Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of propofol and remifentanil for sedation and limitation of movement during periretrobulbar block.
To compare clinical conditions in patients sedated with propofol or remifentanil during combined peri-bulbar and retrobulbar block (PRBB) for cataract surgery. ⋯ Respiratory depression with remifentanil was mild and not clinically significant. Remifentanil sedation for this application was superior to sedation with propofol.
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialEffect of impulse duration on patients' perception of electrical stimulation and block effectiveness during axillary block in unsedated ambulatory patients.
Chronaxie of the motor-neurons (A-alpha) is shorter than that of the sensory A-delta and C neurons. Therefore, a short current impulse should elicit a painless muscle twitch. This randomized, double-blind study of patients having ambulatory axillary block by multiple neurostimulations compared patients' perception of electrical stimulation, latency, and quality of analgesia and the incidence of adverse effects. ⋯ This study did not confirm our hypothesis that short-current impulses (0.1 ms) make neurostimulation of peripheral nerves painless, by selectively depolarizing motor-neurons. Longer impulses (0.3 ms) shorten block performance time, probably by easier location of the nerves, but the clinical relevance of this finding is doubtful.
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Anesthesia and analgesia · Sep 2001
Randomized Controlled Trial Clinical TrialInterscalene brachial plexus block with continuous intraarticular infusion of ropivacaine.
Providing intraarticular analgesia with a continuous infusion of local anesthetic via a disposable infusion pump has gained popularity. Despite the prevalence of this technique, data comparing this method of analgesia to conventional regional anesthesia are not available. We present a prospective study that compared a single-dose interscalene block with a single-dose interscalene block plus continuous intraarticular infusion of local anesthetic. ⋯ Visual analog scale scores at rest and with ambulation in the Mepivacaine/Intraarticular Ropivacaine group were reduced when compared with the Ropivacaine/Saline group (rest: P = 0.003, ambulation: P = 0.006). Oxycodone consumption was also decreased (28 +/- 21 mg vs 44 +/- 28 mg, P = 0.046), respectively. We conclude that a brachial plexus block with 1.5% mepivacaine and a continuous intraarticular infusion of 0.5% ropivacaine at 2 mL/h provides improved analgesia for minor surgery at 24 and 48 h versus a single-injection interscalene block with 0.5% ropivacaine.