Articles: nerve-block.
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Am J Phys Med Rehabil · Jun 2004
Therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain.
To investigate the outcomes resulting from the use of fluoroscopically guided therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain. ⋯ These initial and preliminary findings do not support the use of therapeutic selective nerve root block in the treatment of this challenging patient population with traumatically induced spondylotic radicular pain.
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Paravertebral blockade (PVB) is a regional anaesthetic technique that allows the injection of local anaesthetic agents into the paravertebral space. It has been used for acute and chronic pain relief and as an anaesthetic technique for unilateral surgery of the chest, breast, shoulder, kidney, and inguinal region. Paravertebral blockade has been performed on a limited basis for breast surgery at the University Hospital of the West Indies (UHWI) since 1998. ⋯ Fifteen were done in combination with GA. No complications were recorded The initial experience shows that the performance of PVB is both possible and safe; it may offer an alternative to GA for breast surgery. A randomized prospective study is underway to allow a detailed comparison between the two methods.
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We studied the pain control, narcotic side effects, and PCA utilization with intravenous PCA morphine during 24 hours post cesarean section period. Fifty-two consecutive women were included in the study. Each received subarachnoid block with hyperbaric bupivacain with addition of fentanyl. ⋯ Mean morphine consumption was 50 mg. The ratio between number of time PCA activated and dose received and pain score helped in managing the postoperative pain. Morphine IV-PCA, adequately replaces post cesarean section spinal (bupivacain-fentanyl) analgesia with fewer side effects.
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Anesthesia and analgesia · Jun 2004
Case ReportsSuperficial cervical plexus block for vocal cord surgery in an awake pediatric patient.
Medialization thyroplasty is a surgical procedure that decreases the incidence of dysphonia and dysphagia in patients who have vocal cord paralysis. We report a case of a pediatric patient who underwent this procedure with minimal sedation and bilateral superficial cervical plexus blockade. The use of a regional technique provided analgesia while allowing the patient to phonate at the request of the surgeon. ⋯ Medialization thyroplasty is a surgical procedure that decreases the incidence of dysphagia and dysphonia in patients with vocal cord paralysis. This procedure is best performed in a patient who maintains the ability to phonate. We report a case of medialization thyroplasty in a pediatric patient after bilateral superficial cervical plexus blocks with minimal sedation.
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Anesthesia and analgesia · Jun 2004
Anterior approach to the sciatic nerve block: adaptation to the patient's height.
To improve the incidence of block of the posterior femoral cutaneous nerve (PFCN) when using an anterior approach as described recently, we hypothesized that the distance between the inguinal line and the puncture site depends on the patient's height. A preliminary radiological study performed in 13 patients established a formula describing the relationships between the patient's height and the puncture site "S." A line was drawn between the anterior iliac spine and the superior angle of the pubic tubercle (inguinal line) and another line from the midpoint of the inguinal line to the puncture site "S." "S" was calculated from the midpoint of the inguinal line as "S" = (height in cm--100)/10. A prospective study was conducted in 53 patients. Results are presented as median (range, 0.25-0.75). Two minutes were required to locate the sciatic nerve at a depth of 12 cm (10.5-13.0 cm). Complete sciatic and PFCN blocks were observed in 92% of the patients. We conclude that consideration should be given to the patient's height when the sciatic nerve is blocked using an anterior approach. This technique seems to improve the success of block of the PFCN, essential to tolerate a thigh tourniquet. ⋯ This prospective but noncomparative work was performed to evaluate a new anterior technique of sciatic block, an adaptation of the anatomic landmarks described by Chelly and Delaunay, to patient height.