Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Intercostal nerve blockade with alcohol during operation for postthoracotomy pain].
Purpose of this study was to evaluate the effectiveness of intraoperative intercostal nerve blockade with alcohol in addition to epidural analgesia with morphine for control of postthoracotomy pain syndrome. ⋯ Additional intraoperative intercostal nerve blockade with alcohol provides an additional benefit for postthoracotomy pain relief, especially for at least one month following the thoracotomy.
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Knowledge of the relationship of the lumbar sympathetic chain to the vertebral bodies is needed to perform sympathetic block and sympatholysis. This information should be correlated with fluoroscopy to determine the best method to perform this technique clinically. Twenty cadavers were dissected to demonstrate the lumbar sympathetic chain. ⋯ Use of at least two needles is advisable (L2 and L3 vertebral body). Care should be taken to avoid the lumbar vessels. A transdiscal technique recently advocated may also avoid some of the complications with the paramedian technique, but chances of discitis, nerve root injury, accelerated disc degeneration, disc herniation and rupture of the anterior annulus have to be considered when using this technique.
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Anesthesia progress · Jan 2004
Randomized Controlled Trial Clinical TrialA randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.
The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine. ⋯ Nine percent of children required supplementary local anesthetic: 4 of 52 (7.7%) in the block/long buccal group and 5 of 49 (10.2%) in the infiltration/intrapapillary group (P = .07). The hypothesis that block/long buccal would be more effective than infiltration/intrapapillary was not supported. There was no difference in pain control effectiveness between infiltration/intrapapillary injection and inferior alveolar block/long buccal infiltration using 2% lidocaine with 1:100,000 epinephrine when mandibular primary molars received pulpotomy treatment and stainless steel crowns.
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Randomized Controlled Trial Comparative Study Clinical Trial
The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement.
To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR). ⋯ Both continuous PSOAS block and continuous three-in-one FEM block provided better analgesia than PCA but no differences were seen between the two regional techniques.
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Comparative Study Clinical Trial
Brachial plexus anesthesia compared to general anesthesia when a block room is available.
Regional anesthesia is often felt to be beneficial to patient care but detrimental to operating room (OR) efficiency. In this report we compare how a block room (BR) affects OR time (ORT) utilization for brachial plexus anesthesia (BPA) in a busy upper limb practice. We also compare how anesthetic technique, BPA or general anesthesia (GA), impacts on the time to recovery and discharge in patients having outpatient upper limb surgery. ⋯ The use of a BR reduces the anesthesia ORT associated with BPA. Secondly, BPA improves the recovery time phase of outpatients undergoing surgery on the upper limb.