Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2005
Editorial CommentAnesthetic depth is not (yet) a predictor of mortality!
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Anesthesia and analgesia · Jan 2005
Clinical TrialPeribulbar anesthesia: a percutaneous single injection technique with a small volume of anesthetic.
We evaluated the efficacy and safety of a single injection technique with a small volume of anesthetic for ocular peribulbar anesthesia. We included 857 patients undergoing various ophthalmic procedures. Anesthesia consisted of a medial percutaneous injection of 5-6.5 mL of 2% lidocaine. ⋯ After 5 min 100% of the patients had adequate surgical anesthesia. There were no serious block-related complications. The described technique is a simple and satisfactory alternative to the classical techniques.
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Anesthesia and analgesia · Jan 2005
Comparative Study Clinical TrialTrain-of-four stimulation for adductor pollicis neuromuscular monitoring can be applied at the wrist or over the hand.
Adductor pollicis stimulation over the ulnar nerve at the wrist is the standard method of monitoring neuromuscular function. Stimulation over a muscle is believed to cause direct muscle contraction, but evidence for this is lacking. In this study we sought to determine whether direct muscle stimulation occurred during stimulation of the adductor pollicis in the hand and whether the responses were comparable to those observed with stimulation at the wrist. ⋯ With a Bland and Altman analysis, TOF ratios during recovery at the hand showed a bias of 0.5% and limits of agreement of +/-11.8% as compared with the wrist. Stimulation in the hand causes no direct muscle stimulation because the response is no more than that produced by stimulation at the wrist. Both sites yield comparable TOF ratios.
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Anesthesia and analgesia · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialPlantar flexion seems more reliable than dorsiflexion with Labat's sciatic nerve block: a prospective, randomized comparison.
Labat's classic approach to the sciatic nerve has not been able to show which motor response of the foot provides a more frequent rate of complete sensory and motor block. In this prospective, randomized, double-blind study, we compared plantar flexion with dorsiflexion with regard to onset time and efficacy of sciatic nerve block using the classic posterior approach. A total of 80 patients undergoing hallux valgus repair were randomly allocated to receive sciatic nerve block after evoked plantar flexion (n=40) or dorsiflexion (n=40). ⋯ Success was more frequent after elicited plantar flexion (87.5%) than dorsiflexion (55%; P <0.05). Onset of complete sensory and motor block of the foot was faster after elicited plantar flexion (10 +/- 10 min and 13 +/- 10 min, respectively) compared with dorsiflexion (20 +/- 11 min and 24 +/- 12 min; P <0.05). We conclude that plantar flexion of the foot predicts a shorter onset time and a more frequent success rate than dorsiflexion with Labat's classic posterior sciatic nerve block.