Articles: nerve-block.
-
Letter Randomized Controlled Trial Clinical Trial
Sub-Tenon's block without hyaluronidase.
-
Rev Bras Anestesiol · Dec 2004
[Pain during spinal canal puncture and its relationship with ligamentum flavum, dura-mater and posterior longitudinal ligament innervation.].
Pain during spinal puncture is a warning that needle tip has touched a nervous structure. If patients refer pain during puncture, it is mandatory to interrupt the technique. Anesthetic solution should not be injected to prevent potential nervous root or spinal cord injury. Needle should be drawn back and have its direction changed before a new advance is attempted. Pain complain is totally impossible if patients are asleep under the influence of general anesthesia and that is why blockade with conscious patients is advisable. Pain is only referred when needle or catheter tip bypass the medium sagital plane to reach the antero-lateral epidural compartment, thus being able to touch nervous rootlets close to intervertebral foramina. Except for studies on skin, subcutaneous tissue and interspinous ligament innervation, this study aimed at reviewing the innervation of some spinal canal structures, namely, ligamentum flavum, posterior longitudinal ligament, dura-mater and intervertebral disk. ⋯ Ligamentum flavum is not innervated, thus explaining lack of pain during puncture. Other pains during puncture may be attributed to Luschka's nerve, which innervates posterior longitudinal ligament and dural ventral portion.
-
Rev Esp Anestesiol Reanim · Dec 2004
Case Reports[Ultrasound-guided posterior approach to block the sciatic nerve at the popliteal fossa].
The recent introduction of ultrasound guidance for locating peripheral nerves and nerve plexi has allowed injection of anesthetic agents to block the sciatic nerve at the popliteal fossa proximal to division, thus preventing damage to adjacent structures, repeated punctures, and multiple nerve stimulations to verify anesthetic diffusion around the nerve. We report the case of a 23-year-old man, ASA I, who underwent reduction and osteosynthesis of a fractured right fibula. Ultrasound was used to guide the needle after identification of the sciatic nerve 10 cm from the knee fold and 3.5 cm deep. ⋯ The motor and sensory block of the sciatic nerve was complete and no adverse events occurred during or after surgery. We conclude that the combination of ultrasound guidance and nerve stimulation allows the sciatic nerve to be located easily. The approach to the point before division of the sciatic nerve can be guaranteed so that puncture of neighboring vessels can be avoided and optimal anesthesia provided.
-
We present a case of persistent phrenic nerve paralysis after a successful interscalene brachial plexus block. In addition, there was no observed diaphragmatic stimulation, and the patient underwent an uneventful early postoperative period. Warning signs of a complication were either missed or absent until several days after discharge from the ambulatory surgical unit.
-
Knee arthroscopy is one of the most common orthopedic procedures done in the United States. It usually is performed as an outpatient procedure. This retrospective study was designed to assess the level of postoperative analgesia provided by the local knee block. ⋯ The severity of the knee pain was assessed using verbal pain rating scores during the anesthesia recovery period, before patients left the hospital, and again on the first postoperative day. Patients in group 2 had significantly lower pain scores compared with patients in group 1 during these periods. Results suggest that the local knee block provides superior postoperative analgesia for the knee arthroscopy patient.