Articles: nerve-block.
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Selective spinal nerve block is a useful tool in today's multidisciplinary approach to the diagnosis and treatment of low back pain. The indications, sources of spinal pain, block technique, result interpretation, complications and clinical applications relevant to the subject are discussed. ⋯ In some cases, therapeutic effect including that from surgical intervention can be achieved selectively at the symptomatic root. However, controversy remains and therefore well designed clinical studies are needed to provide more information about the validity of this diagnostic and therapeutic modality.
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To describes a technique of indwelling interscalene catheter placement and to evaluate its complications. ⋯ Indwelling catheter placement into the brachial plexus sheath as described in this communication was effective and associated with few complications.
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Oral Surg Oral Med O · Mar 1999
Randomized Controlled Trial Clinical TrialAnesthetic efficacy and heart rate effects of the supplemental intraosseous injection of 2% mepivacaine with 1:20,000 levonordefrin.
The purpose of this study was to determine the anesthetic efficacy and heart rate effects of a supplemental intraosseous injection of 2% mepivacaine with 1:20,000 levonordefrin. ⋯ We concluded that intraosseous injection of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine or 2% mepivacaine with 1:20,000 levonordefrin, used to supplement an IAN block, significantly increased anesthetic success in first molars and second premolars. The 2 solutions were equivalent with regard to intraosseous anesthetic success rate, failure rate, and heart rate increase after IAN block.
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Reg Anesth Pain Med · Mar 1999
Case ReportsAnxiety, vocalization, and agitation following peripheral nerve block with ropivacaine.
Central nervous system (CNS) and cardiovascular toxicity are potential side effects of local anesthetics. However, ropivacaine has been reported to be less CNS toxic than bupivacaine in human volunteers. ⋯ This case report shows that ropivacaine may cause CNS toxicity that differs from classical signs of local anesthetic-induced toxicity. This effect might be related to the unique structure of ropivacaine, which is formulated in an S-enantiomer preparation. It has been shown that S-enantiomers bind differently to receptors in both the CNS and cardiovascular systems. This property may account for the disinhibition of select neural pathways that are specifically involved in mediation of anxiety and aggression.