Articles: nerve-block.
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Europa medicophysica · Sep 2006
Randomized Controlled Trial Comparative StudyPain relief in early rehabilitation of rotator cuff tendinitis: any role for indirect suprascapular nerve block?
The purpose of the trial was to evaluate the efficacy of suprascapular nerve block (SSNB) to relieve the shoulder pain, ameliorate recovery after physiotherapy and reduce disability due to a rotator cuff tendinitis (RCT). A prospective, randomized, comparison cross over investigation was performed in the setting of a large inpatient rehabilitation unit with more than 200 admissions annually. ⋯ The results indicate that combining nerve block with standard rehabilitative therapy may improve the final outcome of painful RCT. It decreased the severity and frequency of the perceived pain, improved the compliance with physiotherapy, restored more normal sleep patterns, and increased compliance with the rehabilitation program. This result proves to be an effective, safe and inexpensive therapeutic option for patients suffering from painful disabling shoulder tendinitis.
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Anesthesia and analgesia · Sep 2006
Randomized Controlled TrialThe pharmacodynamics of ropivacaine and bupivacaine in combined sciatic and femoral nerve blocks for total knee arthroplasty.
The potency of ropivacaine compared with bupivacaine in regional anesthesia remains controversial. Therefore, we compared the pharmacodynamics of equal concentrations of bupivacaine and ropivacaine in combined sciatic and femoral nerve blocks for patients undergoing knee arthroplasty. Fifty patients received 40 mL of either 0.5% bupivacaine (n = 25) or 0.5% ropivacaine (n = 25) divided between the sciatic (15 mL) and the femoral (25 mL) nerves before induction of anesthesia. ⋯ Overall, pain scores and morphine consumption were similar. In conclusion, we showed that block resolution is different between bupivacaine and ropivacaine when administered for combined sciatic and femoral nerve blocks. A new systematic method to assess sciatic and femoral nerve blockade is proposed.
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Reg Anesth Pain Med · Sep 2006
Randomized Controlled TrialNo differences between 20, 30, or 40 mL ropivacaine 0.5% in continuous lateral popliteal sciatic-nerve block.
The aim of this study was to compare the anesthetic and analgesic characteristics of the administration of an initial bolus of 20, 30, or 40 mL of ropivacaine 0.5% through a lateral popliteal sciatic catheter. ⋯ This dose-response study shows that 20 mL of ropivacaine 0.5% injected through an indwelling lateral popliteal catheter is the optimal dose for foot surgery. Higher doses of 30 mL or 40 mL did not provide any further advantage.
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Anesthesia and analgesia · Sep 2006
Randomized Controlled TrialNerve localization techniques for interscalene brachial plexus blockade: a prospective, randomized comparison of mechanical paresthesia versus electrical stimulation.
Postoperative neurologic symptoms (PONS) are relatively common after upper extremity orthopedic surgery performed under peripheral neural blockade. In this study, we prospectively compared the incidence of PONS after shoulder surgery under interscalene (IS) block using the electrical stimulation (ES) or mechanical paresthesia (MP) techniques of nerve localization. For patients randomized to the MP group, a 1-in, 23-g long-beveled needle was placed into the IS groove to elicit a paresthesia to the shoulder, arm, elbow, wrist, or hand. ⋯ The PONS lasted a median duration of 2 mo, and symptoms in all patients resolved within 12 mo. The success rate, onset time, and patient satisfaction were also comparable between groups. We conclude that the choice of nerve localization technique can be made based on the patient's and anesthesiologist's comfort and preferences and not on concern for the development of PONS.
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J Shoulder Elbow Surg · Sep 2006
Interscalene regional anesthesia for arthroscopic shoulder surgery: a safe and effective technique.
There has been resistance to the use of interscalene regional block for arthroscopic shoulder surgery because of concerns about potential complications and failed blocks with the subsequent need for general anesthesia. The purpose of this study was to assess whether interscalene regional block is safe and effective and offers many advantages over general anesthesia for outpatient arthroscopic shoulder surgery. ⋯ There was a 1% rate of minor complications, all of which were transient sensory neuropathies that resolved within 5 weeks on average. We conclude that interscalene block can provide effective anesthesia for arthroscopic shoulder surgery.