Articles: nerve-block.
-
Reg Anesth Pain Med · May 2002
Case ReportsMandibular nerve block treatment for trismus associated with hypoxic-ischemic encephalopathy.
We describe the use of mandibular nerve block for the management of bilateral trismus associated with hypoxic-ischemic encephalopathy. ⋯ Mandibular nerve block may be an effective treatment for patients with bilateral trismus due to ischemic-encephalopathy, even when consciousness is impaired.
-
The infraclavicular vertical brachial plexus block, first described by Kilka and coworkers, offers a more proximal spread of anaesthesia for the upper extremity than the classic axillary approach. In this technique, the puncture site is defined as lying at the exact centre of an infraclavicular line (k) between the jugular fossa and the ventral process of the acromion. Our study was designed to determine whether the point so defined (P) corresponds with the optimal puncture site determined sonographically (S) and to develop an improved prediction model. ⋯ The suggested modification should help to increase the success rate of the infraclavicular vertical brachial plexus block while decreasing the rate of potentially severe complications, although individual ultrasonographic guidance is to be recommended whenever possible.
-
Anesthesia and analgesia · May 2002
Case ReportsSpinal anesthesia as a complication of brachial plexus block using the posterior approach.
In this case report we describe a technique used to provide local analgesia for surgical procedures. Although this technique has a reduced risk of complications, we present a patient who experienced a life-threatening paralysis without loss of consciousness during an attempted brachial plexus block with a posterior approach.
-
Anesthesia and analgesia · May 2002
Selective and long-lasting neural blockade with resiniferatoxin prevents inflammatory pain hypersensitivity.
Capsaicin can produce a selective and long-lasting neural blockade. Resiniferatoxin (RTX) is an ultrapotent vanilloid agonist with a unique spectrum of activities different from that of capsaicin. We sought to determine whether a single application of RTX to a peripheral nerve could completely prevent the long-lasting mechanical hyperalgesia caused by carrageenan injection. In rat experiments, RTX (0.001%) was administered percutaneously to the sciatic and saphenous nerves before the intraplantar injection of carrageenan. Responses to noxious mechanical (pressure on the paw) and thermal (hot plate) stimulations and changes in paw circumference were measured at various time intervals for 8 days after treatment. The administration of RTX resulted in mechanical and thermal hypoalgesia (for 2 and 8 days, respectively). Inflammatory hyperalgesia was completely prevented by the precarrageenan injection of RTX. Inflammatory enhancement of paw circumference was reduced by RTX (12.0 +/- 2.4 mm versus 6.9 +/- 3.4 mm, P < 0.005). We suggest that the selective nature of the effect of vanilloid agonists on nociception could provide an opportunity for prolonged neural blockade when early mobilization and/or preservation of protective sensation are required. ⋯ We report that an ultrapotent vanilloid agonist resiniferatoxin can provide a selective and long-lasting neural blockade. Applied to the sciatic and saphenous nerves, it completely prevented pain hypersensitivity caused by prolonged inflammatory process (injection of carrageenan into the paw).
-
Randomized Controlled Trial Clinical Trial
Bilateral fine-needle administered local anaesthetic nerve block for pain control during TRUS-guided multi-core prostate biopsy: a prospective randomised trial.
Transrectal multi-core biopsies of the prostate can cause substantial discomfort with the need for high dose systemic analgesics. In a prospective randomised trial we investigated the efficacy of fine-needle administered local anaesthesia for bilateral prostatic nerve block prior to transrectal ultrasound (TRUS) guided prostate biopsy. ⋯ Bilateral local anaesthesia nerve block prior to multi-core TRUS-guided prostate biopsy significantly reduces pain independent of the number of cores taken.