Articles: nerve-block.
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Acta Anaesthesiol Scand · May 2002
Randomized Controlled Trial Clinical TrialEffect of alkalinization and/or hyaluronidase adjuvancy on a local anesthetic mixture for sub-Tenon's ophthalmic block.
pH adjustment and/or addition of hyaluronidase to local anesthetic drugs decrease the time to onset and prolong the duration of regional anesthetic techniques for ocular surgery. The objective of this study was to investigate whether these factors are effective also in sub-Tenon's block. ⋯ pH adjustment and/or addition of hyaluronidase to a mixture of lignocaine and bupivacaine did not shorten the time to onset of akinesia following sub-Tenon's technique. However, the addition of hyaluronidase was associated with a lower fraction of patients experiencing pain during surgery.
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Am. J. Obstet. Gynecol. · May 2002
ReviewParacervical block for labor analgesia: a brief historic review.
This historic review was written to clarify the known efficacy and side effects of paracervical blockade for labor analgesia. Although the popularity of the technique has diminished considerably, it continues to be used by some clinicians with ostensibly good results. The Cochrane Controlled Trials Register (CCTR;SR-PREG) and the electronic database MEDLINE were searched for studies reported in English to determine efficacy and side effects of paracervical block. ⋯ Postparacervical block fetal bradycardia is the most significant side effect with a reported incidence ranging from 0% to approximately 40%. Overall, it appears that the incidence of postparacervical block fetal bradycardia is approximately 15%. However, the etiology of the observed fetal bradycardia remains unclear, and the incidence of adverse impact on fetal or neonatal outcome remains uncertain because there are too few trials with too few patients.
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Patients receiving anticoagulants offer a challenge to anaesthesiologists. The issue of spinal haematoma following central neuraxial block in such patients is a contentious issue. Although rare, with an estimated incidence of < 1:150,000 for epidural blocks and 1:220,000 for spinal anaesthetics in patients with normal coagulation status, this is an emergency situation with a potentially grave prognosis. ⋯ Of the 60 cases reported in the literature, 33% occurred following central neuraxial block and, of these, 55% were associated with concomitant use of anticoagulants. The pharmacology of the newer and older anticoagulants is also described. The variety of risk factors and diverse recommendations that have been described in these patients are reviewed.
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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.
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J Bone Joint Surg Am · May 2002
Scalene regional anesthesia for shoulder surgery in a community setting: an assessment of risk.
A retrospective review of shoulder procedures using scalene block anesthesia was performed. ⋯ Informed consent discussions regarding scalene block anesthesia should include information on the prevalence of complications and the efficacy of the technique.