Articles: nerve-block.
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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.
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Randomized Controlled Trial Clinical Trial
Alkalinisation of lignocaine to reduce the pain of digital nerve blockade.
To see if the alkalinisation of lignocaine caused a reduction in the pain of injection for digital nerve blockade. ⋯ Alkalinisation of lignocaine reduces the pain of injection for digital nerve blockade.
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Sciatic nerve block in the popliteal fossa (popliteal nerve block, PNB) is an anaesthetic technique well-suited for operations below the knee. However, difficulty with positioning the patient in the prone position often precludes the classical, posterior approach to the block. In this report, an alternative approach to PNB that can easily be performed with a patient in the supine position is described. ⋯ The supine approach to PNB allows the use of the block in patients that cannot be positioned in the prone position. Flexion of the leg at the knee greatly facilitates identification of the anatomical landmarks. When combined with a block of the femoral or saphenous nerve, this technique provides excellent anaesthesia for patients undergoing foot and ankle surgery.