Articles: nerve-block.
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Anesthesia and analgesia · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia after peripheral nerve block for podiatric surgery: clinical efficacy and chemical stability of lidocaine alone versus lidocaine plus clonidine.
Postoperative analgesia may be prolonged by the addition of clonidine to local anesthetic solutions used for regional anesthesia. The purpose of this study was to test this hypothesis in a clinical trial of patients undergoing podiatric surgery. The study design was prospective, double-blinded, and randomized. ⋯ Group C20 results suggested no statistically significant improvement over plain lidocaine. One patient in Group C20 experienced significant hypotension postoperatively. pH determinations and chemical analysis by capillary electrophoresis showed no significant change in composition of the solutions when clonidine was mixed with lidocaine and stored at 4 degrees C for 1 wk. Compared to 1.73% lidocaine, combining clonidine (10 micrograms/mL) with lidocaine for local anesthetic block for foot surgery significantly increases the duration and quality of postoperative analgesia.
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Anesthesia and analgesia · Oct 1996
Randomized Controlled Trial Clinical TrialAxillary brachial plexus anesthesia: electrical versus cold saline stimulation.
The aim of this study was to investigate which of two methods of nerve stimulation, cold saline-induced paresthesia or use of a nerve stimulator, was more effective in increasing the successful brachial plexus block rate by the axillary approach. Twenty patients were randomly assigned to Group A (saline below 11 degrees C), and 20 patients to Group B (nerve stimulator). All blocks were performed by the same anesthesiologist using 40 mL of 1.5% mepivacaine and 4 mL of 8.4% sodium bicarbonate. ⋯ A motor response was evoked by a nerve stimulator in 17 patients (85%). Two patients (10%) had a paresthesia in the hand without a motor response with the current at less than 1 mA. A successful block was achieved in 19 patients in each group.
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Anesthesia and analgesia · Oct 1996
The efficacy of axillary block for surgical procedures about the elbow.
Surgical procedures to the distal humerus, elbow, and proximal ulna and radius are ideally suited to regional techniques. However, axillary block is usually not recommended for surgery about the elbow because blockade at this level may result in inadequate block of the terminal nerves that arise from the medial, posterior, and lateral cords, and provide sensory innervation to the upper arm. This study reports the success rates for interscalene, supraclavicular, and axillary blocks for surgery about the elbow. ⋯ In addition, axillary blocks performed with mepivacaine had a higher success rate (93%) than those performed with bupivacaine (81%) (P < 0.01). There were no patients with perioperative respiratory compromise. These results demonstrate that the axillary approach to the brachial plexus may be successfully used for surgical procedures about the elbow.
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Randomized Controlled Trial Clinical Trial
Effect of transcutaneous electrical nerve stimulation on onset of axillary plexus block.
We examined the effect of high frequency transcutaneous electrical nerve stimulation on the onset of brachial plexus block. Three groups of patients scheduled for surgery of the hand had a local anaesthetic block performed with 40 ml mepivacaine 1.5% using the axillary approach. ⋯ There were no differences in the onset of block between the groups. Thus, the frequency-dependent action of local anaesthetics could not be demonstrated.