Articles: nerve-block.
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Acta Anaesthesiol Scand · Aug 2002
Patients' experiences with multiple stimulation axillary block for fast-track ambulatory hand surgery.
Ambulatory axillary block by multiple nerve stimulation (MNS) is effective and time efficient, but may be rejected by patients because of block pain. This prospective study assessed patients' anxiety and acceptance of this block, identified which of the components of blocking procedure is most painful (i.v. line insertion, repeated needle passes, local anesthetic injection, or electrical stimulation) and recorded patients' anesthetic preferences for the future hand surgery. ⋯ Fear of block pain is diminished after experiencing the blocking procedure. Electrical stimuli was perceived as painful by 53% of patients, and this pain was more intense than with other block components. The majority of our patients would choose axillary block without sedation for future hand surgery and are satisfied with fast-tracking.
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Case Reports
[A case report of hemidiaphragmatic paresis caused by interscalene brachial plexus block].
A 76-yr-old woman was scheduled for left upper extremity orthopedic procedure. Preoperative examinations were within normal limits except forced vital capacity. Interscalene brachial plexus block with 0.25% bupivacaine 15 ml, was performed under general anesthesia. ⋯ A chest X-ray demonstrated the elevation of hemidiaphragm. She was diagnosed as ipsilateral hemidiaphragmatic paresis, treated with oxygen inhalation under deep breathing for approximately one hour, and then transferred to the common ward. We conclude that respiratory movement should be carefully observed following interscalene brachial plexus block especially in geriatric patients.
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We developed a continuous lateral sciatic nerve infusion technique for postoperative analgesia. ⋯ Continuous lateral sciatic infusion of 0.2% ropivacaine represents an alternative for acute postoperative pain control after major ankle and foot surgery.
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Peripheral nerve blocks are almost always performed as blind procedures. The purpose of this study was to test the feasibility of seeing individual nerves of the brachial plexus and directing the block needle to these nerves with real time imaging. ⋯ The use of ultrasound appears to permit accurate deposition of the local anaesthetic perineurally, and has the potential to improve the success and decrease the complications of infraclavicular brachial plexus block.
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J. Perianesth. Nurs. · Aug 2002
Case ReportsComplex Regional Pain Syndrome in the ambulatory surgical care setting.
This article provides an historical synopsis from the 17th century to the present regarding the disease process known as Complex Regional Pain Syndrome (CRPS) Type I. An overview of the disease symptoms, plausible theories, and a review of the pain cycle, relief measures, and a case scenario are reported. The focus of pain blockade was chosen because this was the intervention used in this particular case. The author presents the holistic standpoint of the importance of incorporating complementary alternative medical practices (CAMP) to enhance a positive outcome for this client. ⋯ -Based on the content of this article, the reader should be able to (1) distinguish the main characteristic between CRPS Type I (reflex sympathetic dystrophy) and CRPS Type II (causalgia); (2) identify symptoms related to CRPS Type I; and (3) identify the stages of CRPS and state potential interventions used in the treatment of CRPS Type I.