Bad and All Else Fails? Try a Super Sphenopalatine Glanglion Block (SPGB)

Post op case of open pancreaticoduodenectomy, portal lymphadenectomy, retroperitoneal lymphadenectomy for ca pancreas. Afterward had 10/10 severe shoulder tip pains that nothing would help. Given a prior study found SPGB might help post op, attempted SPGB with a brilliant design, and got pain from 5/10 to 0/10 by end of procedure. I have always wondered whether it could save the day elsewhere as there are sporadic reports of help in odd conditions.

Syringe filling hollow tubed swabs with lidocaine for SPB
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Newer Treatments in Long Covid

Metformin reduces long Covid incidence by 41% with just working up to 3/day Bramante, Carolyn T., et al. “Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial.” The Lancet Infectious Diseases 23.10 (2023): 1119-1129. https://experts.umn.edu/en/publications/outpatient-treatment-of-covid-19-and-incidence-of-post-covid-19-c “The metformin dose was titrated over 6 days: […]

Posterior cutaneous Nerve Forearm and Tennis Elbow

Rose, Nicholas E., Scott K. Forman, and A. Lee Dellon. Denervation of the lateral humeral epicondyle for treatment of chronic lateral epicondylitis.The Journal of Hand Surgery 38.2 (2013): 344-349.https://www.sciencedirect.com/science/article/abs/pii/S0363502312015535 •Tested by nerve block 4 cm proximal to the lateral humeral epicondyle. •Nerve was microdissected , transected, and “buried within the lateral head of the triceps […]