Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal lidocaine gel: review of the literature.
Studies have demonstrated the need for pain control during multiple transrectal prostate biopsies. Due to encountered published results on periprostatic nerve block, we prospectively evaluated the efficacy and safety of periprostatic local anaesthesia at the apex in comparison to intrarectal lidocaine gel. ⋯ Periprostatic nerve block at the apex is superior to intrarectal lidocaine gel for controlling pain during transrectal prostate biopsy, with no increased complications. This technique should be recommended for those patients without anal or rectal inflammatory diseases.
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Comparative Study Clinical Trial
Predicting recovery from deep neuromuscular block by rocuronium in the elderly.
To determine the influence of aging on the relationship between posttetanic count (PTC) and train-of-four (TOF) response during intense neuromuscular blockade caused by rocuronium. ⋯ Posttetanic twitch stimulation is a useful method of monitoring intense neuromuscular blockade caused by rocuronium in both age groups. The interval between the earliest appearance of a posttetanic response and the first response to TOF stimulation (T1) is greater in the elderly than in the young.
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Anesthesia and analgesia · Aug 2003
Randomized Controlled Trial Clinical TrialThe effect of exogenous epinephrine on the incidence of hypotensive/bradycardic events during shoulder surgery in the sitting position during interscalene block.
Sudden hypotensive and/or bradycardic events (HBE) have been reported in 13%-28% of patients undergoing shoulder surgery in the sitting position during interscalene block. The Bezold-Jarisch reflex is the most likely mechanism for these events. It has been hypothesized that exogenous epinephrine might be a key component to the occurrence of HBE. We conducted this prospective, randomized study to verify this hypothesis. Patients received a local anesthetic solution with (Group E; n = 55) or without (Group P; n = 55) epinephrine for interscalene block; no further exogenous epinephrine was administered. Blood pressure control was achieved with IV urapidil, a peripheral vasodilator, as needed. The incidence of HBE was 11% in Group P versus 29% in Group E (P = 0.015). Increased intraoperative heart rate and arterial blood pressure were recorded in Group E (P = 0.000). Urapidil was administered to 13% of Group P and to 31% of Group E patients (P = 0.018). Urapidil administration induced a HBE in 4% of Group P and in 5% of Group E patients. We conclude that exogenous epinephrine is involved in the development of HBE in this setting. ⋯ Sudden hypotensive and/or bradycardic events occur during shoulder surgery in the sitting position during interscalene block. In this study, we demonstrated that the presence of epinephrine in the local anesthetic mixture significantly increases the incidence of these events.
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Acta Anaesthesiol Scand · Aug 2003
Case ReportsCardiac arrest after interscalene brachial plexus block with ropivacaine and lidocaine.
Serious adverse reactions to ropivacaine and lidocaine are rare. In this report, we describe a case of sudden cardiac arrest after an interscalene brachial plexus block with a mixture of 150 mg of ropivacaine and 360 mg of lidocaine in a previously healthy, 34-year-old, 97-kg man. ⋯ He eventually made a good recovery. We conclude that although ropivacaine and lidocaine are often considered relatively safe local anesthetics, serious cardiovascular complications can occur after the use of these drugs.