MD Associate Professor of Anesthesiology, Section Chief of Cancer Pain Management, University of Texas M.D. Anderson Cancer Center, Houston, Texas Chronic Pain: Outcomes Using Procedures for Nociceptive Pain JEFFREY CARRUTH MD Chief Resident, Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock, Texas Radiographic Imaging in Regional Anesthesia VINCENT W. S. CHAN MD Associate Professor of Anesthesia, University of Toronto; Director Regional Anesthesia Acute Pain Service, Department of Anesthesia University Health Network, Toronto Western Hospital Toronto, Ontario, Canada Training Education of a Physician for Regional Anesthesia MILES DAY MD, DAPBM Assistant Professor of Pain Management/Anesthesiology, International Pain Institute, Texas Tech University Health Sciences Center School of Medicine; Staff Physician, University Medical Center, Lubbock, Texas V Nerve Root Neurolysis; Sphenopalatine Analgesia FRANCESCO DONATELLI MD Resident, School of Specialization in Anesthesiology, L’Aquila, Italy Economic Impact of Regional Anesthesia; Organization of an Acute Pain Service and Pain Management CLAUDE ECOFFEY MD Professor of Anesthesiology, Centre Hospitalier Universitaire de Rennes, Rennes, France Common Techniques for Regional Anesthesia: Regional Anesthesia in Children SERDAR ERDINE MD Professor, Medical Faculty of Istanbul University; Chairman, Department of Algology, Capa Klinikleri, Istanbul, Turkey Trigeminal Ganglion Procedures P. M. FINCH MD Perth Pain Management Centre, South Perth, Western Australia Sympathetic Neurolysis BRIAN FLANAGAN MD Progressive Pain Management Dallas, Texas Discography Intradiscal Electrothermal Annuloplasty KAREN GALLOWAY MD Instructor, Division of Pediatric Anesthesiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Anesthesiologist, Shriners Hospital for Children, Honolulu, Hawaii Chronic Pediatric Pain MELVIN G. GITLIN MD VI Professor and Interim Chairman, Department of Anesthesiology, Tulane School of Medicine; Director, Pain Management Care, Tulane University Hospital and Clinic, New Orleans, Louisiana Epidural Steroids STEWART GRANT MD Associate Professor of Anesthesiology, Duke University Medical Center Durham, North Carolina Common Techniques for Regional Anesthesia: Peripheral Nerve Blocks ROY GREENGRASS MD Associate Professor of Anesthesiology; Co-Director, Division of Ambulatory Anesthesiology, Duke University Medical Center, Durham, North Carolina Common Techniques for Regional Anesthesia: Peripheral Nerve Blocks PAOLO GROSSI Director, Department of Regional Anesthesia and Pain Treatment, Instituto Policlinico, San Donato Milano, Milano, Italy Aids to Localization of Peripheral Nerves MARC B. HAHN DO Dean, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth Fort Worth, Texas Peripheral Nerve Blockade RICHARD A. HARDART MD Instructor, Department of Anesthesiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland Pediatric Pain Management CRAIG T. HARTRICK MD VII Director, Anesthesia Research, William Beaumont Hospital, Royal Oak, Michigan Regional Anesthesia for Chronic Situations: Nonmalignant Pain; Trauma SAMUEL J. HASSENBUSCH MD Professor of Neurosurgery, University of Texas, M.D. Anderson Cancer Center, Houston, Texas Neuroaugmentative Procedures for Pain JAMES E. HEAVNER DVM, PhD Professor of Anesthesiology and Physiology, Director of Anesthesia Research, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas Pain Mechanisms and Local Anesthetics: Scientific Foundations for Clinical Practice CHRISTOPHER J. JANKOWSKI MD Assistant Professor of Anesthesiology, Mayo Medical School; Consultant, Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minnesota Neuraxial Anesthetic Techniques MOLLY JOHNSTON RN Texas Wesleyan University, Fort Worth, Texas Organization Function of the Nerve Block Facility ALAN D. KAYE MD, PhD Professor and Chairman, Department of Anesthesiology, Professor of Pharmacology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas Drugs Used in Regional Anesthesia: Local Anesthetics; Epidural Steroids VIII HENRIK KEHLET MD, PhD Professor of Anesthesiology, Copenhagen University, Hvidovre Hospital, Hvidovre, Denmark Endocrine-Metabolic Effects STEVEN KLEIN MD Assistant Professor of Anesthesiology, Division of Ambulatory Regional Anesthesia, Duke University Medical Center Durham, North Carolina Common Techniques for Regional Anesthesia: Peripheral Nerve Blocks ADRIENNE E. KNIGHT MD Assistant Professor of Anesthesiology, University of Colorado, Denver, Colorado Acute Situations: Trauma MARK KRAFT MD Private Practice, Las Vegas, Nevada Discography and Intradiscal Electrothermal Annuloplasty ELLIOT S. KRAMES MD Medical Director, Pacific Pain Treatment Centers, San Francisco, California Untreated Pain and Its Cost to Society: What Are Our Options?; Intrathecal Therapies for the Treatment of Chronic Pain DONALD H. LAMBERT MD, PhD Anesthesiologist, Anesthesia Associates of Massachusetts; Boston University Medical Center, Boston, Massachusetts Efficacy of Regional versus General Anesthesia TIM J. LAMER MD Assistant Professor of Anesthesiology, Mayo Medical School, Rochester, Minnesota; Consultant, Department of Anesthesiology, IX Mayo Clinic Jacksonville, Jacksonville, Florida Cancer Pain ERIC LANG MD Pharmaceutical Licensing Group, Johnson and Johnson, Titusville, New Jersey Clinical Research ALBERT Y. LEUNG MD Assistant Clinical Professor of Anesthesiology, University of California, San Diego, School of Medicine; Faculty, Center for Pain and Palliative Medicine, University of California, San Diego, Medical Center, La Jolla, California Regional Anesthesia for Chronic Situations: Malignant Pain ANDRES LÓPEZ MD Chairman, Department of Anesthesiology and Critical Care, Móstoles Hospital, Madrid Montepríncipe Hospital, Madrid, Spain Common Techniques for Regional Anesthesia: Subarachnoid and Epidural Anesthesia EDWARD A. R. LORD MD Pain Fellow, Department of Anesthesiology, University of Texas, M.D. Anderson Cancer Center Houston, Texas Chronic Pain: Outcomes Using Procedures for Nociceptive Pain LELAND LOU MD, MPH, DABPM Assistant Professor of Pain Management, Anesthesiology, International Pain Institute, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas Drugs Used in Regional Anesthesia: Local Anesthetics; Radiographic Imaging in Regional Anesthesia; Spinal Decompressive Neuroplasty via the Caudal and Cervical Approaches X