Essentials of Pain Medicine and Regional Anesthesia

744 Pages·2005·14.25 MB·English

by  Honorio T. Benzon

The Curtis Center
170 S Independence Mall W 300E
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ESSENTIALS OF PAIN MEDICINE AND REGIONAL ANESTHESIA ISBN: 0-443-06651-5
Second Edition
Copyright © 2005, 1999 by Elsevier Inc. All rights reserved.
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NOTICE
Anesthesiology is an ever-changing field. Standard safety precautions must be followed, but as new research and
clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or
appropriate. Readers are advised to check the most current product information provided by the manufacturer
of each drug to be administered to verify the recommended dose, the method and duration of administration,
and contraindications. It is the responsibility of the licensed prescriber, relying on experience and knowledge
of the patient, to determine dosages and the best treatment for each individual patient. Neither the publisher
nor the author assumes any liability for any injury and/or damage to persons or property arising from this
publication.
Previous edition copyrighted 1999.
International Standardized Book Number 0-443-06651-5
Acquisitions Editor:Natasha Andjelkovic
Developmental Editors:Melissa Fisch and Katie Miller
Publishing Services Manager:Joan Sinclair
Project Manager:Cecelia Bayruns
Printed in the United States of America.
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
To our families
To the
Department of Anesthesiology at Northwestern University Feinberg School of Medicine,
Johns Hopkins University School of Medicine,
Virginia Mason Clinic,
and the University of California, Davis School of Medicine.
Contributors
Burak Alptekin, MD Northwestern University Feinberg School of Medicine,
Medical Doctor; Fellow, Clinical and Research Pain; Northwestern Memorial Hospital, Chicago, Illinois.
Fellow, Clinical and Research Critical Care, Taxonomy: Definition of Pain Terms and Chronic Pain
Critical Care and Pain Medicine, Department of Syndromes; Physical Examination of the Pain Patient;
Anesthesiology, Beth Israel Deaconess Medical Membrane Stabilizers; Drugs for the Interventional
Center, Harvard Medical School, Boston, Physician: Botulinum Toxin, Steroids, Radiopaque Dye;
Massachusetts. Patient-Controlled Analgesia; Intraarticular and
Classification of Headache Intraperitoneal Opioids for Postoperative Pain; Postdural
Puncture Headache and Spontaneous Intracranial
Michael L. Ault, MD Hypotension; Cervicogenic Headache and Orofacial Pain;
Assistant Professor, Associate Chief, Section of Critical Overview of Low Back Pain Disorders; Interlaminar
Care Medicine, Department of Anesthesiology, Epidural Steroid Injections for Lumbosacral
Northwestern University Fienberg School of Medicine; Radiculopathy; Selective Nerve Root Blocks and
Attending Physician, Northwestern Memorial Hospital; Transforaminal Epidural Steroid Injection for Back Pain
Consulting Physician, Rehabilitation Institute of and Sciatica; Facet Syndrome: Facet Joint Injections and
Chicago, Chicago, Illinois. Facet Nerve Block; Pain Originating from the Buttock:
Pain Control in the Critically Ill Patient Sacroiliac Joint Dysfunction and Piriformis Syndrome;
Phantom Pain; Geriatric Pain; Lumbar Discography;
Fluoroscopy and Radiation Safety; Lumbar Plexus,
Zahid H. Bajwa, MD
Femoral, Lateral Femoral Cutaneous, Obturator,
Assistant Professor of Anesthesiology (Neurology),
Saphenous, and Fascia Iliaca Blocks; Sciatic Nerve Block;
Harvard Medical School; Director, Education and
Issues in Peripheral Nerve Blocks: Use of Nerve
Clinical Pain Research, Beth Israel Deaconess Medical
Stimulators, Multiple- Versus Single-Injection Techniques,
Center, Boston, Massachusetts.
and Use of Adjuvants; Peripheral Sympathetic Blocks;
Classification of Headache
Anticoagulants and Neuraxial Anesthesia
Bernard R. Bendok, MD
Assistant Professor of Neurological Surgery and Patrick K. Birmingham, MD, FAAP
Radiology, Northwestern University Feinberg Associate Professor of Anesthesiology, Northwestern
School of Medicine; Attending Physician, University Feinberg School of Medicine; Director, Pain
Northwestern Memorial Hospital, Chicago, Illinois. Management Services; Attending Physician, Children’s
Osteoporosis and Percutaneous Vertebroplasty Memorial Medical Center, Chicago, Illinois.
Pediatric Postoperative Pain
Honorio T. Benzon, MD
Professor of Anesthesiology; Senior Associate Chair, E. Richard Blonsky, MD
Academic Affairs; Chief, Division of Pain Medicine; Professor of Clinical Neurology, Northwestern
Director, Pain Medicine Fellowship Program, University Feinberg School of Medicine; Attending
x CONTRIBUTORS
Physician, Northwestern Memorial Hospital; Lowell Davis, DO
Medical Director, The Pain & Rehabilitation Clinic of Fellow, Division of Pain Medicine, Department of
Chicago, Chicago, Illinois. Anesthesiology, Northwestern University Feinberg
Determination of Disability School of Medicine, Northwestern Memorial Hospital,
Chicago, Illinois.
Geriatric Pain
Allen W. Burton, MD
Associate Professor; Section Chief of Pain Management,
Department of Anesthesiology, University of Texas M.D. Oscar A. de Leon-Casasola, MD
Anderson Cancer Center, Houston, Texas. Director, Pain Fellowship Program; Vice-chair for
Spinal Cord Stimulation Clinical Affairs, Department of Anesthesiology,
University at Buffalo, School of Medicine; Chief, Pain
Medicine, Roswell Park Cancer Institute, Buffalo,
Kenneth D. Candido, MD
New York.
Associate Professor of Anesthesiology; Chief, Section of
Neurolytic Visceral Sympathetic Blocks
Acute Pain Medicine, Northwestern Memorial
Hospital, Northwestern University Feinberg
Robert Doty, Jr., MD
School of Medicine, Chicago, Illinois.
Assistant Professor, Department of Anesthesiology,
Diagnostic Nerve Blocks; Intraarticular and
Northwestern University Feinberg School of Medicine;
Intraperitoneal Opioids for Postoperative Pain; Caudal
Attending Anesthesiologist, Northwestern Memorial
Anesthesia; Brachial Plexus Block: Techniques Above the
Hospital, Chicago, Illinois.
Clavicle; Brachial Plexus Block: Techniques Below the
Ankle Block
Clavicle; Lumbar Plexus, Femoral, Lateral Femoral
Cutaneous, Obturator, Saphenous, and Fascia Iliaca
Blocks; Issues in Peripheral Nerve Blocks: Use of Nerve Patrick M. Dougherty, PhD
Stimulators, Multiple- Versus Single-Injection Techniques, Associate Professor, Department of Anesthesiology,
and Use of Adjuvants Division of Anesthesiology and Critical Care Medicine,
The University of Texas M.D. Anderson Cancer Center,
Houston, Texas.
Zenobia Casey, MD
Anatomy and Physiology of Somatosensory and Pain
Assistant Professor, Department of Anesthesiology and
Processing; Neurochemistry of Somatosensory and
Critical Care Medicine, Johns Hopkins Medical
Pain Processing
Institutions, Baltimore, Maryland.
Epidural Opioids for Postoperative Pain
Robert H. Dworkin, PhD
Professor of Anesthesiology, Neurology, Oncology, and
Yuan Chen, MD
Psychiatry, University of Rochester School of Medicine
Medical Director of Pain Management, Rush-Copley
and Dentistry; Director, Anesthesiology Clinical
Medical Center, Aurora, Illinois.
Research Center, Strong Memorial Hospital, Rochester,
Pharmacology for the Interventional Physician
New York.
Herpes Zoster and Postherpetic Neuralgia
Michael R. Clark, MD, MPH
Associate Professor and Director, Chronic Pain Robert R. Edwards, PhD
Treatment Programs, Department of Psychiatry and Assistant Professor, Department of Psychiatry and
Behavioral Sciences, Johns Hopkins Medical Behavioral Sciences, Johns Hopkins University School
Institutions, Baltimore, Maryland. of Medicine, Baltimore, Maryland.
Substance Use Disorders and Detoxification Pain Assessment
Christopher M. Criscuolo, MD Frank D. Ferris, MD
Associate Professor of Anesthesiology and Medical Director, Palliative Care Standards/Outcome
Orthopaedic Surgery; Director, Division of Measures, San Diego Hospice and Palliative Care;
Pain Medicine, Department of Anesthesiology, Clinical Professor, Voluntary, Department of Family &
University of Nebraska College of Medicine, Preventative Medicine, University of California,
Omaha, Nebraska. San Diego, School of Medicine, San Diego, California;
Acupuncture Assistant Professor, Adjunct, Department of Family and
CONTRIBUTORS xi
Community Medicine, University of Toronto, ON, Complex Regional Pain Syndrome: Terminology and
Canada; Affiliate, Buehler Center on Aging, Pathophysiology; Complex Regional Pain Syndrome:
Northwestern University Feinberg School of Medicine, Diagnosis and Treatment
Chicago, Illinois.
Approach to the Management of Cancer Pain Jennifer A. Haythornthwaite, PhD
Associate Professor, Department of Psychiatry and
Scott M. Fishman, MD Behavioral Sciences, Johns Hopkins Medical
Professor of Anesthesiology; Chief, Division of Pain Institutions, Baltimore, Maryland.
Medicine, Department of Anesthesiology and Pain Psychological Evaluation and Testing; Psychological
Medicine, University of California, Davis School of Interventions for Chronic Pain
Medicine, Sacramento, California.
Opioid Receptors; Major Opioids in Pain Management;
James R. Hebl, MD
Minor and Short-Acting Opioids; Opioid Therapy:
Staff Consultant, Department of Anesthesiology, Mayo
Adverse Effects Including Addiction; Drugs for the
Clinic College of Medicine, Rochester, Minnesota.
Interventional Physician: Botulinum Toxin, Steroids,
Complications After Peripheral Nerve Block
Radiopaque Dye
Ursula Heck, MS, MD
Mikhail Fukshansky, MD
Fellow, Pain Medicine, Department of Anesthesiology,
Fellow in Cancer Pain Medicine, Department of
Georgetown University Hospital, Washington, DC.
Anesthesiology, University of Texas M.D. Anderson
Preemptive Analgesia: Physiology and Clinical Studies
Cancer Center, Houston, Texas.
Spinal Cord Stimulation
Leslie J. Heinberg, PhD
Associate Professor, Department of Psychiatry,
Rollin M. Gallagher, MD, MPH
Division of Child and Adolescent Psychiatry,
Director, Pain Management Service, Philadelphia VA
Case Western Reserve University School of Medicine,
Medical Center; Professor of Psychiatry and
Cleveland, Ohio.
Anesthesiology, Department of Psychiatry and
Psychological Evaluation and Testing; Psychological
Anesthesiology, University of Pennsylvania School of
Interventions for Chronic Pain
Medicine; Editor in Chief of Pain Medicine.
Psychopharmacology for Pain Medicine
Matthew D. Hepler, MD
Robert Gould, MD Assistant Professor, Department of Orthopaedic
Assistant Professor, Northwestern University Feinberg Surgery, Northwestern University Feinberg School of
School of Medicine; Medical Director, Simulator Medicine, Chicago, Illinois.
Center; Consulting Physician, Rehabilitation Institute Overview of Low Back Pain Disorders
of Chicago; Attending Physician, Northwestern
Memorial Hospital, Chicago, Illinois. Mark Holtsman, Pharm.D.
Pain Control in the Critically Ill Patient Co-Director, Acute Pain Service; Associate Clinical
Professor, Department of Anesthesiology and Pain
Theodore S. Grabow, MD Medicine, University of California, Davis School of
Assistant Professor, Department of Anesthesiology and Medicine, Sacramento, California.
Critical Care Medicine, Division of Pain Medicine, Opioid Receptors
Johns Hopkins University School of Medicine;
Active Staff, Department of Anesthesiology, Rasha Snan Jabri, MD
St Joseph Medical Center, Baltimore, Maryland. Fellow, Pain Medicine, Department of Anesthesiology,
Complex Regional Pain Syndrome: Terminology and Northwestern University Feinberg School of Medicine,
Pathophysiology; Complex Regional Pain Syndrome: Northwestern Memorial Hospital, Chicago, Illinois.
Diagnosis and Treatment Overview of Low Back Pain Disorders
Anthony H. Guarino, MD Jeffrey A. Katz, MD
Director of Pain Management, Barnes-Jewish Associate Professor of Anesthesiology, Northwestern
West County Hospital; Faculty, Washington University University Feinberg School of Medicine; Associate
Medical School, St. Louis, Missouri. Director, Section of Pain Medicine; Staff Member,
xii CONTRIBUTORS
Department of Anesthesiology, Northwestern Memorial Major Opioids in Pain Management; Opioid Therapy:
Hospital, Chicago, Illinois. Adverse Effects Including Addiction
NSAIDs and COX-2-Selective Inhibitors; Diabetic and
Other Peripheral Neuropathies; Issues in Atif B. Malik, MD
Peripheral Nerve Blocks: Use of Nerve Stimulators, Arnold Pain Center, Department of Anesthesia, Beth
Multiple- Versus Single-Injection Techniques, and Israel Deaconess Medical Center, Boston, Massachusetts.
Use of Adjuvants Classification of Headache
Mark J. Lema, MD, PhD James J. Mathews, MD
Professor and Chair, Department of Anesthesiology, Professor of Clinical Medicine, Northwestern
State University of New York at Buffalo, School of University Feinberg School of Medicine; Senior
Medicine and Biomedical Sciences; Chairman of Attending Staff, Northwestern Memorial Hospital,
Anesthesiology and Pain Medicine, Roswell Park Chicago, Illinois.
Cancer Institute, Buffalo, New York. Pain Management in the Emergency Department
Neurolytic Visceral Sympathetic Blocks
Susan B. McDonald, MD
Staff Anesthesiologist, Virginia Mason Medical Center,
Robert M. Levy, MD, PhD
Seattle, Washington.
Professor of Neurological Surgery; Associate
Combined Spinal–Epidural Technique
Professor of Physiology, Departments of Neurosurgery
and Physiology, Northwestern Comprehensive Pain
Onur Melen, MD
Clinic, Northwestern University Institute for
Assistant Professor of Neurology and Ophthalmology,
Neuroscience, Northwestern University Feinberg School
Northwestern University Feinberg School of Medicine,
of Medicine; Attending Physician, Northwestern
Chicago, Illinois.
Memorial Hospital, Chicago, Illinois.
Muscle Relaxants
Neurosurgical Procedures for Treatment of Intractable
Pain; Implanted Drug Delivery Systems for Control of
Michael M. Minieka, MD
Chronic Pain
Assistant Professor of Clinical Neurology, Department
of Neurology, Northwestern University Feinberg School
Henry M. Liu, MD
of Medicine; Attending Neurologist, Northwestern
Vice Chair, Department of Anesthesiology, Lake Forest
Memorial Hospital, Chicago, Illinois.
Hospital, Lake Forest, Illinois.
Neurophysiologic Testing for Pain; Entrapment
Acupuncture
Neuropathies
John C. Liu, MD
Veronica Mitchell, MD
Assistant Professor, Department of Neurosurgery,
Director of Pain Medicine Services, Department of
Northwestern University Feinberg School of Medicine;
Anesthesiology, Georgetown University Hospital,
Attending Physician, Northwestern Memorial Hospital,
Washington, DC.
Chicago, Illinois.
Preemptive Analgesia: Physiology and Clinical Studies
Osteoporosis and Percutaneous Vertebroplasty
Robert E. Molloy, MD
Spencer S. Liu, MD Assistant Professor of Anesthesiology; Director,
Staff Anesthesiologist, Virginia Mason Medical Center; Residency Program, Northwestern University Feinberg
Clinical Professor of Anesthesiology, University of School of Medicine, Chicago, Illinois.
Washington School of Medicine, Seattle, Washington. Membrane Stabilizers; Diagnostic Nerve Blocks;
Local Anesthetics: Clinical Aspects Interlaminar Epidural Steroid Injections for Lumbosacral
Radiculopathy; Myofascial Pain Syndrome; Fibromyalgia;
Gagan Mahajan, MD Sickle Cell Anemia; Geriatric Pain; Neurolytic Visceral
Assistant Professor; Director, Fellowship in Pain Sympathetic Blocks; Intrathecal and Epidural Neurolysis;
Medicine, Department of Anesthesiology and Pain Head and Neck Blocks; Truncal Blocks: Intercostal,
and Medicine, University of California, Davis School Paravertebral, Interpleural, Suprascapular, Ilioinguinal
of Medicine, Sacramento, California. and Iliohypogastric Nerve Blocks
CONTRIBUTORS xiii
John D. Moore, MD Sunil J. Panchal, MD
Fellow, Pain Medicine, Department of Director, Interventional Pain Medicine, H. Lee Moffitt
Anesthesiology, Northwestern University Feinberg Cancer Center and Research Institute; Associate
School of Medicine, Northwestern Memorial Hospital, Professor of Oncology and Anesthesiology, University
Chicago, Illinois. of South Florida College of Medicine, Tampa, Florida.
Physical Examination of the Pain Patient; Postdural Pelvic Pain
Puncture Headache and Spontaneous Intracranial
Hypotension James C. Phero, DMD
Professor of Clinical Anesthesia, Pediatrics and Surgery;
Kenji Muro, MD Faculty, Pain Control Center, College of Medicine,
Resident Physician, Department of Neurologicalsurgery, University of Cincinnati, Cincinnati, Ohio.
Northwestern University Feinberg School of Medicine, Cervicogenic Headache and Orofacial Pain
Chicago, Illinois.
Implanted Drug Delivery Systems for Control of Heidi Prather, DO
Chronic Pain Assistant Professor; Chief of Section, Physical Medicine
and Rehabilitation, Department of Orthopaedic
Surgery, Washington University School of Medicine,
Antoun Nader, MD
St. Louis, Missouri.
Assistant Professor of Anesthesiology, Northwestern
Physical Medicine and Rehabilitation Approaches to Pain
University Feinberg School of Medicine, Chicago,
Management
Illinois.
Intraarticular and Intraperitoneal Opioids for
Postoperative Pain; Caudal Anesthesia; Peripheral Joel M. Press, MD
Sympathetic Blocks Assistant Professor, Department of Physical Medicine
and Rehabilitation, Northwestern University Feinberg
School of Medicine, Chicago, Illinois.
Joseph M. Neal, MD
Physical Medicine and Rehabilitation Approaches to
Staff Anesthesiologist, Virginia Mason Medical Center;
Pain Management
Clinical Professor of Anesthesiology, University of
Washington, Seattle, Washington.
Srinivasa N. Raja, MD
Complications After Peripheral Nerve Block
Professor of Anesthesiology and Critical Care; Director
of Pain Research, Division of Pain Medicine; Interim
Takashi Nishida, MD
Director, Division of Pain Medicine, Johns Hopkins
Assistant Professor of Clinical Neurology,
University School of Medicine, Baltimore, Maryland.
Department of Neurology, Northwestern University
Anatomy and Physiology of Somatosensory and Pain
Feinberg School of Medicine, Chicago, Illinois.
Processing; Neurochemistry of Somatosensory and Pain
Neurophysiologic Testing for Pain; Entrapment
Processing; Complex Regional Pain Syndrome:
Neuropathies
Terminology and Pathophysiology; Complex Regional Pain
Syndrome: Diagnosis and Treatment; Phantom Pain;
Umeshraya T. Pai, MD Central Pain States
Professor of Clinical Anesthesia; Adjunct Professor of
Anatomy, University of Cincinnati Medical Center, Rebecca Rallo Clemans, MD
Cincinnati, Ohio. Fellow, Pain Medicine, Department of Anesthesiology,
Head and Neck Blocks Northwestern University Feinberg School of Medicine,
Northwestern Memorial Hospital, Chicago, Illinois.
Judith Paice, RN, PhD Pharmacology for the Interventional Physician;
Director, Cancer Pain Program, Division of Facet Syndrome: Facet Joint Injections and Facet
Hematology-Oncology; Research Professor of Medicine, Nerve Blocks
Northwestern University Feinberg School of Medicine,
Robert H. Lurie Comprehensive Cancer Center, Maunak V. Rana, MD
Chicago, Illinois. Interventional Pain Physician, The Illinois Pain
Management of Pain at End of Life Treatment Institute, Elgin, Illinois.
xiv CONTRIBUTORS
Physical Examination of the Pain Patient; Membrane Co-director, Neuroendovascular Program, Interventional
Stabilizers Neuroradiology, Northwestern Memorial Hospital,
Chicago, Illinois.
James P. Rathmell, MD Lumbar Discography
Professor of Anesthesiology, University of Vermont
College of Medicine; Director, Center for Pain Medicine, Nigel E. Sharrock, MD, ChB
Fletcher Allen Health Care, Burlington, Vermont. Attending Anesthesiologist; Senior Scientist,
Diabetic and Other Peripheral Neuropathies Department of Anesthesiology, Hospital for Special
Surgery, New York, New York.
Jeffrey M. Richman, MD Epidural Anesthesia
Assistant Professor of Anesthesiology, Department of
Anesthesiology and Critical Care Medicine, Johns Edward R. Sherwood, MD, PhD
Hopkins Medical Institutions, Baltimore, Maryland. Associate Professor; James F. Arens Endowed Chair,
Intrathecal Opioid Injections for Postoperative Pain Department of Anesthesiology, The University of Texas
Medical Branch, Shriners Hospital for Children,
Jack M. Rozental, MD, PhD, MBA Galveston, Texas.
Vice Chair, Davee Department of Neurology, Patient-Controlled Analgesia
Northwestern University Feinberg School of Medicine;
Chief, Neurology Service, Jesse Brown VA Medical B. Todd Sitzman, MD, MPH
Center, Chicago, Illinois. Director, The Center for Pain Medicine,
Migraine Headache and Cluster Headache; Tension-Type Wesley Medical Center, Hattiesburg, Mississippi.
Headache, Chronic Tension-Type Headache, and other Pharmacology for the Interventional Pain Physician
Chronic Headache Types
Eric M. Spitzer, MD
Eric J. Russell, MD Clinical Instructor, Northwestern University Feinberg
Professor and Chairman, Department of Radiology; School of Medicine, Fellow in Neuroradiology,
Professor of Neurosurgery and Otolaryngology, Northwestern Memorial Hospital,
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Chicago, Illinois. Anatomy, Imaging, and Common Pain Generating
Anatomy, Imaging, and Common Pain-Generating Degenerative Pathologies of the Spine
Degenerative Pathologies of the Spine
Steven P. Stanos, DO
Francis V. Salinas, MD Instructor, Department of Physical Medicine and
Clinical Assistant Professor of Anesthesiology, Rehabilitation, Northwestern University Feinberg
University of Washington School of Medicine; Staff School of Medicine; Medical Director, Chronic Pain
Anesthesiologist, Virginia Mason Medical Center, Care Center, Rehabilitation Institute of Chicago,
Seattle, Washington. Chicago, Illinois.
Spinal Anesthesia Physical Medicine and Rehabilitation Approaches to Pain
Management
Kenneth E. Schmader, MD
Associate Professor of Medicine, The Center for the Rom A. Stevens, MD
Study of Aging and Human Development, Duke Captain, Medical Corps U.S. Naval Reserve; Adjunct
University Medical Center; Vice-Chief, Division of Associate Professor, Department of Anesthesiology,
Geriatrics, Geriatric Research, Education and Clinical Uniformed Services University of the Health Sciences,
Center, Durham VA Medical Center, Durham, North Bethesda, Maryland.
Carolina. Epidural Anesthesia
Herpes Zoster and Postherpetic Neuralgia
Lila A. Sueda, MD
Ali Shaibani, MD Staff Anesthesiologist, Virginia Mason Medical Center,
Assistant Professor of Radiology and Neurosurgery, Seattle, Washington.
Northwestern University Feinberg School of Medicine; Complications After Neuraxial Blockade
CONTRIBUTORS xv
Radha Sukhani, MD Matthew T. Walker, MD
Associate Professor of Anesthesiology; Director, Chief, Neuroradiology; Assistant Professor, Northwestern
Regional Anesthesia Service, Northwestern University University Feinberg School of Medicine Chicago,
Feinberg School of Medicine, Chicago, Illinois. Illinois.
Sciatic Nerve Block; Ankle Block Anatomy, Imaging, and Common Pain-Generating
Degenerative Pathologies of the Spine
Santhanam Suresh, MD, FAAP
Associate Professor of Anesthesiology, Northwestern Ajay D. Wasan, MD, MSc
University Feinberg School of Medicine; Co-Director, Instructor in Pain Medicine, Department of
Pain Management Services, Children’s Memorial Anesthesiology, Perioperative, and Pain Medicine,
Hospital, Chicago, Illinois. Department of Psychiatry, Brigham and Women’s
Chronic Pain Management in Children Hospital, Harvard Medical School, Boston,
Massachusetts.
Jay R. Thomas, MD, PhD Psychopharmacology for Pain Medicine
Clinical Medical Director, San Diego Hospice and
Palliative Care; Assistant Clinical Professor of Medicine, Barth L. Wilsey, MD
University of California, San Diego, School of Associate Clinical Professor of Anesthesiology and
Medicine, San Diego, California. Pain Medicine; Director, Residency Program in
Approach to the Management of Cancer Pain Pain Medicine, University of California,
Davis School of Medicine, Sacramento,
Muthukumar Vaidyaraman, MBBS California.
Post-Doctoral Clinical Fellow, Division of Pain Minor and Short-Acting Opioids; Opioid Therapy:
Medicine, Department of Anesthesiology and Critical Adverse Effects Including Addiction
Care Medicine, Johns Hopkins Medical Institutions,
Baltimore, Maryland. Cynthia A. Wong, MD
Central Pain States Associate Professor of Anesthesiology; Director of
Obstetric Anesthesiology; Medical Director, Labor and
Murugusundaram Veeramani, MD Delivery, Northwestern University Feinberg School of
Clinical Instructor, Northwestern University Feinberg Medicine, Chicago, Illinois.
School of Medicine; Fellow in Neuroradiology, Pain Management During Pregnancy and Lactation
Northwestern Memorial Hospital, Chicago, Illinois.
Anatomy, Imaging, and Common Pain Generating Christopher L. Wu, MD
Degenerative Pathologies of the Spine Associate Professor of Anesthesiology, Department of
Anesthesiology and Critical Care Medicine,
Charles F. von Gunten, MD, PhD, FACP Johns Hopkins Medical Institutions, Baltimore,
Medical Director, Center for Palliative Studies, Maryland.
San Diego Hospice and Palliative Care; Editor-in-Chief, Intrathecal Opioid Injections for Postoperative Pain;
Journal of Palliative Medicine; Associate Clinical Epidural Opioids for Postoperative Pain
Professor of Medicine, University of California,
San Diego, School of Medicine, San Diego, Edward Yaghmour, MD
California. Instructor in Anesthesiology, Northwestern University
Approach to the Management of Cancer Pain Feinberg School of Medicine, Chicago, Illinois.
Brachial Plexus Block: Techniques Below the Clavicle
David R. Walega, MD
Assistant Professor of Anesthesiology, Northwestern Jeffrey L. Young, MD, MA
University Feinberg School of Medicine; Director, Director, Musculoskeletal Health Program, Hudson
Anesthesiology Pain Medicine Center, Northwestern Valley Physical Medicine and Rehabilitation, Sleepy
Memorial Hospital, Chicago, Illinois. Hollow, New York.
Intradiscal Techniques: Intradiscal Electrothermal Physical Medicine and Rehabilitation Approaches to
Therapy and Nucleoplasty Pain Management
Preface
The first edition of our book provided a quick reference and they prefer a hard cover for the book, as the soft cover nature
easy reading. It was ideal for residents who were looking for of the first edition did not lend itself to repeated usage.
short and precise discussions of a subject. It was not adequate An endeavor of this kind cannot be completed without the
for the fellows who were reviewing for their pain medicine help of many people. Our contributors took time off from
boards or for the researcher looking for a comprehensive treatise their busy schedules to write their chapters. Our secretaries,
on a topic. The short format constrained us from satisfying especially Robb Rabito and Sandra Taylor, performed numer-
readers looking for more detailed information. ous tasks to bring this book into fruition. Our editors, Katie
We made several changes in this second edition. We expanded Miller and Melissa Fisch, showed diplomacy in waiting for the
each chapter to make it more authoritative and comprehensive manuscripts and patience in correcting our mistakes. To all of
in depth and in its references. Several important topics on you, thank you.
pharmacology, back pain and the other pain syndromes, and This second edition of our book shows maturity. We hope
interventional procedures were added to be more representative the readers like it.
of the complex nature of pain management and to incorporate
the recent advances in the field. The chapters on regional anes-
thesia were increased, expanded, and updated. We added key Honorio T. Benzon, M.D.
points at the end of most chapters to highlight the important Srinivasa N. Raja, M.D.
contents of the chapter. However, we maintained one format Robert E. Molloy, M.D.
of the first edition: the discussion of each topic in a separate Spencer S. Liu, M.D.
chapter. Readers who voiced their opinions to us appreciated Scott M. Fishman, M.D.
this unique feature of the book. Readers also informed us that EDITORS