Articles: nerve-block.
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Randomized Controlled Trial
High volume and low concentration of anaesthetic solution in the perivascular interscalene sheath determines quality of block and incidence of complications.
In the perivascular sheath of the brachial plexus, the volume of anaesthetic solution determines the quality of anaesthetic cover. Fibrous septa may divide the perivascular space into compartments, leading to inadequate diffusion of the anaesthetic solution. The aim of our study was to obtain good anaesthesia and less complications using high volume of low concentration anaesthetic solution, overcoming the obstacle of the septa with a double approach to the scalene sheath. ⋯ The lower concentration of the anaesthetic solution avoids complications while increased volume provides good analgesic cover. The combination of the Winnie interscalene plexus block and the Pippa proximal cranial needle approach should contribute to fill up the scalene sheath overcoming the septa obstacles.
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Middle East J Anaesthesiol · Oct 2006
Case ReportsCervical plexus block for carotid endarterectomy followed by general anesthesia for abdominal aortic surgery--a case report.
The aim of this clinical report is to describe the use of sequential regional and general anesthesia for concomitant carotid and abdominal aortic surgery. We performed, in a 70-year-old man, a cervical plexus block for carotid endarterectomy (CEA) followed immediately by general anesthesia for resection of an abdominal aortic aneurysm. ⋯ Sequential regional and general anesthesia may be an alternative to general anesthesia for concomitant carotid and abdominal aortic surgery. This approach offers an adequate neurological monitoring during the CEA phase of the combined surgery and the opportunity to postpone the aortic surgery should the CEA be associated with a non-reversible neurological deficit.
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J Hand Surg Eur Vol · Oct 2006
Review Randomized Controlled Trial Meta AnalysisA comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials.
A randomised, double-blinded, controlled trial was performed to compare traditional digital blocks with single subcutaneous palmar injection blocks at the base of the finger. A search for randomised controlled trials of digital blocks through MEDLINE, EMBASE, Cochrane Controlled Trials Register and CBM was conducted and a meta-analysis including the current trial was performed. ⋯ The meta-analysis suggests that traditional digital blocks and single subcutaneous palmar injection blocks are similar with regard to injection pain and are less painful than the transthecal digital block. The palmar techniques, including single subcutaneous palmar block and transthecal block, carry a risk of not anaesthetising the dorsum of the digit adequately, particularly the dorsum of the thumb and the proximal phalanx of the fingers.