Articles: nerve-block.
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Paediatric anaesthesia · Jan 1996
The rectus sheath block in paediatric anaesthesia: new indications for an old technique?
The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra- and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day-cases surgery.
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Cahiers d'anesthésiologie · Jan 1996
Randomized Controlled Trial Clinical Trial[Value of ilio-hypogastric block in appendectomy in children].
This prospective study aimed to evaluate the efficiency of ilio-hypogastric nerve block for control of post appendicectomy pain in children. Forty-two children aged 3-15 years scheduled for appendicectomy were anaesthetized in the same way. After randomization, a preoperative ilio-hypogastric nerve block was performed in 21 patients. ⋯ Five inefficient blocks were recorded. No complications were noted. Ilio-hypogastric block was found to be safe and efficient for control of post-appendicectomy pain in most children.
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Anesthesia and analgesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialIlioinguinal iliohypogastric nerve blocks--before or after cesarean delivery under spinal anesthesia?
Preoperative local anesthetic blockade of somatosensory pathways involved with skin incision and other noxious perioperative stimuli may "preempt" or attenuate the postoperative pain response. Since the Pfannenstiel incision lies within the L1 dermatome, bilateral ilioinguinal, iliohypogastric nerve blocks (IINBs) should provide analgesia after low transverse cesarean section. We designed this study to compare the analgesic effect of IINBs placed before or after cesarean delivery. ⋯ Patient satisfaction and morphine use did not differ among the groups. We conclude that there is no benefit to ilioinguinal nerve blocks, either before or after surgery, in patients who receive spinal anesthesia for elective cesarean delivery. Our finding of increased pain in the After group is perplexing and requires confirmation.
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Sciatic nerve block is considered difficult to perform, but very useful for lower limb anaesthesia and analgesia. The use of a nerve stimulator makes the technique easier. Functionally, it is better to consider that there are three independent sciatic nerves, namely, the posterior cutaneous nerve, the tibial nerve and the common peroneal nerve. Searching for blocking these three nerves and especially the latter two, specifically improve the reliability and quality of blockade.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Combined "3-in-1"/sciatic nerve block. Block effectiveness, serum level and side effects using 700 mg mepivacaine 1% without and with adrenaline and prilocaine 1%].
A high dose of local anaesthetic is necessary for the combined "3-in-1"/sciatic nerve block. Prilocaine is recommended for its low toxicity. However, in some patients prilocaine results in pronounced methaemoglobin formation due to toludine. Little has been known hitherto about the use of high-dose mepivacaine for the combined 3-1/sciatic nerve block. This study was undertaken to compare the use of 700 mg mepivacaine 1% and of 700 mg prilocaine 1%. ⋯ Both mepivacaine 1% and prilocaine 1% are appropriate local anaesthetics for the combined 3-in-1/sciatic nerve block at a dose of 700 mg. There was no difference in the blocking efficacy. No patient showed clinical signs or symptoms of a local anaesthetic toxicity. Following prilocaine we are sometimes faced with high methaemoglobinemia, which may necessitate prolonged monitoring.