Articles: nerve-block.
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Ann Fr Anesth Reanim · Jan 1996
Review[Three-in-one block or femoral nerve block. What should be done and how?].
The "3 in 1" block and the femoral nerve block are widely used for lower limb surgery and postoperative analgesia. Whether these blocks are in fact a same regional block with two different names or represent definitively two different blocks remains controversial. A large number of anatomical as well as functional variations of the lumbar plexus have been described and complicate a rational analysis of the spread of local anaesthetics following these blocks. ⋯ However, once the "3 in 1" block is well performed, a complete anaesthesia covering the territories of the femoral nerve, the lateral femoral cutaneous nerve, and the obturator nerve occurs. Specific indications of each technique are different: major knee surgery and postoperative analgesia for the "3-in-1" block and leg surgery for femoral nerve block. The best approach for knee arthroscopy remains open for discussion.
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Regional anesthesia · Jan 1996
A trigonometric analysis of needle redirection and needle position during neural block.
Successful regional anesthesia involves a three-dimensional visualization of anatomy and an informed approach to needle placement and repositioning. This study trigonometrically examines the relationship between needle insertion angle and resultant needle position. ⋯ Incremental needle redirection of 5 degrees allows a precise survey of neural and adjacent anatomy and results in approximately one half the change in needle position occurring with a 10 degree angle of redirection. However, a 10 degree angle of redirection may result in walking over the desired neural structure.
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J Comput Assist Tomogr · Jan 1996
Retrocrural splanchnic nerve alcohol neurolysis with a CT-guided anterior transaortic approach.
Retrocrural splanchnic nerve alcohol neurolysis with a CT-guided anterior transortic approach, a new method for splanchnic block alleviation of chronic abdominal pain, is described. Ten patients with chronic abdominal pain requiring narcotic treatment, six with pancreatic carcinoma, one with gastric carcinoma, two with chronic pancreatitis, and one with pain of unknown etiology, were referred for splanchnic nerve neurolysis. With CT guidance, a 20 gauge needle was placed through the aorta into the retrocrural space at T11-T12, and 5-15 ml 96% alcohol was injected into the retrocrural space. ⋯ There were no significant complications. CT-guided anterior transaortic retrocrural splanchnic nerve alcohol neurolysis is technically feasible, easier to perform than the classic posterolateral approach, and may have less risk of complications. The success rate in this initial trial was reasonable and, therefore, this technique provides an additional method for the treatment of abdominal pain.
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Paediatric anaesthesia · Jan 1996
Case ReportsTotal spinal anaesthesia following caudal block with bupivacaine and buprenorphine.
This is a case report of an 18-month-old 10 kg child who presented for emergency repair of a recurrent diaphragmatic hernia with a history of craniofacial dystosis and was given a caudal block postoperatively with a combination of 4 ml of 0.5% bupivacaine and 2.5 micrograms.kg-1 buprenorphine made up to a total volume of 10 ml. An inadvertent dural puncture occurred resulting in total spinal block which was managed symptomatically. ⋯ The patient's exposure to a large intrathecal dose of buprenorphine did not lead to prolonged respiratory depression. The possibility of a midbrain insult due to a sudden rise in intracranial pressure is also discussed.