Articles: nerve-block.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous infusion is superior to bolus doses with thoracic paravertebral blocks after thoracotomies.
This study was designed to determine whether a continuous thoracic paravertebral infusion of bupivacaine (continuous TPVI) offers a higher quality of analgesia than a bolus regimen after thoracotomy. ⋯ Results suggest that continuous TPVI provides better pain control than the bolus regimen after this kind of surgery.
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Anesthesia and analgesia · Aug 1996
Randomized Controlled Trial Clinical TrialDigital pressure during interscalene block is clinically ineffective in preventing anesthetic spread to the cervical plexus.
The application of digital pressure above the injection site during interscalene block has been advocated to prevent cephalad spread of local anesthetic. In prior studies, radiographs taken immediately after interscalene injection of radiographic contrast have supported this concept. However, the clinical efficacy of digital pressure has not been previously tested. ⋯ Peak sensory level of anesthesia to pinprick was not significantly different between groups, each group having mean levels of C-2 to C-3. Digital pressure was ineffective in limiting the flow of local anesthetic into the cervical plexus. Digital pressure influenced neither the incidence of diaphragmatic paresis nor the resulting large decreases in pulmonary function that result from interscalene block.
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J Orthop Sports Phys Ther · Aug 1996
Glenohumeral gliding manipulation following interscalene brachial plexus block in patients with adhesive capsulitis.
Previous studies describing nonconservative treatment of shoulder adhesive capsulitis include distention arthrography, brisement techniques, arthrotomy of the anterior/inferior axillary fold and subscapularis tendon, and manipulation under general anesthesia. The purpose of this study was to develop and describe an alternative treatment method that utilizes glide manipulation under interscalene brachial plexus block. Eight patients (four females and four males), age 31-55 years, with a mean age of 44 years, were treated conservatively for adhesive capsulitis of the shoulder and failed to produce increased measurable objective active or passive ranges of motion. ⋯ At the time of discharge, average increases in passive range of motion/active range of motion for flexion, abduction, external rotation, and internal rotation were 76/67 degrees, 82/73 degrees, 50/44 degrees, and 49/40 degrees, respectively. All patients manipulated showed increases in function, such as overhead activities, dressing activities, and hair care. These preliminary findings show that effective gliding manipulation can be carried out under regional blockade and performed in an office setting by practitioners knowledgeable in manipulation techniques.
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Rev Esp Anestesiol Reanim · Aug 1996
Randomized Controlled Trial Clinical Trial[Comparison of the double burst stimulus with the train-of-four stimuli in monitoring muscle relaxation during anesthesia].
To compare double burst stimulus (DBS) and the train-of-four stimuli (TOF) for monitoring neuromuscular blockade during anesthesia in terms of muscle relaxation requirements, dose of anticholinesterase agents and the possibility of postanesthetic residual relaxation. ⋯ The use of DBS increased the vecuronium dose required during anesthesia and risk in those patients who arrived at the PARU with residual muscle block (T4/T1r < 70%).
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The heads from 6 mature male wapiti and 8 mature male fallow deer were dissected to provide a description of the nerves supplying the antler pedicles. Innervation in both species was found to resemble that of the red deer, with major contributions coming from the infratrochlear and zygomaticotemporal nerves. ⋯ The dorsal branches of the 2nd cervical nerve were isolated in each head but could not be traced to the pedicles. Failure to induce anesthesia of the antler employing specific nerve blocks on the infratrochlear and zygomaticotemporal nerves can occur if the dorsal branch of the auriculopalpebral nerve is not blocked.