Articles: nerve-block.
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Quantitative behavioral testing is necessary to establish a reproducible measure of differential functional blockade during regional anesthesia. Methods for assessment of the neurologic status (mental status, posture, gait, proprioception, motor function, autonomic function, and nociception) in veterinary neurology were adapted for the rat and used to monitor functional changes separately during a sciatic nerve block. ⋯ Quantitative observations of the onset, offset, and intensity of differential functional impairment or block over time will make it possible to establish the doses and conditions for local anesthetics that result in differential nerve block and will permit comparison of these changes among different drugs and "clinical" protocols.
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J Neurosurg Anesthesiol · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of anesthetic techniques for awake intubation in neurosurgical patients.
Two different methods of achieving upper airway anesthesia for awake fiberoptic intubation were prospectively compared in patients undergoing surgery for cervical spine instability. Forty patients were randomized to either topical anesthesia or nerve block groups. Topical anesthesia patients were administered nebulized 4% lidocaine (approximately 20 ml) via the oropharynx plus a transtracheal injection of 4% lidocaine (3 ml). ⋯ Ten minutes later there was no difference for plasma lidocaine concentration between groups. No patients had evidence of seizures or neurologic change during the procedure. There was no difference in patient perception of discomfort during the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Effect of arm position on the effectiveness of perivascular axillary nerve block.
The influence of arm position on the effectiveness of perivascular axillary nerve block with a catheter was assessed prospectively in two groups of patients. Ninety patients were allocated randomly to receive 1% mepivacaine with adrenaline 40 ml with the arm either adducted or abducted. ⋯ There were no statistically significant differences in onset time, spread of analgesia, motor block or success rate between the two groups. Proximal flow of the local anaesthetic-contrast agent mixture was neither facilitated by arm adduction nor was it necessary for the development of a successful block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antagonism of pancuronium- and pipecuronium-induced neuromuscular block.
We have compared the antagonism of neuromuscular block produced by pipecuronium with pancuronium in 80 anaesthetized surgical patients using mechanomyography and electromyography. Pancuronium 0.1 mg kg-1 or pipecuronium 0.07 mg kg-1 was given after induction of anaesthesia and neuromuscular block was adjusted to 75% twitch depression at the time of antagonism. The following regimens were used: edrophonium 0.5 and 1.0 mg kg-1, neostigmine 0.04 mg kg-1, pyridostigmine 0.3 mg kg-1 and edrophonium 0.25 mg kg-1 with pyridostigmine 0.15 mg kg-1. ⋯ However, TOF fade antagonism was more complete with pyridostigmine, neostigmine and edrophonium 1.0 mg kg-1 than with edrophonium 0.5 mg kg-1. The head lift test indicated somewhat less antagonism with edrophonium 0.5 and 1.0 mg kg-1. Using five monitoring methods, the rank order of reversal potency was: pyridostigmine approximately neostigmine > edrophonium 1.0 mg kg-1 > edrophonium+pyridostigmine > edrophonium 0.5 mg kg-1.
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Two hundred children underwent day-care surgery using peripheral nerve blockade as an adjunct to general anaesthesia during a twelve month period. Total post-operative analgesia was achieved in 86%, simple oral analgesia was needed in 9% and the remaining 5% of patients required systemic opiate administration for pain.