Articles: nerve-block.
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For correction of a shoulder instability (Bankart's operation) in a 33-year-old woman, a combined regional and general anaesthesia was chosen. An interscalene catheter to block the brachial plexus was placed preoperatively without complication. The following day this resulted in an upper extremity almost without motor function and with complete hypoesthesia of the dermatomes C5-C7. ⋯ Stimulation of the three truncs of the brachial plexus was possible and showed electrophysiological signs of recovery of distal parts of the plexus. After 2 years no clinical corresponding recovery could be observed. Despite all investigations (electroneuromyography, evoked potentials, etc.) no clear etiology could be established to explain this adverse outcome.
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Rev Esp Anestesiol Reanim · Jun 2002
Randomized Controlled Trial Comparative Study Clinical Trial[Duration and quality of postoperative analgesia after brachial plexus block for shoulder surgery: ropivacaine 0.5% versus ropivacaine 0.5% plus clonidine].
Some authors have found that nerve blocks with local anesthetics may last longer if clonidine is added. The present study analyzed the duration and quality of analgesia provided by an interscalene brachial plexus block for shoulder surgery using 0.5% ropivacaine or 0.5% ropivacaine with added clonidine. ⋯ Adding 40 micrograms of clonidine to 200 mg of 0.5% ropivacaine does not prolong the sensory-motor block or improve the quality of analgesia in the early postoperative period.
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Regional anesthesia of the hand can be used in a vast array of hand injuries and minor operations. Local infiltration techniques require multiple injections and higher doses of anesthetic the that make them less preferable to peripheral nerve blocks. Regional anesthesia can be safe and effective as long as the provider has a firm understanding of the anatomy and technique. Multiple peripheral nerve blockade at the wrist can be a safe means of exploring complex wounds to the hand in both the emergency department and the operating room with minimal tissue distortion.