Articles: nerve-block.
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J Shoulder Elbow Surg · Jul 2007
Case ReportsThe types and severity of complications associated with interscalene brachial plexus block anesthesia: local and national evidence.
Interscalene brachial plexus block is a commonly used anesthetic. However, substantial complications can be associated with its use. Our study included 15 years of data from a local medical center and 3 decades of records from the national American Society of Anesthesiology Closed Claims Project. ⋯ The American Society of Anesthesiology Closed Claims database had 20 peripheral neurologic injuries, 10 respiratory complications, 5 central nervous system complications, 4 deaths, 2 emotional disturbances, and 1 other unknown event. Of the complications, 19 were described as permanent. Interscalene brachial plexus block can be accompanied by substantial and disabling complications, especially when administered by less experienced anesthesiologists.
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Randomized Controlled Trial
Priming with rocuronium accelerates neuromuscular block in children: a prospective randomized study.
To determine the effects of a priming technique with respect to onset time and duration of action of rocuronium (1.5 x ED(95), 2.0 x ED(95)) in a pediatric patient population. ⋯ Priming accelerated the onset of rocuronium in children. A priming interval of one minute and a cumulative dose of rocuronium 1.5 x ED(95) resulted in an onset of neuromuscular block comparable to a single dose of rocuronium (2.0 x ED(95)).
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Reg Anesth Pain Med · Jul 2007
ReviewShould we add clonidine to local anesthetic for peripheral nerve blockade? A qualitative systematic review of the literature.
Although clonidine has been shown to prolong analgesia in central neuraxial blocks, its use in peripheral nerve blocks remains controversial. We performed a systematic review of the current literature to determine the benefit of adding clonidine to peripheral nerve blocks. ⋯ Clonidine improves duration of analgesia and anesthesia when used as an adjunct to intermediate-acting local anesthetics for some peripheral nerve blocks. Side-effects appear to be limited at doses up to 150 mug. Evidence is lacking for the use of clonidine as an adjunct to local anesthetics for continuous catheter techniques. Further research is required to examine the peripheral analgesic mechanism of clonidine.
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Reg Anesth Pain Med · Jul 2007
Randomized Controlled Trial Comparative StudyPreliminary evaluation of infraclavicular catheters inserted using ultrasound guidance: through-the-catheter anesthesia is not inferior to through-the-needle blocks.
This prospective study compared the initial block quality and surgical anesthesia rates of ultrasound-guided infraclavicular blocks with local-anesthetic injected through a catheter versus through a needle. We hypothesized that positioning of the catheter immediately posterior to the axillary artery would produce through-the-catheter (TTC) anesthesia with rates of complete block not inferior to through-the-needle (TTN) injection. ⋯ Ultrasound-guided TTC infraclavicular block produced perioperative anesthesia that was not inferior to a TTN technique.
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Anesthesia and analgesia · Jul 2007
Randomized Controlled Trial Comparative StudyParasacral sciatic nerve block: does the elicited motor response predict the success rate?
In this prospective, randomized, double-blind study, we compared the tibial and the peroneal evoked motor response with regard to efficacy of sciatic nerve block using the parasacral approach. ⋯ Eliciting a tibial motor response predicts a higher success rate than eliciting a peroneal motor response with parasacral sciatic nerve block.