Articles: nerve-block.
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Maxillary nerve blockade is not commonly used by general practitioners due to a lack of experience with the techniques involved and the fear of iatrogenic damage. Nevertheless, it represents an excellent method of producing profound anesthesia in the maxilla, with definite indications in selected instances. The anatomy and techniques associated with the maxillary block, as well as the indications, contraindications and complications are reviewed, and the use of the greater palatine foramen approach to treat a patient with a facial abscess is described.
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Neuroscience letters · Mar 1995
Contribution of the sciatic and saphenous nerve to the ventrobasal thalamic neuronal responses to pinch in rats with a chronic sciatic nerve constriction: a study using anesthetic blocks and nerve section.
To extend the study on the respective contribution of the sciatic and saphenous nerve in abnormal nociceptive responses observed in rats with a loose constriction of one sciatic nerve, neuronal responses to pinch applied to the territory of the injured nerve, recorded in the ventrobasal complex of the thalamus have been studied. Eleven neurones recorded in 11 rats with a nerve constriction since 15-19 days and clear abnormal pain-related behaviour to mechanical stimulus, were tested before and during an anesthetic block of the saphenous and/or of the sciatic nerve, and/or after the saphenous nerve section. Only the sciatic nerve block depressed significantly the pinch responses.
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Adjuvant analgesics are drugs that are not primarily used as analgesics but can produce analgesia in certain types of pain. Adjuvant analgesics can be administered together with non-opioid and opioid analgesics on each step of the WHO analgesic ladder. They should be given when an additional or specific indication exists, but should not be used as a substitute for a thorough treatment with opioids and nonopioids. ⋯ Biphosphonates (etidronate, clodronate, pamidronate derivates) also produce analgesic effects in patients with bone metastases. However, differences among the various compounds have not been clearly evaluated yet. Potent and specific radioisotopes are still under development and the use of calcitonin in bone pain is considered controversial.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialAddition of bicarbonate to plain bupivacaine does not significantly alter the onset or duration of plexus anesthesia.
In an effort to elucidate further the effect of alkalinization of bupivacaine on its anesthetic effect, a study was undertaken using alkalinized and non-alkalinized bupivacaine for lumbar plexus block and comparing the results with those obtained previously with brachial plexus block. ⋯ The data obtained in the present study indicate that alkalinization of non-epinephrine-containing bupivacaine does not reduce the latency or increase the duration of analgesia or anesthesia after lumbar plexus block. Since most of the studies that do show such an effect of alkalinization were carried out using epinephrine-containing bupivacaine, it is postulated that in those studies alkalinization contributed to the decrease in latency and increase in duration, not so much by providing an increased amount of local anesthetic in the free base form, but by reactivating epinephrine's vasoconstrictor activity, which is inactivated by a low pH.