Articles: nerve-block.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of intra-articular lignocaine and a suprascapular nerve block for acute anterior shoulder dislocation.
We compared the analgesic effects of a suprascapular nerve block with intra-articular local anaesthetic in 20 patients presenting with acute anterior glenohumeral dislocations. The intra-articular local anaesthetic technique was a simpler procedure which provided significantly more analgesia for patients.
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Comment Letter Clinical Trial
Ambulatory surgical management of breast carcinoma using a paravertebral block.
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Anesthesia and analgesia · Feb 1997
A common epineural sheath for the nerves in the popliteal fossa and its possible implications for sciatic nerve block.
Sciatic nerve block in the popliteal fossa is associated with a highly variable success rate. Frequently, anesthesia is profound in the distribution of both the tibial (TN) and common peroneal nerves (CPN), although the response to nerve stimulation or paresthesia is obtained in the distribution of one division of the nerve. However, anesthesia in the distribution of only one division of the nerve is also a common occurrence under apparently identical clinical circumstances. ⋯ In a majority of the legs, the dye reached the division of the sciatic nerve in the popliteal fossa, bathing both the TN and CPN. Gross inspection and histologic examination of the sciatic nerve specimens revealed a common epineural sheath enveloping the TN and CPN. The presence of the common epineural sheath and its characteristics may have important clinical implications for sciatic nerve blockade in the popliteal fossa.
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Anesthesia and analgesia · Feb 1997
Comparative StudyContinuous popliteal sciatic nerve block: an original technique to provide postoperative analgesia after foot surgery.
Our study describes an original technique of continuous popliteal sciatic nerve block (CPSB) (Group A, 60 patients) and compares its analgesic efficacy after foot surgery with intramuscular (IM) opioids (Group B, 15 patients) and intravenous patient-controlled analgesia (IV PCA) with morphine (Group C, 45 patients). CPSB was performed using Singelyn's landmarks. The sciatic nerve was localized with a short-beveled needle connected to a peripheral nerve stimulator. ⋯ Only 8% of patients required postoperative opioid in Group A compared with 91% and 100% in Groups B and C, respectively. No immediate or delayed complications other than postoperative technical problems (kinked or broken catheter 25%) were noted in Group A. In conclusion, CPSB is easy to perform, safe, and a more efficient technique than parenteral opioid for providing postoperative analgesia after foot surgery.
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Parascalene block is a technique of blocking the brachial plexus at the lateral border of the anterior scalene muscle superior to the clavicle. The objective of this study was to define the position of the needle in parascalene block with relationship to the brachial plexus and the dome of the pleura, which is important in determining whether this technique minimizes the incidence of pneumothorax. In the first group, 10 patients scheduled for minor upper extremity surgery agreed to parascalene block, which was performed in the computed tomographic examination room. ⋯ The distances from the skin to the interscalene groove and the interscalene groove to the first rib at the level of the needle insertion or the marker in both groups were measured to be 17 +/- 4 mm and 15 +/- 3 mm, respectively. This study suggests that the level of the parascalene needle entry is superior to the dome of the pleura. At this level, the incidence of pneumothorax should be minimized.