Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil or propofol for sedation during carotid endarterectomy under cervical plexus block.
During carotid endarterectomy under regional anaesthesia, patients often require medication to control haemodynamic instability and to provide sedation and analgesia. Propofol and remifentanil are used for this purpose. However, the benefits, side-effects, and optimal dose of these drugs in such patients are unclear. ⋯ As a result of the higher incidence of adverse respiratory effects with remifentanil and similar sedative effects, propofol is preferable for sedation during cervical plexus block in elderly patients with comorbid disease at the dosage used.
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In recent years there has been a renewed interest in regional anesthesia, particularly peripheral nerve blockade, in order not only to improve the patient's well being, but also to meet the requirements of modern orthopedic surgery. These requirements include appropriate conditions to perform early and efficient rehabilitation. ⋯ Early rehabilitation is currently a key point for the success of orthopedic surgery. The rapid development of peripheral nerve blockade gives the anesthesiologist the means to face this new challenge.
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A total of 35 patients who presented in the Accident and Emergency Department of University College Hospital with displaced distal radial fracture between January 2000 and March 2001 had reduction of the fracture under haematoma block using 10ml of 2% lignocaine. There was significant reduction of the pain following infiltration of the fracture site with lignocaine and significant pain reduction during manipulation compared to pain score at presentation. ⋯ All patients had good range of movement at 8 weeks after removal of Plaster of Paris and patients expressed satisfaction with this method. We recommend the use of Haematoma block for patients of 15 years and above with displaced distal radial fracture in the Accident and Emergency Department.