Iatrogenic reflex sympathetic dystrophy.
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Biomedical subjects
Publications and source records attributed to H Carron.
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A modified low-dose paratracheal approach to stellate ganglion block at the C6 level prevents the possible complications of subarachnoid introduction of large quantities of local anesthetic, brachial plexus block, and toxic reaction to local anesthetics. It is a technically simple procedure with readily identifiable landmarks and can be performed on an outpatient basis with short recovery periods. Successful block can be readily evaluated. It is emphasized that a series of blocks is required to "disorganize" the reflex activity triggered in the internuncial pools of the spinal cord as well as in the sympathetic ganglia themselves.
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Changing concepts of pain mechanisms deemphasize the somatic aspects of chronic pain and enhance the concept that chronic pain is primarily a psychological disorder. As such, interruption of straight-through pain pathways through nerve blocking may not always be the treatment of choice. Evidence is given encouraging anesthesiologists to modify their thinking on the value of nerve blocks in the treatment of chronic pain and direct their efforts to the management of acute, postoperative, and cancer pain problems.