Articles: nerve-block.
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Acta Anaesthesiol Scand · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialHigh-dose bupivacaine, levobupivacaine and ropivacaine in axillary brachial plexus block.
Racemic bupivacaine is clinically similar to levobupivacaine, or ropivacaine. The drugs were compared in brachial plexus block for the first time in the same randomized and double-blind study. ⋯ Ropivacaine-HCl 5 mg ml(-1) produced slightly better sensory and motor block intensity than the same dose of levobupivacaine-HCl. General success in relation to surgery and in the duration of the blocks was similar in the three groups.
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Reg Anesth Pain Med · May 2004
Case ReportsThe use of cervical paravertebral block as the sole anesthetic for shoulder surgery in a morbid patient: a case report.
The purpose of this case report is to describe the use of the cervical paravertebral block as the sole anesthetic for shoulder surgery in a patient unable to tolerate general anesthesia. Recent literature describes the continuous cervical paravertebral block as an effective alternative to the interscalene block for the management of postoperative pain after shoulder surgery. ⋯ Continuous cervical paravertebral block provided excellent surgical conditions and postoperative pain relief for this patient and allowed gradual and intermittent dosing of the catheter and continuous assessment of the anesthetic impact on respiratory function.
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Reg Anesth Pain Med · May 2004
Clinical evaluation of a modified posterior anatomical approach to performing the popliteal block.
Tibial and common peroneal nerves can be blocked by the posterior approach to the popliteal fossa. Techniques using fixed measured distances between knee skin crease and puncture point have been described. We report on an approach that is based on manual identification of the apex of the popliteal fossa. ⋯ The modified posterior anatomical approach for popliteal sciatic nerve block is easy to perform, has a high success rate, and has a low complication rate. The location of the needle insertion point is assessed without any measurement, thus avoiding inaccuracies caused by repeated skin-distance measurements.
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Lumbar facet nerve (medial branch) block for pain relief in facet syndrome is currently performed under fluoroscopic or computed tomography scan guidance. In this three-part study, the authors developed a new ultrasound-guided methodology, described the necessary landmarks and views, assessed ultrasound-derived distances, and tested the clinical feasibility. ⋯ Ultrasound guidance seems to be a promising new technique with clinical relevance and the potential to increase practicability while avoiding radiation in lumbar facet nerve block.
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Anesthesia and analgesia · May 2004
Case ReportsTransient vascular insufficiency after axillary brachial plexus block in a child.
Axillary block is used in children for procedures on the hand and forearm. We report on a child with an amputation of the thumb in whom an axillary block was given, after which the limb became pale and pulseless. The pulses returned spontaneously in 15 min. The awareness of this possibility and chances of spontaneous recovery should be considered. ⋯ Transient vascular insufficiency of the upper limb may happen as a rare complication after axillary block. Knowledge of this complication can help the anesthesiologist in the management of this problem.