Articles: nerve-block.
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Hip fractures can cause considerable pain when untreated or under-treated. To enhance pain relief and diminish the risk of delirium from typically administered parenteral analgesics and continued pain, we tested the efficacy of using fascia-iliaca blocks (FICB), administered by one of four attending physicians working in the emergency department (ED), with commonly available ED equipment. After informed consent, a physician administered one FICB to 63 sequential adult ED patients (43 women, 20 men; ages 37-96 years, mean 73.5 years) with radiographically diagnosed hip fractures. ⋯ Resident physicians learned the procedure and could perform it successfully with less than 5 min instruction. Physicians rarely use the FICB in EDs, although the technique is simple to learn and use. This rapid, effective, and safe method of achieving excellent pain control in ED patients with hip fractures can be performed using standard ED equipment.
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Anesthesia and analgesia · Apr 2007
Clinical TrialCo-injection of clonidine prolongs the anesthetic effect of lidocaine skin infiltration by a peripheral action.
The addition of clonidine to local anesthesia prolongs the local anesthetic action, but in humans, the contribution of a peripheral mechanism remains unclear. ⋯ Clonidine has a significant peripheral action in enhancing duration of local anesthesia on superficial co-infiltration with lidocaine.
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This study sought to determine whether it is possible reliably to avoid phrenic nerve block using the bent needle technique for continuous supraclavicular brachial plexus anaesthesia. In a prospective study, 100 patients undergoing a variety of upper extremity surgical procedures were studied. ⋯ Factors were identified in all three cases that we think contributed to the phrenic nerve blocks. We think it is possible to provide continuous supraclavicular regional anaesthesia and analgesia for a wide range of upper extremity operations without phrenic nerve blockade.
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Randomized Controlled Trial
Continuous brachial plexus blockade in combination with the NMDA receptor antagonist memantine prevents phantom pain in acute traumatic upper limb amputees.
Hyperexcitability of N-methyl-d-aspartate acid (NMDA) receptors may play an important role in the development of phantom limb pain (PLP). ⋯ We conclude that memantine can reduce intensity of phantom limb pain and might also prevent the development of PLP. However, despite the very early begin of treatment; no long-term effect on established PLP was evident.