By Steven D. Waldman MD JD
This atlas, a better half to the preferred INTERVENTIONAL discomfort administration, offers step by step full-color illustrations demonstrating interventional discomfort administration suggestions. Over two hundred computer-generated figures supply a vibrant and colourful method to view ache administration equipment in a virtually three-D strategy. The textual content bargains concise details on anatomy, symptoms, procedure, and issues in an easy, bulleted structure.
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5% phenol in ~and absolute alcohol all have been successfully used for ~ of the gasserian ganglion. 1mL increments, with time allotted between additional increments to allow for observation of the clinical response. If hyperbaric neurolytic solutions such as glycerol or phenol in glycerin are used, the patient should be moved to the sitting position with the chin on the chest prior to injection (Fig. 7-5). This will ensure that the solution is placed primarily around the maxillary and mandibular divisions and avoids the ophthalmic division.
The skin at the point where the bridge of the nose abuts the supraorbital ridge is prepared with antiseptic solution, with care being taken to avoid spillage into the eye. A 25-gauge, 1'12inch needle is inserted just lateral to the junction of the bridge of the nose and the supraorbital ridge and is advanced medially into the subcutaneous tissue (Fig. 10-2). ' ~rned of such. Because of the loose alveolar tissue of the eydid, a gauze sponge should be used to apply gentle pressure on the upper eyelid and supratrochlear tissues before injection of solution to prevent the injectate from dissecting inferiorly into these tissues.
In spite of the vascularity of this anatomic region, this technique can safely be performed in the presence of anticoagulation by using a 25- or 27-gauge needle, albeit at increased risk of hematoma, if the clinical situation dictates a favorable risk-to-benefit ratio. These complications can be decreased if manual pressure is applied to the Supraorbital nerve block is especially useful in the palliation of pain secondary to acute herpes zoster involving the ophthalmic division and its branches.