Articles: nerve-block.
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Anesthesia and analgesia · May 2008
Case ReportsIntravenous lipid infusion in the successful resuscitation of local anesthetic-induced cardiovascular collapse after supraclavicular brachial plexus block.
We describe a case of successful resuscitation with an i.v. lipid infusion of local anesthetic-induced cardiovascular toxicity after supraclavicular brachial plexus block with mepivacaine and bupivacaine. Lipid therapy was initiated after 10 min of unsuccessful resuscitation and resulted in restoration of cardiovascular activity and hemodynamic stability. This case illustrates the utility of i.v. lipid therapy in the treatment of local anesthetic toxicity.
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Theoretically, sciatic nerve block can be used alone or in combination with lumbar plexus block or femoral nerve block for anesthesia and/or analgesia of lower limb surgery. However, clinical use of sciatic nerve block was limited by technical difficulties in performing the block since techniques used relies only on surface anatomical landmarks. ⋯ In this article we describe the anatomy of the sciatic nerve, sonographic features, and technique of three major approaches including subgluteal, anterior, and popliteal approaches. The use of this technique for postoperative analgesia is also discussed.
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Since the advent of ultrasound-guided peripheral nerve block, it has been thought that this new technique has many advantages over conventional ones. However, few of them have been confirmed yet. Nor is it free from problems that are associated with peripheral nerve block itself. ⋯ There are clearly some limitations today for imaging smaller and deeper nerves. The needle placement with ultrasound guidance requires skills which conventional techniques do not. Therefore, it would be prudent to think that this new technique carries a similar risk of complications and requires similar amount of training to conventional ones.