Articles: nerve-block.
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Fracture of the femoral neck (FNF) is a significant cause of morbidity and mortality in the elderly, and the elderly with FNF are often high-risk patients for anesthesia. We studied 15 patients above 80 years of age with severe physical status (ASA III-IV). ⋯ After the operation, morphine 2 mg was administered subcutaneously. In our experience, the majority of 15 patients cardiovascular status of remained stable, except one patient who needed ephedrine for hypotension and another patient who needed diclofenac sodium for post-operative pain relief.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialRegional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques.
The purpose of this prospective, randomized study was to evaluate the time required to perform anaesthesia, achieve surgical block and fulfil standardized discharge criteria in outpatients receiving knee arthroscopy with either spinal anaesthesia or combined sciatic-femoral nerve block. ⋯ In patients receiving elective outpatient knee arthroscopy, using a combined sciatic-femoral nerve block with 25 ml of mepivacaine 20 mg ml(-1) and a multiple injection technique results in a slightly longer preoperative time but provides similarly effective anaesthesia with no differences in home discharge times as compared to spinal anaesthesia with 8 mg hyperbaric bupivacaine.
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Randomized Controlled Trial Clinical Trial
Extent of hyperbaric spinal anesthesia influences the duration of spinal block.
The influence of spread of spinal anesthesia on the duration of spinal blockade has been suggested but never investigated specifically. Because elimination of local anesthetic from subarachnoid space is probably dependent of the surface available for its diffusion and vascular absorption, the current study was designed to evaluate the hypothesis that with a same dose of hyperbaric bupivacaine, a higher anesthetic level would result in a shorter duration of spinal blockade than a lower level. ⋯ The results indicate that with the same dose of hyperbaric bupivacaine, the duration of spinal blockade is longer in patients with restricted spread.
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The psoas compartment acts as a conduit for the nerve roots of the lumbar plexus. Originating at approximately the 12th thoracic vertebrae, this potential compartment continues on caudally, bordered posterolaterally by fascia of the quadratus lumborum and iliacus muscles, medially by the fascia of the psoas major muscle, and anteriorly by the transversalis fascia. ⋯ Spread of the anesthetic to all roots of the plexus occurs in 15 to 20 minutes. Profound sensory and motor blockade can be achieved providing surgical anesthesia as well as long duration postoperative pain relief.