Articles: nerve-block.
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To determine the number of interscalene blocks that are necessary for a resident in anesthesiology to complete so as to achieve autonomous success with that specific block. ⋯ Experience with only 40 unspecified peripheral nerve blocks, as currently required by the Residency Review Committee as of January 2001, may not provide adequate opportunity for an individual to develop expertise in regional anesthesia.
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Case Reports
[Incorrect positioning of a catheter for continuous block of the nervus suprascapularis. A case report].
The case of a 55-year-old woman is described where shoulder pain was successfully treated with a suprascapular catheter. During arthroscopy of the shoulder the catheter was detected in the subacromial space. The reasons and consequences of an abnormal position of the suprascapular catheter are discussed.
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Rev Esp Anestesiol Reanim · Jun 2003
[Possibility of nerve lesions related to peripheral nerve blocks. A study of the human sciatic nerve using different needles].
When a needle tip comes too close to a nerve axon, the mechanical effect over the nerve membrane produces paresthesia. We examined the hypothetical mechanical damage of short bevel and long bevel needles over sciatic nerve bundles under scanning electron microscopy. ⋯ Lesions that affect superficially the epineurum can cause paresthesia by compression of nerve fascicles without damaging the axons. If the perineurm is damaged, the lession will also affect the blood-nerve barrier, leading probably to posterior sequels.
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The axillary brachial plexus block is a very safe, but sometimes unreliable technique for anaesthesia of the upper extremities. Alternative methods like the infraclavicular block offer a higher success rate, but also the possibility of severe complications. We suggest a modified axillary technique with an injection site medial to the artery, evaluated by clinical experience and anatomical investigations, which could solve the problem of high failure rate, especially in the area of the radial nerve while still maintaining patient safety.