Articles: nerve-block.
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Regional anesthesia · Jul 1997
Randomized Controlled Trial Clinical TrialContinuous axillary brachial plexus block for postoperative pain relief. Intermittent bolus versus continuous infusion.
The aim of this study was to compare the efficacy and safety of continuous axillary brachial plexus block by infusion and by intermittent injection of bupivacaine 0.25% in the management of postoperative pain. ⋯ Overall, both techniques provided safe and effective postoperative analgesia. As compared with continuous infusion, intermittent bolus administration resulted in lower plasma bupivacaine levels despite similar infusion rates.
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Regional anesthesia · Jul 1997
Comparative StudyIntraneural lidocaine uptake compared with analgesic differences between pregnant and nonpregnant rats.
Pregnant patients need less local anesthetic in order to obtain the same quality of functional block as nonpregnant patients. Our goal was to demonstrate a similarly increased functional susceptibility to local anesthetics in the awake pregnant rat during peripheral nerve block and to investigate the pharmacokinetic and/or pharmacodynamic mechanisms responsible for this phenomenon. ⋯ Block of peripheral neural function is prolonged in pregnant rats, and lidocaine content in the nerve is lower at a specific stage of neural block. These results are consistent with a pharmacodynamic mechanism for increased susceptibility to lidocaine neural block during pregnancy.
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Regional anesthesia · Jul 1997
Case ReportsBilateral fascia iliaca catheters for postoperative pain control after bilateral total knee arthroplasty: a case report and description of a catheter technique.
The pain following total knee arthroplasty can be associated with significant morbidity, especially in the elderly. Regional anesthetic techniques attenuate or eliminate postoperative pain, which may reduce this morbidity. ⋯ Lumbar plexus blockade with continuous local anesthetic infusion via the fascia iliaca compartment is an effective means of providing postoperative analgesia after total knee arthroplasty when epidural analgesia is contraindicated.
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Int J Obstet Anesth · Jul 1997
Bilateral trigeminal nerve palsy during an extensive lumbar epidural block.
A rare case of trigeminal nerve blockade arising in the course of obstetric lumbar epidural anaesthesia is described. There was extensive bilateral spread of nerve-block up to the C4 level with respiratory distress after top-up for caesarean section, and subsequent epidurography revealed high epidural spread of contrast. The mechanism of the trigeminal nerve palsy was the source of some controversy, particularly as to whether intracranial spread of local anaesthetic had occurred, possibly following accidental subdural or subarachnoid injection.
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Regional anesthesia · Jul 1997
Distribution of local anesthetic solution in retromediastinal block. Preliminary experimental results.
Interpleural anesthesia blocks pain perception from the thoracoabdominal wall without impairment of leg function. Bilateral interpleural anesthesia is not recommended because of possible bilateral impairment of respiratory function. Infiltration of the retromediastinum with local anesthetic might cause bilateral thoracoabdominal somatic block and block of sympathetic afferents from the abdominal cavity without impairing respiration. ⋯ Block of pain perception from the abdominal wall and cavity is possible by injection of local anesthetic into the retromediastinum via a catheter introduced through the esophageal diaphragm hiatus. The block would not be expected to impair respiratory or leg function. Its efficacy and safety have yet to be established.