Articles: nerve-block.
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Regional anesthesia · Nov 1993
Comparative StudyComparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block.
This study compared the efficacy of three perivascular techniques of axillary block. ⋯ There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.
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Comparative Study
The efficacy and acceptability of using a jet injector in performing digital blocks.
This prospective, nonblinded study, comparing jet injection with needle-syringe injection of lidocaine in performing digital blocks, tested the hypothesis that jet injection can be used effectively as a less painful way to perform digital blocks. Twenty-four adult patients with injuries of the middle or distal phalanges of the fingers received digital blocks using a jet injector on one side of the finger and a needle-syringe on the other side; pain was assessed at 0, 1, 3, 6, 12, and 24 hours using visual analog scales. Differences in pain scores for the two procedures (jet injector vs needle) were tested at each time period using nonparametric statistical procedures for paired or matched data (paired Wilcoxon). ⋯ Comparisons made at the other points were statistically nonsignificant at .05. The anesthesia achieved using the jet injector was considered adequate in 23 of 24 patients. We conclude that the jet injector can be used effectively in performing digital blocks and is less painful than standard needle-syringe methods.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative local anaesthetic blocks in the diagnosis of cervical zygapophysial joint pain.
The utility of randomised, double-blind, controlled, comparative local anaesthetic blocks for the diagnosis of cervical, zygapophysial joint pain was studied in 47 patients with chronic neck pain following whiplash injury. Each patient was investigated with radiologically controlled blocks of the medial branches of the cervical, dorsal rami to anaesthetise the target cervical, zygapophysial joint. The blocks were performed using either lignocaine or bupivacaine, randomly allocated, and the patients' responses were assessed in a double-blind fashion. ⋯ The durations of pain relief obtained from the anaesthetics were consistent with the known characteristics of these drugs with bupivacaine lasting significantly longer than lignocaine (P = 0.0003). A subgroup of 13 patients were identified with unexpected, prolonged responses to one or both of the anaesthetics. Comparative, diagnostic blocks are a valid technique in the identification of painful zygapophysial joints, and constitute an implementable alternative to normal saline controls.