Articles: nerve-block.
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Journal of anesthesia · Jan 2004
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialRopivacaine produces sensory blockade in the lumbar sacral region more frequently than mepivacaine in lower thoracic epidural anesthesia.
The first sacral nerve has the largest diameter among the spinal nerves and is resistant to local anesthetics. Ropivacaine is a newly developed local anesthetic. There is a possibility that a difference in chemical properties between ropivacaine and other local anesthetics produces a difference in the blockade of the S1 dermatome by lower thoracic epidural anesthesia. Mepivacaine, 2%, is frequently used for epidural anesthesia and produces a level of blockade similar to that of bupivacaine, 0.5%. The purpose of this study was to examine the sensory blockade in the sacral region induced by ropivacaine with that induced by mepivacaine administered in the lower thoracic epidural space. ⋯ Ropivacaine, 1%, administered in the lower thoracic epidural space, induces sensory blockade to cold and pinprick in the S1 dermatome more frequently than 2% mepivacaine.
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Randomized Controlled Trial Clinical Trial
Modified transthecal digital block versus traditional digital block for anesthesia of the finger.
This study compared the modified transthecal digital block (MTDB) technique with the traditional digital block (TDB) according to the degree of discomfort caused by injection and to the onset and the duration of anesthesia. ⋯ The effect of MTDB is equal to that of TDB in terms of pain perception. For the dorsal and radial proximal zones, the TDB appears to have better distribution of anesthesia. The MTDB has slower onset to anesthesia than the TDB.
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This study evaluates the clinical efficacy of interscalene brachial plexus block (according to G. Meier) for shoulder surgery. ⋯ Single injection interscalene brachial plexus block is a reliable anesthetic and effective method of providing postoperative pain relief after shoulder surgery.
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Selective nerve root blocks are valuable diagnostic and therapeutic procedures in patients with radicular symptoms. Understanding the anatomy, benefits, and risks, as well as precise needle placement, are important factors in performing successful nerve root blocks. The techniques we describe come from our training and ongoing experience. There are other acceptable methods as well.
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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.