Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Differential sensory block: spinal vs epidural with lidocaine.
In this study we sought to determine if and when a difference exists with regards to differential sensory blockade between spinal and epidural anaesthesia using lidocaine. ⋯ Spinal and epidural anaesthesia with lidocaine produce a similar degree of differential sensory blockade. Epidural anaesthesia produces a detectable difference between the level of analgesia and cold sensation at various times, whereas spinal anaesthesia did not reliably do so in this study.
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Case Reports
Continuous blockade of both brachial plexus with ropivacaine in phantom pain: a case report.
A 39-year-old patient developed phantom pain after amputation of both upper arms following a burn injury. The pain did not respond to naproxen, morphine, carbamazepine, amitriptyline, calcitonin or transcutaneous electrical nerve stimulation (TENS). At the 39th post-operative day an axillary catheter was placed on the right side, as well as an interscalene catheter on the left. ⋯ Thus, the patient not only received analgesia, but also got an effective treatment of established phantom pain. A similar approach with bupivacaine may not have been feasible, because of the possibility of toxic side effects. Ropivacaine is a long-acting local anaesthetic which is less toxic than bupivacaine and has the additional advantage of producing less motor-blockade in the concentration used, so the patient was able to move actively without experiencing any pain.