BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distres...BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.展开更多
Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptoma...Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptomatic treatment like simple analgesics. Those who have unremitting symptoms following conservative measures are offered an epidural blood patch (EBP). However, EBP, an invasive procedure, is associated with complications in itself. Case: We report a 40-year-old man who experienced PDPH after spinal anesthesia. His symptoms recurred after conservative management was instituted. He was then offered a trans-nasal sphenopalatine ganglion (SPG) block. He had excellent pain relief and did not require an EBP. Conclusion: SPG blocks can be considered early in the treatment of PDPH together with general supportive measures. However, if pain relief is not achieved, an epidural blood patch should still be considered.展开更多
Recent studies have found that although tinnitus originates from the cochlea,its root lies in the plasticity of the auditory center.In other words,the peripheral auditory system damage causes abnormal excitement and e...Recent studies have found that although tinnitus originates from the cochlea,its root lies in the plasticity of the auditory center.In other words,the peripheral auditory system damage causes abnormal excitement and even functional reorganization of the brain stem and cerebral cortex,finally leading to tinnitus progresses and persists in the center.The mechanism of"central plasticity"is related to the physiological characteristics of related brain regions,the characteristics of electrophysiological changes,the changes of central neurotransmitters,and psychological factors.It is speculated that the possible mechanisms of the acupuncture treatment of tinnitus are as follows:1.Acupuncture can alter the level of neurotransmitters 5-HT and GABA in nerve center,that is,GABA increases and 5-HT decreases after acupuncture;2.Acupuncture changes the wrong central pattern of the cerebral cortex caused by tinnitus through strong stimulation,and aids the cerebral cortex adapt to the changes of the internal and external environment to produce benign functional reorganization,in order to treat tinnitus;3.External stimulation of acupuncture can accelerate the contraction of muscle vessels around the ears,accelerate blood circulation and metabolism,and improve the blood supply of the auditory system,thus improving tinnitus.4.Acupuncture can improve or even cure tinnitus by stimulating the acupoint-nerve pathway around the ear,regulating unbalanced neurotransmitters,inhibiting abnormal nerve discharge,correcting wrong auditory pathway patterns,and establishing new auditory pathway nerve conduction patterns.展开更多
文摘BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.
文摘Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptomatic treatment like simple analgesics. Those who have unremitting symptoms following conservative measures are offered an epidural blood patch (EBP). However, EBP, an invasive procedure, is associated with complications in itself. Case: We report a 40-year-old man who experienced PDPH after spinal anesthesia. His symptoms recurred after conservative management was instituted. He was then offered a trans-nasal sphenopalatine ganglion (SPG) block. He had excellent pain relief and did not require an EBP. Conclusion: SPG blocks can be considered early in the treatment of PDPH together with general supportive measures. However, if pain relief is not achieved, an epidural blood patch should still be considered.
基金supported by the TCM Evidence-based capacity Building project-evidence-based research on acupuncture and moxibustion treatment of dominant diseases(2019XZZX-ZJ010)National Key Research and development Program(2017YFC1703600,2017YFC1703603)Shaanxi Provincial Administration of Traditional Chinese Medicine:Shaanxi Electroacupuncture School Inheritance Studio(construction)project(2018).
文摘Recent studies have found that although tinnitus originates from the cochlea,its root lies in the plasticity of the auditory center.In other words,the peripheral auditory system damage causes abnormal excitement and even functional reorganization of the brain stem and cerebral cortex,finally leading to tinnitus progresses and persists in the center.The mechanism of"central plasticity"is related to the physiological characteristics of related brain regions,the characteristics of electrophysiological changes,the changes of central neurotransmitters,and psychological factors.It is speculated that the possible mechanisms of the acupuncture treatment of tinnitus are as follows:1.Acupuncture can alter the level of neurotransmitters 5-HT and GABA in nerve center,that is,GABA increases and 5-HT decreases after acupuncture;2.Acupuncture changes the wrong central pattern of the cerebral cortex caused by tinnitus through strong stimulation,and aids the cerebral cortex adapt to the changes of the internal and external environment to produce benign functional reorganization,in order to treat tinnitus;3.External stimulation of acupuncture can accelerate the contraction of muscle vessels around the ears,accelerate blood circulation and metabolism,and improve the blood supply of the auditory system,thus improving tinnitus.4.Acupuncture can improve or even cure tinnitus by stimulating the acupoint-nerve pathway around the ear,regulating unbalanced neurotransmitters,inhibiting abnormal nerve discharge,correcting wrong auditory pathway patterns,and establishing new auditory pathway nerve conduction patterns.
