Anesthesia (2)

Lateral cervical epidural catheter placement for continuous unilateral upper extremity analgesia and sympathetic block. (Wake Forest University School of Medicine, Winston‐Salem, NC) Reg Anesth Pain Med 2000;25:313–317. This article discussed the use of a laterally directed cervical epidural catheter for the treatment of acute and chronic pain. The technique was used in a series of 30 patients to produce unilateral upper extremity analgesia and sympathetic block. A case report of a patient treated with this technique and a description of the technique as well as the results from the series are presented. The method included placement of an epidural catheter at the C6‐7 vertebral interspace; the needle bevel and catheter were directed to the affected side in a woman with a history of complex regional pain syndrome of the right upper extremity. A unilateral block was shown with the technique by anatomic parameters (unilateral contrast dye spread), physiologic parameters (unilateral Horner's syndrome), and symptomatic parameters (unilateral, subjective neural block). One patient treated with the technique had bilateral effects; however, no patient had a predominant block on the contralateral side and no complications developed. The case report showed results that were typical of the series of 30 patients. Conclude that the laterally directed cervical epidural catheter was an effective technique to produce continuous unilateral analgesia and sympathetic block.