Articles: nerve-block.
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Acta Anaesthesiol Belg · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of mandibular nerve block on opioid consumption, nausea and vomiting in bilateral mandibular osteotomies.
The purpose of this study was to compare the efficacy of a mandibular nerve block to placebo, in patients undergoing mandibular osteotomy surgery, regarding opioid consumption and adverse opioid induced side effects. Forty healthy individuals with a mean age of 19.7 years participated in the study. All subjects received lidocaïn 2% + adrenaline 1/80,000 versus placebo for mandibular nerve block in a randomized double-blind manner. Opioid consumption and opioid related side effect such as postoperative nausea and vomiting (PONV), and respiratory depression were assessed. ⋯ The mandibular block during mandibular osteotomy reduces intra-operative opioid consumption but does not alternate the opioid related side-effects in the postoperative phase.
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Anesthesia and analgesia · Jan 2003
Randomized Controlled Trial Clinical TrialThe analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy.
Used as the sole analgesic, clonidine produces analgesia after central neural blockade and intraarticular injection but not after axillary block. In this study, we sought to determine whether interscalene clonidine induces analgesia for shoulder arthroscopy. Forty patients scheduled for shoulder arthroscopy were prospectively included in this double-blinded study. Using a nerve stimulator technique, an interscalene catheter was inserted. The patients were randomly divided into two groups. The interscalene group (n = 20) received clonidine 150 micro g in 15 mL of saline through the catheter and 1 mL of subcutaneous saline, and the systemic group (n = 20) received 15 mL of saline through the catheter and clonidine 150 micro g (1 mL) subcutaneously. All patients underwent general anesthesia for surgery. On completion of arthroscopy, all patients received, via a patient-controlled analgesia, on demand a bolus of 8 mL of ropivacaine 0.2% through the catheter with a 1-h lockout period. Postoperative pain was measured every 4 h using the visual analog scale (VAS) for 24 h. Additional postoperative analgesia was available with parenteral nalbuphine if required until VAS < 3. VAS scores in the recovery room were significantly higher in the systemic group compared with the interscalene group (P < 0.0001). Analgesic duration was significantly longer in the interscalene group (P < 0.00001), and ropivacaine consumption was significantly less than in the systemic group (P < 0.0001). No significant difference was observed between groups for nalbuphine consumption. Side effects were comparable in the two groups. ⋯ Clonidine administered via an interscalene catheter enhanced analgesia compared with systemic administration. Nevertheless, the adverse effect of clonidine at this dose limits its use for routine management for postoperative analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
The use of a local anesthetic foot block in patients undergoing outpatient bony forefoot surgery: a prospective randomized controlled trial.
Foot blocks are known to prolong postoperative pain relief. Consequently, their use has been extended to patients having outpatient surgery, despite little evidence to show improved patient satisfaction. Indeed, patients having outpatient surgery actually may be less satisfied because they will first experience pain at home on the first postoperative night, which may be more severe than anticipated. ⋯ All patients were assessed at home by telephone interview on the first and second postoperative day. There was a significantly longer time to first perceived pain in the foot block group compared with the control group, but no difference in the number of postoperative analgesic tablets consumed, no difference in pain score on the first night, first postoperative or second postoperative day, or any difference in the overall patient satisfaction scores at 2 days. The authors conclude that a local foot block, although prolonging the time to first perceived pain, does not improve patient satisfaction and is not detrimental when used as analgesia in the outpatient setting.
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Am J Hosp Palliat Care · Jan 2003
Review Case ReportsPhenol saddle blocks for intractable pain at end of life: report of four cases and literature review.
Four cancer patients with prior bladder diversions had phenol neurolytic saddle blocks performed for intractable pelvi-sacral pain. All patients had advanced disease, the focus of their treatment being palliative. ⋯ No significant block-related adverse effects were encountered. The value and technical aspects of intrathecal saddle blocks in end-of-life pain management is discussed.