Articles: nerve-block.
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Clin. Orthop. Relat. Res. · Sep 2001
Applied anatomy of the axillary nerve for selective neurotization of the deltoid muscle.
Morphologic and internal topographic features of the axillary nerve were studied in 40 cadaveric shoulders to provide anatomic data for selective neurotization of the deltoid muscle in axillary nerve injury. The axillary nerve can be divided into three segments. Proximal to the subscapularis muscle, the axillary nerve is a single nerve trunk. ⋯ In 90% of cases, the posterior branch contains part or all nerve fibers to the posterior deltoid muscle. Nerve fibers to the teres minor and cutaneous sensory fibers are found in the posterior branch. In neurotization of the deltoid muscle, the best approach is to match the donor nerve to the lateral fasciculi group, which will give the highest percentage of reinnervation of the deltoid muscle.
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Oral Surg Oral Med O · Sep 2001
Clinical significance of the length of the pterygopalatine fissure in dental anesthesia.
This study determined the average length of the pterygopalatine fissure by using human cadavers. Recommendations are made to improve the success of maxillary nerve block injections. ⋯ Depth of penetration with a needle that is longer than that normally available is necessary to predictably ensure a successful maxillary nerve block.
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Acta Anaesthesiol Scand · Sep 2001
Evidence that spinal segmental nitric oxide mediates tachyphylaxis to peripheral local anesthetic nerve block.
Tachyphylaxis to sciatic nerve blockade in rats correlates with hyperalgesia. Spinal inhibition of nitric oxide synthase with N(G)nitro-L-arginine methyl ester (L-NAME) has been shown to prevent hyperalgesia. Given systemically, L-NAME also prevents tachyphylaxis. The action of L-NAME in preventing tachyphylaxis therefore may be mediated at spinal sites. We compared systemic versus intrathecal potency of L-NAME in modulating tachyphylaxis to sciatic nerve block. ⋯ The increased potency of intrathecal versus systemic L-NAME suggests a spinal site of action in inhibiting tachyphylaxis. Descending pathways are not necessary for the development of tachyphylaxis since it occurs even after T10 spinal cord transection. Thus tachyphylaxis, like hyperalgesia, is mediated at least in part by a spinal site of action.
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Case Reports
Ipsilateral thoraco-lumbar anaesthesia and paravertebral spread after low thoracic paravertebral injection.
We report ipsilateral thoraco-lumbar anaesthesia and paravertebral spread of contrast after injection through a thoracic paravertebral catheter that was placed at the right T8-9 spinal level for pain management in a patient with multiple fractured ribs. We review the literature and describe the subendothoracic fascial communication between the thoracic paravertebral space and the retroperitoneal lumbar paravertebral region, which we propose, is the anatomical basis for ipsilateral thoraco-lumbar anaesthesia and paravertebral spread of contrast in our patient.
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Anesthesia and analgesia · Aug 2001
A study of the paravertebral anatomy for ultrasound-guided posterior lumbar plexus block.
We investigated the feasibility of posterior paravertebral sonography as a basis for ultrasound-guided posterior lumbar plexus blockades. Posterior paravertebral sonography proved to be a reliable as well as accurate imaging procedure for visualization of the lumbar paravertebral region except the lumbar plexus.