Articles: nerve-block.
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Anterior cruciate ligament (ACL) reconstruction is associated with significant postoperative pain, usually requiring parenteral narcotics. A prospective study of arthroscopically assisted autograft patellar tendon ACLR was initiated using Winnie's "three-in-one" femoral nerve block (FNB) as the primary means of postoperative pain control. Patient satisfaction and absence of parenteral narcotic use indicated clinical success. ⋯ The average duration of pain control was 29 hours and the majority of patients (79%) believed discharge was possible within 23 hours. There were two patients who failed to respond to FNBs (8%) and no major complications. FNB is a safe, reliable, and effective form of analgesia following ACLR, eliminating the need for parenteral narcotics.
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Anesthesia and analgesia · Aug 1995
Regional anesthesia and local anesthetic-induced systemic toxicity: seizure frequency and accompanying cardiovascular changes.
We sought to determine the contemporary frequency of seizures, and the associated cardiovascular changes, resulting from local anesthetic-induced seizures in all patients undergoing brachial plexus, epidural, and caudal regional anesthetics. We investigated the following variables: development and treatment of seizure or cardiac arrest during the regional anesthetic, type of anesthetic (including local anesthetic used), gender, age, ASA physical status class and type of operation (elective or emergent). In addition, each patient who experienced a seizure underwent retrospective review of the acute event to determine the arterial blood pressure and heart rate changes accompanying the seizure, as well as details of the regional block technique. ⋯ A significant difference was also noted in the rate of seizure development within types of brachial block, with supraclavicular and interscalene > axillary. No adverse cardiovascular, pulmonary or nervous system events were associated with any of the seizures, including the 16 patients who received bupivacaine blocks. The frequency of local anesthetic-induced seizures stratified by block type has a wide range, and cardiovascular collapse after bupivacaine-associated seizure has a low incidence.
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Int J Obstet Anesth · Jul 1995
Fiberoptic intubation using intraoral glossopharyngeal nerve block in a patient with severe preeclampsia and HELLP syndrome.
Rationale and technique for use of intraoral glossopharyngeal nerve block is described in a parturient with severe preeclampsia and a past history of difficult intubation. Indications and contraindications for administration of other forms of airway anesthesia are discussed.
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Regional anesthesia · Jul 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffects of brachial plexus fentanyl on supraclavicular block. A randomized, double-blind study.
The study examined the effects of adding fentanyl to mepivacaine supraclavicular blocks on block characteristics and postoperative analgesia. ⋯ Adding fentanyl 75 micrograms to mepivacaine supraclavicular blocks has no significant effects on block characteristics. It may enhance postoperative analgesia, but the duration of this effect is too brief to be clinically useful.