Articles: nerve-block.
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This article describes the use of interventional endoscopic ultrasonography, namely, endoscopic ultrasound-guided injection therapy for the treatment of pain. With the assistance of endoscopic ultrasonography, it is now possible to safely inject the celiac plexus with pharmacological agents to provide analgesia in painful pancreatic conditions such as cancer and chronic pancreatitis. The indications for celiac plexus injection, the procedure, required accessories, complications, and nursing care are discussed.
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Reg Anesth Pain Med · Jul 2003
Case ReportsApplying ultrasound imaging to interscalene brachial plexus block.
Previous studies have examined ultrasound-assisted brachial plexus blocks, but few have applied this imaging technology to the interscalene region. We report a case of interscalene brachial plexus block using ultrasound guidance to show the clinical usefulness of this technology. ⋯ Advanced ultrasound technology is useful for nerve localization and can generate brachial plexus images of high resolution in the interscalene groove, guide block needle placement and advancement in real time to targeted nerves, and assess adequacy of local anesthetic spread at the time of injection. Ultrasound imaging guidance can potentially improve success during interscalene brachial plexus block.
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Comparative Study
Prolonged duration local anesthesia from tetrodotoxin-enhanced local anesthetic microspheres.
There is interest in developing prolonged duration local anesthesics. Here we examine whether tetrodotoxin (TTX) can be used to prolong the block from bupivacaine microspheres with and without dexamethasone. Rats received sciatic nerve blocks with 75 mg of microspheres containing 0.05% (w/w) TTX, 50% (w/w) bupivacaine and/or 0.05% (w/w) dexamethasone. 0.1% (w/w) TTX microspheres were also tested. ⋯ In summary, coencapsulation of TTX in controlled release devices containing bupivacaine and dexamethasone resulted in very prolonged nerve blocks. As formulated here, this preparation had a narrow margin of safety. While the myotoxicity appears consistent with the well-known reversible myotoxicity associated with local anesthetics, its long-term significance remains to be established.
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Reg Anesth Pain Med · Jul 2003
Case ReportsUltrasound guidance for ulnar nerve block in the forearm.
The objective of this study was to establish the feasibility of ulnar nerve block under direct imaging. ⋯ Ultrasound guidance for ulnar nerve block in the forearm is a promising technique that includes block of the dorsal cutaneous branch. Anatomic and sonographic considerations are discussed.
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Arch Phys Med Rehabil · Jul 2003
Motor branch of the rectus femoris: anatomic location for selective motor branch block in stiff-legged gait.
To determine the ideal target point for selective motor branch block of the rectus femoris to treat stiff-legged gait. ⋯ The point T is the most suitable target point to selectively block the motor branch of the rectus femoris without affecting the other 3 motor branches of the femoral nerve in the treatment of stiff-legged gait.