Articles: nerve-block.
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Sustained nerve trauma is unlikely in a block. Local anaesthetics need time to work--the bigger the nerve the longer they need. ⋯ Very young children and the frail elderly are more susceptible to cardiac toxicity. When used appropriately adrenaline slows the uptake of local anaesthetic into plasma.
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The interscalene brachial plexus block with and without a catheter has become an indispensable method for anaesthesia and analgesia in shoulder surgery. Not only thorough knowledge of anatomy, but also accurate indication assessment and discussion with the surgeon regarding the location of access, is essential for the successful practice of this technique. Important and practical tips for implementation should especially help the less experienced, with special emphasis on correct positioning of the patient for surgery to avoid iatrogenic neural damage. Preoperative counselling of inevitable side-effects of the technique enhances the patient's acceptance and satisfaction.
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General anaesthesia and peripheral neuronal blockade are techniques which were introduced into clinical practice at the same time. Although general anaesthesia was accepted significantly faster due to effective new drugs and apparent ease of handling, neuronal blockade has recently gained great importance. The reasons are in particular newer aids such as industrially produced catheter sets, nerve stimulators and ultrasound guidance which have facilitated that these economical techniques can be used not only for intraoperative anaesthesia but also for perioperative analgesia without any major risks for the patients. ⋯ By using low concentrations of these potent drugs even for a longer period of time, no toxic plasma levels are seen with the exception of artificial intravasal injections. Additives such as opioids and alpha 2-sympathomimetics are also used. While the use of opioids is controversial, alpha 2-sympathomimetics are able to accelerate the onset and to extend the duration of regional anaesthesia and analgesia.
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Arch Phys Med Rehabil · May 2001
Comparative StudyPhenol block of peripheral nerve conduction: Titrating for optimum effect.
To verify the dose-response relationship in phenol nerve block and to determine the concentration and volume of phenol injectate required for effective nerve conduction block. ⋯ The nerve block effect of phenol can be titrated by adjusting the concentration and volume of phenol solution if the technique of application and localization of a block site are standardized.
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Acta Anaesthesiol Scand · May 2001
Inclusion of lignocaine base into a polar lipid formulation--in vitro release, duration of peripheral nerve block and arterial blood concentrations in the rat.
Slow-release formulations of local anaesthetics may produce nerve blocks of long duration. The present study aimed at investigating the in vitro and in vivo properties of a polar lipid formulation for slow release of lignocaine and the effects on nerve block duration by inclusion of dexamethasone into the system. ⋯ Our findings indicate that lignocaine base in polar lipids acts as a slow-release preparation of local anaesthetic both in vitro and in vivo.