Articles: nerve-block.
-
Rev Bras Anestesiol · Nov 2002
[Simplified sciatic nerve approach by the posterior route at the median gluteus-femoral sulcus region, with a neurostimulator.].
The sciatic nerve may be blocked by several routes, all of them with advantages and disadvantages. It is the largest human nerve in diameter and length, being the prolongation of the upper sacral plexus fascicle (L4, L5, S2 and S3). It leaves the pelvis through the foramen ischiadicum majus, passing below the piriform muscle and going down between the greater trochanter and the ischial tuberosity, continuing along the femoral dorsum, anterior to biceps femoris and semitendinous muscles, to the lower femoral third, where it is divided in two major branches called tibial and common fibular nerves. It becomes superficial at the lower border of the gluteus maximus muscle. Based on this anatomic description, we developed a posterior approach with the following advantages: easy identification of the surface anatomy, superficial level of the nerve at this location; and less discomfort to patients since a 5 cm needle may be used. ⋯ This new approach is effective and easy. However, it is not indicated when the cutaneous femoris posterior nerve anesthesia is necessary.
-
Use of single-dose and continuous interscalene brachial plexus block (ISB) are gaining widespread popularity. When compared with general anesthesia, ISB has been reported to provide superior postoperative analgesia with fewer side effects, and it is associated with greater patient satisfaction. Anatomical landmarks are readily identifiable, which contributes to the ease of performing this block. In the future, we anticipate increased use of continuous interscalene catheters or injection of biodegradable local anesthetic impregnated microspheres to provide prolonged perioperative outpatient analgesia.
-
Letter Clinical Trial Controlled Clinical Trial
Sciatic nerve block and the improvement of femoral nerve block analgesia after total knee replacement.
-
Reg Anesth Pain Med · Nov 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialInfraclavicular plexus block: multiple injection versus single injection.
This prospective, randomized, and multicentered study was undertaken to evaluate the success rate of coracoid infraclavicular nerve block performed with a nerve stimulator when either 1 or 3 motor responses were sought. ⋯ We conclude that by performing an infraclavicular block with stimulation of all 3 cords of the brachial plexus, the success rate is higher than when only a single stimulation is used.
-
Reg Anesth Pain Med · Nov 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPostoperative analgesia by femoral nerve block with ropivacaine 0.2% after major knee surgery: continuous versus patient-controlled techniques.
This prospective study compared the efficacy and adverse effects after knee surgery of ropivacaine 0.2% administered as patient-controlled femoral analgesia (PCFA), as a continuous femoral infusion (Inf), or as both (PCFA+Inf). ⋯ All 3 strategies provided effective pain relief. PCFA resulted in a lower consumption of ropivacaine (toxic and financial impact). PCFA + Inf does not improve postoperative analgesia.