Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lateral popliteal sciatic nerve block compared with ankle block for analgesia following foot surgery.
The purpose of this study was to compare postoperative analgesia after foot surgery in patients anaesthetised either with popliteal sciatic nerve block or ankle block. In a prospective study, 40 patients scheduled for foot surgery involving osteotomies were allocated randomly into one of two groups. Following induction of general anaesthesia, Group PS (n = 21) received a lateral popliteal sciatic nerve block and Group AB (n = 19) received an ankle block. ⋯ The ankle block appeared to be more reliable, providing more consistent analgesia in the PAR. Postoperative analgesia in Group PS lasted a median of 18.0 hr and in Group AB lasted 11.5 hr (P < 0.05). Both techniques provided effective analgesia after discharge home and high levels of patient satisfaction.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Clinical TrialDouble-blind randomized evaluation of intercostal nerve blocks as an adjuvant to subarachnoid administered morphine for post-thoracotomy analgesia.
Thoracotomy is associated with pain and compromised pulmonary function. Intercostal nerve blocks (INB) and subarachnoid morphine (SM) act on different portions of the pain pathway. Each is effective for post-thoracotomy pain relief. The combination of these two modalities in relieving post-thoracotomy pain and improving postoperative pulmonary function has not been investigated. ⋯ Although postoperative INB provided modest improvements in pain and pulmonary function when used as an adjuvant to 0.5 mg SM for post-thoracotomy analgesia, the benefits were transient. The authors do not recommend adding INB for patients undergoing lateral thoracotomy who receive 0.5 mg SM.
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Acta urologica Belgica · Sep 1995
Comparative StudyThe contribution of the obturator nerve block in the transurethral resection of bladder tumors.
This study was designed to evaluate the efficacy of local block of the obturator nerve to avoid it's stimulation during transurethral resection (TUR) or tumors localised on the lateral bladder wall. Forty-five patients were studied, in whom the TUR operations were performed under spinal anaesthesia. ⋯ In the first group no stimulation was observed while in 5 patients of the second group was not possible to totally resect the tumor due to the persistent stimulation of the obturator nerve. In conclusion the local block of the obturator nerve is an effective method to avoid it's stimulation, easily performed and without complications.
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Femoral nerve "sheath" for inguinal paravascular lumbar plexus block is not found in human cadavers.
To determine if a femoral nerve sheath capable of conveying local anesthetic to the lumbar plexus and the obturator nerve exists in human cadavers. ⋯ A femoral nerve sheath capable of conveying a solution to the cadaver lumbar plexus does not exist in human cadavers. Dye injected into the cadaver femoral nerve does not reach either the lumbar plexus or the obturator nerve. When 40 ml of methylene blue dye is injected into the cadaver femoral nerve, some dye usually diffuses under the iliacus muscle fascia to the lateral femoral cutaneous nerve. This study indicates that in patients the "3-in-1 block" always blocks the femoral nerve, it usually blocks the lateral femoral cutaneous nerve, but it probably does not block the lumbar plexus or the obturator nerve.
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During general anesthesia, different modes of nerve stimulation are used for estimation of the degree of neuromuscular blockade. When switching between the different modes, it is important to know whether the preceding mode influences the responses to the succeeding mode, and if so, for how long. The object of our study was to determine the number of stimulations required for stabilization of the muscular response when switching between double-burst stimulation (DBS) applied every 20 sec, train-of-four (TOF) applied every 12 sec, and posttetanic count (PTC) at surgical degrees of neuromuscular blockade. ⋯ When switching from DBS to TOF, 4 to 7 stimulations (56 to 92 sec) were required for stabilization of the T1 response. When switching from TOF to DBS, 3 stimulations (36 to 52 sec) were required for stabilization of the D1 response, and, finally, when switching from PTC to DBS, 5 to 11 stimulations (81 to 201 sec) were required for stabilization of the D1 response. Stabilization of D1 was faster following TOF than following PTC (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)