Articles: nerve-block.
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Reg Anesth Pain Med · Jan 2007
Randomized Controlled TrialEffect of addition of various doses of fentanyl intrathecally to 0.5% hyperbaric bupivacaine on perioperative analgesia and subarachnoid-block characteristics in lower abdominal surgery: a dose-response study.
The purpose of this randomized, double-blind, placebo-controlled trial is to study the effect of adding various doses of fentanyl to 2.2 mL of bupivacaine (0.5% hyperbaric), for spinal anesthetic in non-obstetric population undergoing superficial lower abdominal surgery (hernia repair). ⋯ The data suggest that in a non-obstetric population receiving spinal anesthetic for superficial lower abdominal surgery (hernia repair), addition of 10 microg fentanyl to bupivacaine 0.5% (hyperbaric) significantly improves the quality and duration of analgesia. No further advantage occurs if the dose of fentanyl is increased up to 40 mug.
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Eur J Vasc Endovasc Surg · Jan 2007
Randomized Controlled TrialThe superficial cervical plexus block for postoperative pain therapy in carotid artery surgery. A prospective randomised controlled trial.
Rapid and reliable neurological evaluation soon after carotid artery surgery is feasible with modern methods of general anesthesia, but postoperative pain therapy remains a challenge. Use of opioids can mask neurological deficits. We investigated whether superficial cervical plexus block reduced postoperative opioid consumption after carotid endarterectomy. ⋯ The significant and clinically relevant lower morphine consumption and pain score, as well as the substantially higher patient satisfaction demonstrate that superficial cervical plexus block provides effective pain relief for patients undergoing carotid endarterectomy.
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Dent. Clin. North Am. · Jan 2007
ReviewA critical review of the use of botulinum toxin in orofacial pain disorders.
This article reviews the appropriate use, cautions, and contraindication for botulinum neurotoxin (BoNT) and reviews the peer-reviewed literature that describes its efficacy for treatment of various chronic orofacial pain disorders. The literature has long suggested that BoNT is of value for orofacial hyperactivity and more recently for some orofacial pain disorders; however, the results are not as promising for orofacial pain. ⋯ The one exception is that BoNT has reasonable RBCT data to support its use as a migraine prophylaxis therapy. The major caveat is that the use of BoNT in chronic orofacial pain is "off-label".
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Reg Anesth Pain Med · Jan 2007
Hospitalization costs of total knee arthroplasty with a continuous femoral nerve block provided only in the hospital versus on an ambulatory basis: a retrospective, case-control, cost-minimization analysis.
After total knee arthroplasty (TKA), hospitalization may be shortened by allowing patients to return home with a continuous femoral nerve block (CFNB). This study quantified the hospitalization costs for 10 TKA patients receiving ambulatory CFNB versus a matched cohort of 10 patients who received CFNB only during hospitalization. ⋯ This study provides evidence that ambulatory CFNB for selected patients undergoing TKA has the potential to reduce hospital length of stay and associated costs and charges. However, the current study has significant inherent limitations based on the study design. Additional research is required to replicate these results in a prospective, randomized, controlled trial and to determine whether any savings exceed additional CFNB costs such as from complications, having caregivers provide care at home, and additional hospital/health care provider visits.
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Anesthesia progress · Jan 2007
Randomized Controlled TrialAnesthetic efficacy of buccal and lingual infiltrations of lidocaine following an inferior alveolar nerve block in mandibular posterior teeth.
The authors, using a crossover design, randomly administered, in a single-blind manner, 3 sets of injections: an inferior alveolar nerve block (IANB) plus a mock buccal and a mock lingual infiltration of the mandibular first molar, an IANB plus a buccal infiltration and a mock lingual infiltration of the mandibular first molar, and an IANB plus a mock buccal infiltration and a lingual infiltration of the mandibular first molar in 3 separate appointments spaced at least 1 week apart. An electric pulp tester was used to test for anesthesia of the premolars and molars in 3-minute cycles for 60 minutes. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes following completion of the injection sets, and the 80 reading was continuously sustained for 60 minutes. ⋯ For the IANB plus mock buccal infiltration and lingual infiltration, successful pulpal anesthesia ranged from 54 to 76% from the second molar to second premolar. There was no significant difference (P > .05) in anesthetic success between the IANB plus buccal or lingual infiltrations and the IANB plus mock buccal infiltration and mock lingual infiltration. We conclude that adding a buccal or lingual infiltration of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine to an IANB did not significantly increase anesthetic success in mandibular posterior teeth.