Articles: nerve-block.
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Clinical Trial
Factors affecting the spread of bupivacaine in the adult thoracic paravertebral space.
Factors affecting the spread of bupivacaine in the paravertebral space were investigated in patients undergoing paravertebral nerve blocks for the treatment of chronically painful conditions. Injections of bupivacaine 0.5%, 10-15 ml mixed with depomedrone up to 80 mg were repeated at 2-wk intervals up to a maximum of four times. A blinded observer mapped out the subsequent distribution of sensory loss to cold on both sides of the torso at 5-min intervals after each injection. ⋯ A single bolus of bupivacaine produces a safe but unpredictable block. Yet to be defined physical properties and anatomical factors are probably key determinants of the spread of bupivacaine in the paravertebral space. This single bolus technique may be better supplanted by a reversion to the older multiple level injection technique.
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Comparative Study
Prolonged duration local anesthesia from tetrodotoxin-enhanced local anesthetic microspheres.
There is interest in developing prolonged duration local anesthesics. Here we examine whether tetrodotoxin (TTX) can be used to prolong the block from bupivacaine microspheres with and without dexamethasone. Rats received sciatic nerve blocks with 75 mg of microspheres containing 0.05% (w/w) TTX, 50% (w/w) bupivacaine and/or 0.05% (w/w) dexamethasone. 0.1% (w/w) TTX microspheres were also tested. ⋯ In summary, coencapsulation of TTX in controlled release devices containing bupivacaine and dexamethasone resulted in very prolonged nerve blocks. As formulated here, this preparation had a narrow margin of safety. While the myotoxicity appears consistent with the well-known reversible myotoxicity associated with local anesthetics, its long-term significance remains to be established.
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Kathmandu Univ Med J (KUMJ) · Jul 2003
Randomized Controlled TrialSupraclavicular brachial plexus block with and without dexamethasone - a comparative study.
To compare the analgesic efficacy of local aesthetic with and without dexamethasone in supraclavicular brachial plexus block. ⋯ Addition of dexamethasone for brachial plexus block significantly prolongs the duration of analgesia without any unwanted effects.
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Reg Anesth Pain Med · Jul 2003
Case ReportsUltrasound guidance for ulnar nerve block in the forearm.
The objective of this study was to establish the feasibility of ulnar nerve block under direct imaging. ⋯ Ultrasound guidance for ulnar nerve block in the forearm is a promising technique that includes block of the dorsal cutaneous branch. Anatomic and sonographic considerations are discussed.