Pain-Relieving Procedures

P. Prithvi Raj MBBS, FFARCS (Eng), FIPP, Departments of Anesthesiology and Pain Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA Serdar Erdine MD, FIPP, Istanbul Pain Center, Istanbul, Turkey

Foreword by Professor Dr Maarten van Kleef vii

Foreword by Dr J. C. D. Wells ix

Preface xi

Acknowledgments xiii

Part 1 General Principles 1

1 History of Interventional Pain Medicine 3

2 Principles for Performing Percutaneous Invasive Procedures 9

3 Physical and Psychological Assessment of the Patient with Pain 12

4 Preparing the Patient for Interventional Pain Procedures 18

5 Monitoring the Patient Before During and After the Procedure 25

6 Radiation Safety and Use of Fluoroscopy During Interventional Pain Procedures 28

7 Sedation and Analgesia for Interventional Pain Procedures 40

8 Drugs Used During Interventional Pain Procedures 46

9 Tools and Equipment Used in Interventional Pain Procedures 61

10 Principles and Descriptions of Special Techniques 68

Radiofrequency lesions (contributed by Eric R. Cosman Sr and Eric R. Cosman Jr) 68

Principles of ultrasonography 79

Further reading 90

Part 2 Description of Specific Techniques 93

11 Simple, Frequent Procedures in the Musculoskeletal Region 95

Injections into Upper Extremity Joints 95

Shoulder joint 95

Elbow joint 99

Wrist joint 102

Injections into Lower Extremity Joints 104

Hip joint 104

Knee joint 107

Ankle joint 110

Injections into Myofascial Trigger Points 112

Further reading 128

12 Interventional Pain Procedures in the Head 130

Percutaneous block and lesioning of the trigeminal ganglion 130

Percutaneous maxillary nerve block 142

Percutaneous mandibular nerve block 146

Percutaneous block of the terminal branches of the trigeminal nerve 149

Percutaneous block and lesioning of the sphenopalatine ganglion 154

Percutaneous block and lesioning of the glossopharyngeal nerve 161

Further reading 165

13 Interventional Pain Procedures in the Neck 166

Percutaneous block and lesioning of greater and lesser occipital nerves 166

Percutaneous block and lesioning of third occipital nerve 169

Percutaneous interlaminar block of the cervical epidural space 173

Percutaneous transforaminal block of the cervical epidural space 184

Percutaneous block and lesioning of the cervical facet joint 191

Percutaneous discography of the cervical discs 200

Percutaneous block of the phrenic nerve 205

Percutaneous block and lesioning of the stellate ganglion 207

Further reading 217

14 Interventional Pain Procedures in the Thoracic Region 219

Percutaneous interlaminar block of the thoracic epidural space 219

Percutaneous transforaminal block of the thoracic epidural space 225

Percutaneous block and lesioning of the thoracic facet joint and medial branch 229

Percutaneous thoracic discography 235

Percutaneous block and lesioning of the suprascapular nerve 240

Percutaneous block and lesioning of the thoracic sympathetic chain 244

Percutaneous block of the intercostal nerve 249

Further reading 255

15 Interventional Procedures for Visceral Pain in the Thoraco-Abdominal Region 256

Percutaneous block and lesioning of the splanchnic nerve 256

Percutaneous block and lesioning of the celiac plexus 264

Further reading 272

16 Interventional Pain Procedures in the Lumbar Region 274

Percutaneous interlaminar block of the lumbar epidural space 274

Percutaneous transforaminal block of the lumbar epidural space 283

Percutaneous block and lesioning of the lumbar facet joint and medial branch 293

Percutaneous block and lesioning of the lumbar sympathetic ganglia 302

Percutaneous block and lesioning of the rami communicantes 308

Percutaneous discography and lesioning of the lumbar disc 311

Percutaneous intradiscal procedures 323

Further reading 335

17 Interventional Pain Procedures in the Pelvic and Sacral Regions 337

Percutaneous interlaminar block of the caudal epidural space 337

Percutaneous technique of caudal epidural neuroplasty 344

Epiduroscopy 353

Percutaneous block and lesioning of the sacral nerve 361

Percutaneous block and lesioning of the superior hypogastric plexus 365

Percutaneous block of the impar ganglion 372

Percutaneous block and lesioning of the sacroiliac joint 376

Further reading 383

18 Advanced Techniques 384

Technique of intraspinal continuous analgesia 384

Technique of spinal cord stimulation 401

Technique of sacral nerve root stimulation (contributed by S. Ozyalcin) 413

Vertebroplasty 423

Kyphoplasty 432

Further reading 436

Index 437