Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being.
To determine cardiovascular effects and neonatal outcome of ropivacaine 0.75% and bupivacaine 0.5% for elective epidural caesarean section. ⋯ Both drugs produced equally satisfactory epidural block. Although ropivacaine 0.75% resulted in a greater decrease of maternal heart rate, this effect did not influence neonatal well-being. Both ropivacaine 0.75% and bupivacaine 0.5% can therefore be recommended for epidural anaesthesia in elective caesarean section.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ropivacaine plasma concentrations are similar during continuous lumbar plexus blockade using the anterior three-in-one and the posterior psoas compartment techniques.
To compare ropivacaine blood concentrations obtained after a continuous lumbar plexus block performed either by the anterior three-in-one femoral (FEM) technique or the posterior (psoas compartment; PSOAS) technique. ⋯ Although the posterior PSOAS block results in higher early plasma concentrations of local anesthetic than the anterior three-in-one FEM block, both techniques are equivalent with regards to their potential toxicity when a continuous infusion is administered. Local anesthetic accumulation occurs with an infusion of ropivacaine 0.2% at 12 mL.hr(-1) and can lead to potentially dangerous concentrations at 48 hr.
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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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Anesthesia and analgesia · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe effects of three different approaches on the onset time of sciatic nerve blocks with 0.75% ropivacaine.
We studied three different injection techniques of sciatic nerve block in terms of block onset time and efficacy with 0.75% ropivacaine. A total of 75 patients undergoing foot surgery were randomly allocated to receive sciatic nerve blockade by means of the classic posterior approach (group classic; n = 25), a modified subgluteus posterior approach (group subgluteus; n = 25), or a lateral popliteal approach (group popliteal; n = 25). All blocks were performed with the use of a nerve stimulator (stimulation frequency, 2 Hz; intensity, 2-0.5 mA) and 30 mL of 0.75% ropivacaine. Onset of nerve block was defined as complete loss of pinprick sensation in the sciatic nerve distribution with concomitant inability to perform plantar or dorsal flexion of the foot. In the three groups, an appropriate sciatic stimulation was elicited at <0.5 mA. The failure rate was similar in the three groups (group popliteal: 4% versus group classic: 4% versus group subgluteus: 8%). The onset of nerve block was slower in group popliteal (25 +/- 5 min) compared with group classic (16 +/- 4 min) and group subgluteus (17 +/- 4 min; P < 0.001). There was no significant difference in the onset of nerve block between group classic and group subgluteus. No differences in the degree of pain measured at the first postoperative administration of pain medication were observed among the three groups. We conclude that the three approaches resulted in clinically acceptable anesthesia in the distribution of the sciatic nerve. The subgluteus and classic posterior approaches generated a significantly faster onset of anesthesia than the lateral popliteal approach. ⋯ Comparing three different approaches to the sciatic nerve with 0.75% ropivacaine, the classic and subgluteal approaches exhibited a faster onset time of sensory and motor blockade than the lateral popliteal approach.
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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.