Articles: nerve-block.
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Acta Anaesthesiol. Sin. · Jun 1997
Case ReportsDyspnea resulting from phrenic nerve paralysis after interscalene brachial plexus block in an obese male--a case report.
Phrenic nerve paralysis is a common complication in interscalene brachial plexus block. This complication is often ignored by most anesthesiologists because no clinical symptoms occur in patients who have no underlying lung disease. ⋯ The decreased respiratory reserve and direct compressing effect of the abdominal organs on the diaphragm in the supine position are thought to be the risk factors in this obese patient. Also discussed are the incidence, diagnostic methods, clinical presentation and treatments of phrenic nerve paralysis during interscalene brachial plexus block.
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Anesthesia and analgesia · Jun 1997
Case Reports Randomized Controlled Trial Clinical TrialGlossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial.
A regional anesthetic technique formerly used in adults for tonsillectomy was adapted to provide posttonsillectomy pain relief in children. Injection of 3-10 mL of 0.25%-0.5% bupivacaine into each lateral pharyngeal space appeared to provide good postsurgical analgesia. A retrospective chart review failed to link the technique to airway-related complications. ⋯ We conclude that the volume and concentration of bupivacaine were sufficient to block the vagus nerves proximal to the take off of the recurrent laryngeal nerves and/or the hypoglossal nerves, resulting in severe UAO. The short distance between the hyoid and jugular foramen would predispose children and adults with a short neck to the development of this complication. In conclusion, bilateral local anesthetic injection into the lateral pharyngeal space may result in severe UAO and loss of protective reflexes.
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Randomized Controlled Trial Clinical Trial
ORG 9487 neuromuscular block at the adductor pollicis and the laryngeal adductor muscles in humans.
ORG 9487 is a new steroidal nondepolarizing muscle relaxant with a rapid onset of action. This study was designed to determine the neuromuscular blocking profile of ORG 9487 at the adductor muscles of the larynx and the adductor pollicis. ⋯ ORG 9487 has a rapid onset of action at the laryngeal adductor and the adductor pollicis muscles. Onset and duration of action are faster at the vocal cords than at the adductor pollicis muscle. However, the maximum block obtained at the laryngeal muscles was less than at the adductor pollicis, regardless of the dose of ORG 9487.