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Biomedical subjects

H T Benzon

Publications and source records attributed to H T Benzon.

28 records · Page 2Linked to original sources
PubMed1981

Delayed onset of epidural anesthesia in patients with back pain.

Onset and completeness of anesthesia were compared in 15 patients with back pain or sciatica and in 10 patients without back pain given lumbar epidural anesthesia with 20 to 25 ml of 1.5% mepivacaine, 80 mg of methylprednisolone, and 1:200,000 epinephrine. Sensory block was complete within 30 minutes in patients without back pain. Eleven of 15 (73%) patients with back pain had delayed onset of anesthesia ranging from 35 to 95 minutes. The difference between the two groups was statistically significant (p less than 0.001). When there was a delay, the affected nerve roots were blocked 10 to 70 minutes after the contralateral unaffected roots. Differences in time of onset between affected nerves and contralateral nerves were also significant (p less than 0.01). The nerve roots involved, as determined from the myelogram or the electromyogram, or those adjacent to them, were the roots with delayed onset of block. Any effect of the steroid on nerve blockade was ruled out as there was solid anesthesia in patients without back pain.

Adult↗
PubMed1980

Postdural puncture headache in patients with chronic pain.

The incidence of headache after dural puncture in patients being treated for chronic pain was studied prospectively. Dural punctures were performed in 142 patients and headache developed in 13 (9.2%). Four of 32 patients (12.5%) who underwent diagnostic differential spinal and nine of 110 patients (8.2%) given intrathecal steroid injection developed headache. There was a 10.7% incidence of headache when a 22-gauge needle was used as compared to 5% with a 25-gauge needle. This difference was not statistically significant. The incidence decreased with increasing age. The incidence of postdural puncture headache in chronic pain patients does not differ significantly from that previously reported for surgical patients. All patients who developed headache responded to treatment which consisted of intravenous and oral fluids, analgesics, bed rest, and, if necessary, epidural blood patch.

Adult↗
PubMedDate not supplied

Pain on intramuscular injection of bupivacaine, ropivacaine, with and without dexamethasone.

BACKGROUND AND OBJECTIVES: We wished to determine which long-acting local anesthetic would produce the least pain on injection for treatment of myofascial pain disorders. We compared the pain on intramuscular injection of bupivacaine, ropivacaine, bupivacaine with dexamethasone, ropivacaine with dexamethasone, and needle placement alone. METHODS: Thirty volunteers received 5 injections each: (1) needle only, (2) bupivacaine 0.5%, (3) ropivacaine 0.5%, (4) bupivacaine 0.5% with dexamethasone 0.13 mg/mL, and (5) ropivacaine 0.5% with dexamethasone 0.13 mg/mL. The injections were made in the volunteers' upper trapezius muscles; there was a 15-minute interval between injections. The sequence of injections was randomized by Latin square design. The intensity of pain was rated on a 0 to 10 cm visual analogue scale (VAS) score. Neither the investigator nor the volunteer was aware of the nature of the injectate. The pH of the injected solutions was checked to determine if differences in the intensity of pain on injection were due to differences in the pH of the solutions. RESULTS: The VAS pain scores were 3.1 +/- 2.4 for needle only, 4.4 +/- 2.8 for bupivacaine, 2.5 +/- 2.0 for ropivacaine, 4.7 +/- 2.7 for bupivacaine/dexamethasone, and 3.7 +/- 2.2 for ropivacaine/dexamethasone. The pain on injection of ropivacaine was significantly less than the pain on injection of bupivacaine or bupivacaine/dexamethasone. The pH values of the solutions were as follows: (1) bupivacaine, 5.50; (2) ropivacaine, 5.57; (3) bupivacaine/dexamethasone, 6.64; and (4) ropivacaine/dexamethasone, 6.60. CONCLUSIONS: The pain on intramuscular injection of bupivacaine is significantly more intense than with ropivacaine. The difference in the intensity of the pain on injection between bupivacaine and ropivacaine does not appear to be related to differences in pH. The results of our study have implications on the choice of the local anesthetic used in trigger point injections.

Adult↗
PubMedDate not supplied

Cerebrospinal fluid leak treated by aspiration and epidural blood patch under computed tomography guidance.

BACKGROUND AND OBJECTIVES: Cerebrospinal fluid (CSF) leakage secondary to surgery of the spine is usually treated by drainage of CSF through a subarachnoid catheter or surgical repair of the dural tear. We present 2 cases in which the pseudomeningocele was treated by aspiration of the leaked CSF and blood patch under computed tomography (CT) guidance. CASE REPORT: Two patients had headache after spine surgery. Physical examination showed a bulging accumulation of fluid at the laminectomy site. Aspiration of the fluid followed by injection of the patients' blood was performed aseptically under CT guidance. The patients had resolution of their headache, and follow-up showed no recurrence of the CSF leak. CONCLUSIONS: CSF leak secondary to a surgical tear of the dura can be successfully treated by aspiration of the fluid followed by injection of the patient's blood. CT guidance is recommended to assess the extent of the CSF leakage, determine the degree of evacuation of the leaked CSF, and to confirm the injection of the blood into the epidural space and the space created by the pseudomeningocele.

Adult↗
PubMedDate not supplied

Clinical experience with the peribulbar block for ophthalmologic surgery.

BACKGROUND AND OBJECTIVES: The peribulbar block is a safe and reliable alternative to the retrobulbar block. In this clinical report, we describe the anatomy of the orbit and the technique involved in performing the block. METHODS: The technique is not new, and modifications from the original paper by Mandel and Davis are few but significant. Complications include peribulbar hemorrhage, perforation of the globe and intravascular injection. RESULTS: In our experience of 2600 peribulbar blocks, we have seen five patients with minor peribulbar hemorrhage. CONCLUSIONS: Supplementation of the block was required in 3% of the patients.

Humans↗