Articles: nerve-block.
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Acta Anaesthesiol Scand · Mar 2003
Letter Case ReportsNeuraxial complications after epidural and spinal anaesthesia.
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Paediatric anaesthesia · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus anaesthesia in children: lateral infraclavicular vs axillary approach.
Brachial plexus blockade is a well-established technique in upper-limb surgery. In paediatric patients, the axillary route is usually preferred to infraclavicular approaches because of safety considerations. Recent reports on a lateral infraclavicular approach offering greater safety in adults prompted us to perform a prospective randomized study to assess the analgesic efficacy of axillary vs lateral vertical infraclavicular brachial plexus (LVIBP) blocks in paediatric trauma surgery. ⋯ We conclude that LVIBP blocks can be safely performed in children and that they add to the spectrum of sensory and motor blockade seen with the axillary approach.
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Anesthesia and analgesia · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialEMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children.
We conducted a prospective, randomized, double-blinded trial comparing preoperative application of EMLA cream and sodium chloride solution dorsal penile block (n = 31) with placebo cream and bupivacaine dorsal penile nerve block (n = 32) for postcircumcision analgesia. Pain was assessed using modified Children's Hospital of Eastern Ontario Pain Scale and the duration of block by the time to requirement of first dose of postoperative analgesic. ⋯ There were no local or systemic complications related to either technique, and there was a very small incidence of vomiting. We conclude that preoperative application of EMLA cream is an effective and simple method to produce postcircumcision analgesia with a very small incidence of adverse effects.
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Paediatric anaesthesia · Feb 2003
Case ReportsIs ilioinguinal/iliohypogastric nerve block always totally safe in children?
We report a case of accidental puncture of the small bowel during an ilioinguinal/iliohypogastric nerve block procedure for hernia repair. The diagnosis was made a few days later during a laparoscopic exploration owing to the progressive onset of clinical and radiological intestinal obstruction. ⋯ This case is the first reported using an atraumatic short bevel needle. We discuss the technical aspects of the procedure and underline the fact that regional anaesthesia in children is never totally risk free.
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Randomized Controlled Trial Clinical Trial
Block of the sacral segments in lumbar epidural anaesthesia.
Block of the first sacral segment is often delayed in lumbar epidural anaesthesia. The addition of either epinephrine or sodium bicarbonate to the local anaesthetic enhances the efficacy of epidural block. We assessed the block of lumbo-sacral segments in lumbar epidural anaesthesia adding epinephrine and/or bicarbonate to lidocaine. ⋯ A combination of lidocaine, bicarbonate, and epinephrine increases the pain threshold over the sacral segments.