Articles: nerve-block.
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Femoral nerve palsy has been reported after percutaneous ilioinguinal field infiltration with general anaesthesia for inguinal herniorrhaphy. The mechanism whereby this could occur was studied in cadaver dissections. ⋯ Femoral nerve palsy may result from infiltration of a sufficient volume of local anaesthetic into the plane between the transversus abdominis muscle and the transversalis fascia with tracking of the injectate deep to the iliacus fascia to affect the femoral nerve. This finding has important implications for the performance of a percutaneous ilioinguinal field block particularly in day surgery provision.
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Randomized Controlled Trial Clinical Trial
Readiness for surgery after axillary block: single or multiple injection techniques.
We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1. In group 1 (single injection) the whole volume of mepivacaine was injected after locating only one of the plexus nerves. ⋯ The frequency of adverse effects (vessel puncture or paraesthesia) was similar in both groups. No neurological sequelae were observed. We conclude that the multiple injection technique takes longer to perform than single injection, but that readiness for surgery is faster because of shorter block latency and better spread of analgesia.
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Regional anesthesia · Mar 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of clonidine and epinephrine in lidocaine for cervical plexus block.
Carotid endarterectomy under cervical plexus block offers the advantage of awake neurologic assessment. The hypothesis was tested that the addition of clonidine 5 micrograms/mL to lidocaine 1.5% for the block is as effective clinically as the addition of epinephrine 5 micrograms/mL but without the associated tachycardia. ⋯ Clonidine 5 micrograms/mL is a useful additive to lidocaine 1.5% for cervical plexus block to reduce the incidence of tachycardia; however, omission of epinephrine results in higher serum lidocaine levels.