Articles: nerve-block.
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Paediatric anaesthesia · Jan 1997
Case ReportsBilateral continuous paravertebral block used for postoperative analgesia in an infant having bilateral thoracotomy.
We describe the successful postoperative pain management in an 11-month-old infant who underwent bilateral thoracotomy, using continuous infusions of bupivacaine into two directly placed paravertebral catheters. Haemodynamic parameters and pain scores were measured 1-2 h for 60 h while the infusions were continued and, intermittently, blood samples were taken for subsequent measurement of serum bupivacaine concentrations. ⋯ There were no adverse haemodynamic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occur.
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Acta Anaesthesiol Belg · Jan 1997
Randomized Controlled Trial Clinical TrialTenoxicam does not enhance the spread of sensory block produced by intrathecal lidocaine.
Systemic opioids enhance the spread of spinal analgesia. This study was designed to determine whether i.v. tenoxicam, a nonsteroidal anti-inflammatory drug (NSAID), affects the spread of sensory block produced by lidocaine. Sixty patients undergoing transurethral procedures were randomly assigned in a double blind design to receive i.v. either 3 ml normal saline (N/S group, n = 20), or 150 micrograms fentanyl (F group, n = 20), or 40 mg tenoxicam (T group, n = 20), 20 minutes after spinal anesthesia. ⋯ The overall change in the level of sensory block 15 minutes after i.v. treatment was -4.6 +/- 6.3 cm in the N/S group, 2.4 +/- 6.0 cm in the F group, and -1.6 +/- 5.8 cm in the T group. The F group differed from the N/S group (P < 0.01). Intravenous administration of tenoxicam does not enhance the level of spinal analgesia produced by lidocaine.
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The evolution of central segmental blockades was studied in 133 patients by using epidural and spinal anesthesias. The efficiencies of 2% Ultracaine (Hoechst) and 2% Lidocaine (Egis) solutions used for epidural anesthesia and 5% Ultracaine (Hoechst) and 0.75% Bupivacaine (Astra) hyperbaric solutions were evaluated. Central segmental blockade induced by Ultracaine was found to be similar to Lidocaine and Bupivacaine in clinical parameters. ⋯ No differences were found in the magnitude of hemodynamic changes both with various anesthetics and different types of segmental blockades. The findings make it possible to regard Ultracaine as an drug that has some advantage over Lidocaine for prolonged epidural anesthesia and similar to the latter in pharmacological characteristics. Ultracaine may be regarded as alternative to Bupivacaine for spinal anesthesia.
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Ann Fr Anesth Reanim · Jan 1997
Randomized Controlled Trial Clinical Trial[Brachial plexus block: effect of the addition of sufentanil to local anesthetic mixture on postoperative analgesia duration].
To compare the quality and the duration of analgesia produced by a supraclavicular brachial plexus blockade obtained with a mixture of lidocaine and bupivacaine when supplemented or not with sufentanil. ⋯ Sufentanil added to a mixture of lidocaine and bupivacaine increases twofold the duration of postoperative analgesia following branchial plexus blockade.
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Ann Fr Anesth Reanim · Jan 1997
Clinical Trial Controlled Clinical Trial[Interscalenic block and surgery of the shoulder. A prospective study of a continuous series of 167 patients].
To determine the relationship between minimal stimulating current and success rate of interscalene brachial plexus block (IBPB), to assess the quality of anaesthesia and postoperative analgesia, and to evaluate the benefits and drawbacks of this technique in shoulder surgery. ⋯ The correlation between minimal stimulating current and success rate has clearly shown the benefit of the nerve stimulation. IBPB, which provides a successful and efficient anaesthesia with minimal risk and satisfactory postoperative analgesia, has become the standard technique for shoulder surgery.