Interventional Pain Flashcards
borders of safe triangle
lateral border = lateral edge of vertebral body
superior border = parallel to inferior pedicle
hypotenuse = spinal nerve root
angle of C-arm for lumbar MBB vs cervical MBB
lumbar = obliquely cervical = caudally
where is the injection target for a sympathetic block
chassaignac tubercle of C6 vertebral body
celiac plexus blocks are often indicated for controlling pain arising from where?
epigastric viscera
1 symptom that patient experiences for anesthetic toxicity
metallic taste
slightly soluble steroids
methylprednisolone
presynaptic sympathetic fibers arise from where?
intermediolateral cell column of the spinal level T1-L2
soluble steroids
dexamethasone
innervation of SI joints
anterior SI joint = L2-S2 ventral rami
posterior SI joint = L4-S3 dorsal rami
Benefit of using epinephrine with anesthetics
prolongs duration of action
the stellate ganglion is composed of
lower cervical sympathetic and upper thoracic ganglia
where do you want the needle in a TFESI
6 o’clock position inferior to pedicle in the upper third the neuroforamen
is lidocaine an amide or ester?
amide. All amides have “i” before “-caine”
relatively insoluble steroids
triamcinolone
when doing discography, normal opening disc pressure is how many psi?
5 to 25 psi
relationship between radiation exposure and distance from source
radiation exposure is inversely proportional to square of distance from source.
Increase distance, decrease radiation.
where is hypogastric plexus located
lower 1/3 of L5 vertebral body
celiac plexus receives sympathetic and parasympathetic fibers from where?
sympathetic - greater, lesser and least splanchnic nerves
parasympathetic - vagus nerve
particulate steroids
- betamethasone sodium phosphate and acetate
- methylprednisolone
- triamcinolone
most potent steroids
betamethasone and dexamethasone
advantage of amides over esters
amides have less allergic/adverse reactions
longest acting steroids, in order
- dexamethasone
- methylprednisolone
- betamethasone
- triamcinolone
where is stellate ganglion located
anterolateral to C7
in a caudal approach, the needle should not advance higher than what level
S3, because dural sac ends at around S2 level
non-particulate steroids
dexamethasone
positive response after a diagnostic MBB is when there is how much pain relief?
> 80%
