Articles: nerve-block.
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Anesthesia and analgesia · Jul 2004
Randomized Controlled Trial Clinical TrialPostoperative analgesia after total knee replacement: the effect of an obturator nerve block added to the femoral 3-in-1 nerve block.
Femoral nerve block (FNB) does not consistently produce anesthesia of the obturator nerve. In this single-blind, randomized, controlled study we added a selective obturator nerve block (ONB) to FNB to analyze its influence on postoperative analgesia after total knee replacement (TKR). Before general anesthesia, 90 patients undergoing TKR received FNB (Group 1), FNB and selective ONB (Group 2), or placebo FNB (Group 3). ⋯ We conclude that FNB does not produce complete anesthesia of the obturator nerve. Single-shot FNB does not provide additional benefits on pain at rest over opioids alone in the early postoperative period. The addition of an ONB to FNB improves postoperative analgesia after TKR.
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Paediatric anaesthesia · Jul 2004
Comparative StudyGenerating a learning curve for penile block in neonates, infants and children: an empirical evaluation of technical skills in novice and experienced anaesthetists.
Literature concerning learning curves for anaesthesiological procedures in paediatric anaesthesia is rare. The aim of this study was to assess the number of penile blocks needed to guarantee a high success rate in children. ⋯ Penile block in children is easily learned by residents. A steep learning curve was found. The success rate was over 93.5% after more than 40 blocks.
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We present a case of a 68-year-old female patient who had an interscalene nerve block (ISB) complicated by compression of her brachial plexus by a pseudoaneurysm. The complication occurred after the patient received an ISB as anesthesia for an outpatient shoulder procedure. Review of this complication should alert surgeons to consider this diagnosis as a possibility in patients with postoperative pain and/or neurologic compromise after receiving an ISB.
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Comparative Study
Site 1 sodium channel blockers prolong the duration of sciatic nerve blockade from tricyclic antidepressants.
Many recent reports in the literature address the local anesthetics efficacy of tricyclic antidepressants (TCAs). Here we investigated whether nerve block from TCAs is prolonged by site 1 sodium channel blockers such as tetrodotoxin and saxitoxin, which are known to prolong block from conventional local anesthetics. Tetrodotoxin and saxitoxin greatly prolonged block from TCAs. ⋯ Systemic (subcutaneous) delivery of tetrodotoxin or amitriptyline did not result in prolongation of block from the other class of drug injected at the sciatic nerve. In TCA-containing formulations, motor blockade was consistently longer than thermal nociceptive block; motor blockade was also prolonged by tetrodotoxin and saxitoxin. In summary site 1 sodium channel blockers prolong the duration of TCAs via a locally mediated mechanism.