Articles: nerve-block.
-
Randomized Controlled Trial Clinical Trial
The efficacy of intraoperative internal intercostal nerve block during video-assisted thoracic surgery on postoperative pain.
Video-assisted thoracic surgery (VATS) is widely used for many thoracic surgical procedures. Post-operative pain is less after VATS than after conventional thoracic surgery, but is still significant. The objective of this study was to assess the efficacy of thoracoscopic, internal intercostal nerve block in alleviating immediate postoperative pain. ⋯ Thoracoscopic, internal intercostal nerve block with bupivacain 0.5% during VATS is safe and effectively reduced the immediate postoperative pain and analgesic requirements.
-
Anesthesia and analgesia · Dec 2000
Randomized Controlled Trial Clinical TrialInterscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump.
Continuous interscalene brachial plexus blockade traditionally requires a hospital stay for local anesthetic infusion, and achieving consistent catheter insertion may be difficult. Incorporating long-acting pain relief from a continuous peripheral nerve block, with a reliable method of catheter insertion, and a self-contained infusion system would be a valuable asset for short-stay care. We compared the efficacy of single injection interscalene brachial plexus blockade to a continuous peripheral nerve block, with an insulated Tuohy system and a disposable infusion pump. ⋯ In addition, initial interscalene blockade was successful in all patients and all redosed catheters were functional after 24 h with the continuous catheter insertion system. We conclude that it is possible to achieve a high rate of successful catheter placement and analgesia by using the continuous catheter insertion system and a disposable infusion pump in the ambulatory setting. This method of analgesia may offer improved pain relief after outpatient rotator cuff repair.
-
Clinical Trial
Penile prosthesis surgery under local penile block anaesthesia via the infrapubic space.
The aim of this study was to evaluate the effectiveness and patient tolerance to local penile block anaesthesia via the infrapubic space with penile prosthesis implantation. Local anaesthesia was administered using a 23-guage 1.5-inch needle. A 50-50 mixture of 0.5% bupivicaine (Marcaine) and 0.5% lidocaine (Xylocaine) without adrenaline was injected into the infrapubic space with additional subcutaneous penile ring infiltration at the level of the penile root. ⋯ In 148 (93%) patients, no booster sedation was needed; eight (5%) patients needed a boost of the pre-operative sedative during crural dilatation; three (1.8%) patients required general anaesthesia owing to insufficiently effective local anaesthesia and unexpectedly difficult dilatation. It is concluded that local anaesthesia was effective and safe to produce a pain-free procedure in 93% of cases. However, as the need for booster sedation or general anaesthesia exists, the procedure should be performed under monitored anaesthetic care and pre-operative evaluation should be performed as for general anaesthesia.
-
We present a case of a rapid onset reversible phrenic nerve block following vertical infraclavicular blockade of the brachial plexus. Five minutes after injection of local anaesthetics the SpO2 fell to 80%. ⋯ The postoperative X-ray showed an elevated diaphragm of the ipsilateral side. After five hours oxygen supply could be terminated, an X-ray control the next day showed normal bilateral diaphragm position.
-
Ugeskrift for laeger · Nov 2000
Randomized Controlled Trial Clinical Trial[Infusion of mivacurium and atracurium guided by manual tactile evaluation].
The aim of this investigation was to compare the use of a continuous infusion of mivacurium or atracurium guided by tactile evaluation of the neuromuscular block. ⋯ A continuous infusion of mivacurium and atracurium can easily be performed, guided by tactile evaluation of the neuromuscular block and the effect can be reversed by neostigmine.