Articles: nerve-block.
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Comparative Study
Effect of subarachnoid bupivacaine block on anesthetic requirements for thiopental in rats.
Subarachnoid bupivacaine blockade has been reported to reduce thiopental and midazolam hypnotic requirements in patients. The purpose of this study was to examine if local anesthetically induced lumbar intrathecal blockade would reduce thiopental requirements for blockade of motor responses to noxious and nonnoxious stimuli in rats. ⋯ This study demonstrates that lumbar intrathecally administered local anesthetic blockade decreases anesthetic requirements for thiopental for a spectrum of end points tested. This effect is due neither to altered pharmacokinetics nor to a direct action of the local anesthetic on the brain; rather, it is most likely due to decreased afferent input.
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Anesthesia and analgesia · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialThe use of a selective axillary nerve block for outpatient hand surgery.
Although no guidelines concerning discharge criteria after axillary plexus block are available, many institutions consider recovery of motor function as a critical factor. With the midhumeral approach, the four main nerves of the upper extremity can be blocked separately using a peripheral nerve stimulator. The aim of this double-blind study was to block the radial (R) and musculocutaneous (MC) nerves with lidocaine, and the median (M) and ulnar (U) nerves with bupivacaine to recover motor function of the elbow and wrist more rapidly while maintaining long-lasting postoperative analgesia at the operative site. Patients undergoing surgery for Dupuytren's contracture were randomized into two groups in a double-blind fashion: in the control group (n = 17), each of the four nerves was infiltrated with 10 mL of a mixture of 2% lidocaine and 0.5% bupivacaine, whereas in the selective group (n = 17), the R and MC nerves were blocked with 10 mL of 2% lidocaine each and the M and U nerves were blocked with 10 mL of 0.5% bupivacaine each. Recovery of motor block was significantly faster in the selective group (231 +/- 91 vs 466 +/- 154 min). However, time to first sensation of pain was not different between groups (707 +/- 274 vs 706 +/- 291 min). In conclusion, this new approach at the midhumeral level enables the anesthesiologist to selectively administer local anesthetics on different nerves. ⋯ In outpatients undergoing surgery for Dupuytren's contracture, a midhumeral block was used with the musculocutaneous and radial nerves blocked by lidocaine and the median and ulnar nerves blocked with bupivacaine. Recovery of motor function and time to discharge were shorter compared with patients who received the mixture on all four nerves.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesia for neonatal circumcision: a randomized controlled trial of EMLA cream versus dorsal penile nerve block.
To compare the efficacy of the dorsal penile nerve block (DPNB) with a less invasive form of local anesthesia, eutectic mixture of local anesthetic (EMLA) cream, for reduction of pain during neonatal circumcision. ⋯ DPNB provides better pain reduction during neonatal circumcision than EMLA cream. EMLA cream may provide pain reduction compared with no anesthesia during neonatal circumcision.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effect of EMLA and semicircular subcutaneous anaesthesia in the prevention of tourniquet pain during plexus block anaesthesia of the arm.
In 54 patients who were to undergo surgery of the upper extremity in plexus block anaesthesia the effect of 5 g EMLA (group E) on tourniquet pain was examined and compared with the effect of a semicircular subcutaneous anaesthesia using 10 ml 0.25% bupivacaine (group B) or 10 ml 1% mepivacaine (group M). Among the patients with satisfactory brachial plexus analgesia allowing for surgery (n = 51), the incidence of tourniquet pain was not significantly different between groups E, M and B. Notably, there was no significant difference in the time of tourniquet application. We conclude that topical application of EMLA is as effective as a semicircular subcutaneous anaesthesia with mepivacaine or bupivacaine in the prevention of tourniquet pain during brachial plexus anaesthesia.