Articles: nerve-block.
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The clinical utility of a new parasacral approach for conduction block of the sciatic nerve was investigated, with critical examination of onset, extent, and success rates when this block was used for surgical procedures below the knee. ⋯ The parasacral approach to the sciatic nerve exhibits a high success rate, resulting in anesthesia of the entire sacral plexus and generally in motor block of the obturator nerve was an interesting observation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Priming with rocuronium accelerates the onset of neuromuscular blockade.
To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. ⋯ Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.
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Randomized Controlled Trial Clinical Trial
The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution.
Ninety patients undergoing scheduled upper limb orthopaedic surgery were studied to determine the optimal anaesthetic dose using the 'orthogonal two-needle technique'. The patients were randomly assigned to one of three groups to receive one of three different volumes (20, 30 and 40 mL) (n = 30) of anaesthetic solution (a mixture of equal parts of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine). A significant correlation was found between the volume injected and the anaesthetic spread for all tested areas. ⋯ The comparisons between the 20 mL group and the other two groups are significant in all the tested areas, as well as the comparisons between 30 and 40 mL groups in the areas innervated by radial and musculocutaneous nerves. Only the area innervated by the axillary nerve showed a weaker volume-analgesia relation, confirming the elusiveness of this area to anaesthesia in the axillary approaches. The improved results observed using greater amounts of anaesthetic solution might result from a higher intrasheath pressure with disruption of sheath septa, or from a greater availability of drug for all the terminal branches of brachial plexus, or both.
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Anesthesia and analgesia · May 1997
Clinical Trial Controlled Clinical TrialQuantitative assessment of differential sensory blockade after lumbar epidural lidocaine.
A cutaneous current perception threshold (CPT) sensory testing device measures both large and small diameter sensory nerve fiber function and may be useful in evaluating differential neural blockade. Eight subjects received both lumbar epidural saline and lumbar epidural lidocaine. Five milliliters of normal saline was administered and the CPTs were measured. ⋯ There was a significant decrease in touch, pinprick, and cold sensation at the umbilicus and knee and a significant decrease in the cold sensation at the great toe. There was no effect on any measurements made at the mastoid. Epidural lidocaine resulted in a differential neural blockade as measured by a CPT monitor but not with crude sensory measurements.
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A cross-sectional study. ⋯ When the appropriate technique is used, medial branch blocks are target specific. To guard against false-negative responses due to intravenous up-take, contrast medium must be used before the injection of local anaesthetic.