Articles: nerve-block.
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Lumbar facet (zygapophysial) joints have been implicated as the source of chronic pain in 15% to 45% of patients with chronic low back pain. Diagnosis may be confounded by false-positive results with a single diagnostic block and administration of anxiolytics and narcotics prior to or during the diagnostic facet joint blocks. ⋯ The administration of sedation with midazolam or fentanyl is a confounding factor in the diagnosis of lumbar facet joint pain in patients with chronic low back pain. However, this study suggests that if strict criteria including pain relief and ability to perform prior painful movements is used as the standard for evaluating the effect of controlled local anesthetic blocks, the diagnostic validity of lumbar facet joint nerve blocks may be preserved.
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Success of plexus nerve block is most dependent upon the correct positioning of the local anaesthetic solution within proximity to the corresponding nerve trunk. With the aim of verifying the close approximation of needle and nerve, and increasing the corresponding success rate, in the course of the history of regional anaesthesia, and in addition to the classical methods like seeking of paraesthesia, different mechanical aids have been used for nerve detection. In the last two decades, important medical diagnostic and therapeutic advances in imaging technology have been presented. In this review we will analyse the role such imaging diagnostic procedures will play in regional anaesthesia practice. ⋯ In this paper we will analyse which imaging techniques are of relevance to anaesthesia in terms of clinical outcome, research and teaching of regional anaesthetic techniques, and the clinical impact of such imaging techniques upon anaesthesia practice.
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The purpose of this review is to present the most important recent studies into the clinical use of peripheral nerve blocks for anesthesia and postoperative analgesia of the lower limb surgery. ⋯ Introduction of new methods and techniques are increasing and improving the use of lower peripheral nerve blocks. These techniques are gaining interest after the important increase of the lower molecular weigh heparins.
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Plast. Reconstr. Surg. · Oct 2004
Randomized Controlled Trial Clinical TrialComparison of transthecal digital block and traditional digital block for anesthesia of the finger.
A randomized, double-blind study was performed in 50 patients to compare the transthecal and traditional subcutaneous infiltration techniques of digital block anesthesia regarding the onset of time to achieve anesthesia and pain during the infiltration. All the patients had sustained injury involving two or four fingers of the hand. Each patient served as his or her own control, having one finger infiltrated with the transthecal technique and the other with the subcutaneous infiltration technique. ⋯ However, none of the patients who received the subcutaneous infiltration block complained of pain at the digit. The technique of anesthesia preferred by patients for their finger was the subcutaneous infiltration block, because it causes less pain. Our results confirm the efficacy of the transthecal block for achieving anesthesia of the finger; however, because it is a more painful procedure, it is not recommended.