Articles: nerve-block.
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Acta Anaesthesiol Scand · Aug 2004
Randomized Controlled Trial Clinical TrialIs a double-injection technique superior to a single injection in posterior subgluteal sciatic nerve block?
Currently, no information is available on the effects of a double-injection technique on onset time and efficacy following subgluteal sciatic nerve blockade. We hypothesized that the success rate and time to onset of subgluteal nerve block following a double-injection technique would be superior to that after a single injection. ⋯ Both the single- and double-injection technique for subgluteal sciatic nerve blockade resulted in acceptable anesthesia in most patients. The double injection generated a faster onset of anesthesia than the single injection. However, the double-injection technique caused more patient discomfort during establishment of the nerve block.
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Anesthesia and analgesia · Aug 2004
Randomized Controlled Trial Comparative Study Clinical TrialLumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine.
Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relationship with pain. Therefore, 20 patients, of which 19 finished the complete protocol, with chronic lumbosacral radicular pain without neurological deficits underwent segmental nerve blocks at L4 with both lidocaine and ropivacaine. ⋯ A difference in effect on MVMF was found for affected versus control side (P = 0.016; Tukey test). Multiple regression revealed a significant negative correlation for change in VNRS score versus change in median MVMF (Spearman R = -0.48: P = 0.00001). This study demonstrates that in patients with unilateral chronic low back pain radiating to the leg, pain reduction induced by local anesthetic segmental nerve (L4) block is associated with increased quadriceps femoris and tibialis anterior MVMF, without differences for lidocaine and ropivacaine.
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Randomized Controlled Trial Clinical Trial
The addition of clonidine to bupivacaine in combined femoral-sciatic nerve block for anterior cruciate ligament reconstruction.
Clonidine has been shown to prolong sensory analgesia when given as an adjunct to peripheral nerve blocks but has not been evaluated when given in conjunction with a femoral-sciatic nerve block. The purpose of this investigation was to determine whether the addition of clonidine to a femoral-sciatic nerve block would prolong the duration of sensory analgesia in groups of patients undergoing anterior cruciate ligament (ACL) reconstruction. This prospective, randomized, double-blind investigation was performed on 64 subjects undergoing ACL reconstruction. ⋯ No significant differences were noted between groups for pain intensity scores, duration of sensory analgesia, postoperative analgesic requirements, or overall patient satisfaction. Both groups reported minimal amounts of postoperative pain and high analgesic satisfaction scores. Based on our results, we do not recommend the addition of clonidine to a femoral-sciatic nerve block when given to facilitate postoperative analgesia in patients undergoing ACL reconstruction.