Articles: nerve-block.
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The influences of stimulation frequency and temperature on mechanisms of nerve conduction block induced by high-frequency biphasic electrical current were investigated using a lumped circuit model of the myelinated axon based on Schwarz and Eikhof (SE) equations. The simulation analysis showed that a temperature-frequency relationship was determined by the axonal membrane dynamics (i.e. how fast the ion channels can open or close.). ⋯ The simulation results also indicated that as the stimulation frequency increased the mechanism of conduction block changed from a cathodal/anodal block to a block dependent upon continuous activation of potassium channels. Understanding the interaction between the minimal blocking frequency and temperature could promote a better understanding of the mechanisms of high frequency induced axonal conduction block and the clinical application of this method for blocking nerve conduction.
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Ann Fr Anesth Reanim · Apr 2008
Case Reports[Interscalene brachial plexus block for glenohumeral luxation in prehospital medicine].
We report the case of a successful interscalene block for the pain management of a glenohumeral luxation in prehospital care. Interscalene block is an attractive technique in prehospital pain management. However, this regional anaesthesia technique must be performed only by a skilled anaesthesiologist.
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Lidocaine is frequently used as a local anesthetic and has very low incidence of serious complications. I report on a case of lidocaine intoxication in a 66-year-old man who presented with seizure and cardiac periarrest following the brachial plexus block with 450 mg of lidocaine. ⋯ Bradycardia and subsequent cardiovascular depression were found 74 minutes after the lidocaine block. The patient was successfully treated with diazepam, atropine sulphate and transcutaneous pacing for each symptom, respectively.