Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialA paravenous approach for the saphenous nerve block.
This study assesses a paravenous approach for saphenous nerve block at approximately the level of the tibial tuberosity, and compares it with the conventional technique of blind subcutaneous infiltration between the tibial tuberosity and the gastrocnemius muscle. ⋯ The saphenous nerve can be blocked effectively by a paravenous approach using only 5 mL of local anesthetic solution. This approach is advantageous because of its easily identifiable landmark.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialClonidine versus ketamine to prevent tourniquet pain during intravenous regional anesthesia with lidocaine.
Both clonidine and ketamine have been found to prolong the action of local anesthetics through a peripheral mechanism. Our study compares the efficacy of a low dose of clonidine or ketamine separately added to intravenous regional anesthesia (IVRA) with lidocaine to prevent tourniquet pain. ⋯ The addition of clonidine 1 microg/kg or ketamine 0.1 mg/kg to lidocaine for IVRA delays the onset of unbearable tourniquet pain and decreases analgesic consumption for tourniquet pain relief, although ketamine has a more potent effect.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialEffects of epidural anesthesia on thermal sensation.
Epidural anesthesia decreases the core temperatures triggering vasoconstriction and shivering, presumably by increasing apparent (as opposed to actual) lower-body temperature. We therefore tested the hypothesis that epidural anesthesia also increases the overall perception of warmth. ⋯ Thermal sensation with and without epidural anesthesia was comparable at a lower-body temperature near 34 degrees C, which is a normal leg skin temperature. This suggests that autonomic and behavioral thermoregulatory consequences of epidural anesthesia differ-or that the current explanation for reduced vasoconstriction and shivering thresholds during epidural anesthesia is incorrect.
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Reg Anesth Pain Med · Nov 2001
Multicenter Study Clinical TrialAnatomic considerations in relation to the maxillary nerve block.
To determine the length of the needle that should be used to reach the maxillary nerve after the lateral pterygoid plate has been contacted. ⋯ The needle should not be advanced by more than approximately 0.25 cm beyond the distance to the pterygoid plate while performing maxillary nerve block by the lateral extraoral approach.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialAxillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection techniques.
The multiple-injection technique for axillary block, in which the main 4 nerves of the plexus are located by a nerve stimulator and separately injected, has been shown to produce a high success rate. However, this technique may prove to be more difficult and time-consuming than other methods. Therefore, a simplified technique, with a reduced number of injections, might be desirable. A comparison between 2- and 3-injection techniques was made in the present double-blind study. ⋯ The 2-injection technique offers a success rate in blocking the 3 nerves innervating the hand similar to that obtained with the 3-injection technique. The latter approach should be considered when the musculocutaneous nerve distribution is involved in the surgical area.