Articles: nerve-block.
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Neuroblockade techniques can serve many functions in the management of the chronic pain patient. These various functions are discussed and a brief insight given for their use in specific pain syndromes. A run-down of the type of blocks useful in the management of cancer pain is also given.
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Comparative Study
Comparison of neostigmine-induced recovery with spontaneous recovery from mivacurium-induced neuromuscular block.
In 24 ASA I-II adults anaesthetized with thiopentone, fentanyl and nitrous oxide in oxygen, we studied neuromuscular transmission with isometric adductor pollicis monitoring. Patients received mivacurium 0.2 mg kg-1 followed by an infusion lasting at least 60 min and adjusted to maintain twitch height at 1-5%. After termination of the mivacurium infusion, when twitch height spontaneously regained 25% of its control value, the patients were allocated to two groups of 12 patients each. ⋯ All patients in group NEO recovered to a TOF ratio greater than 0.7 after 6 min compared with 15 min in group SPO (P < 0.005). A TOF ratio greater than 0.9 was observed in all patients in group NEO compared with only six in group SPO (P < 0.025). Nevertheless, RF50HZ and RF100HZ did not differ significantly (0.92 (0.01) (group NEO), 0.91 (0.01) (group SPO) and 0.83 (0.02) (group NEO), 0.78 (0.03) (group SPO), respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Regional anaesthesia for circumcision in adults: a comparative study.
Penile block (PB) in adults is not a well-recognized technique. The aim of this study was to compare, in a randomized prospective manner, five different techniques of PB in 250 adults undergoing circumcision with regard to anaesthetic quality, complications and postoperative analgesia. Patients were divided into five groups (50 per group) according to the technique used: Group A--"10, 30-13, 30" approach; Group B--the subpubic approach; Group C--subcutaneous ring block; Group D--a combination of frenulum infiltration and the "10, 30-13, 30" approach; Group E--a combination of frenulum infiltration and the subpubic approach. ⋯ The five groups did not differ with regard to adverse effects or time until the onset of postoperative pain when the blocks were successful. It is concluded that good surgical anaesthesia, a low rate of adverse effects and prolonged postoperative analgesia can be achieved by the use of either subcutaneous ring block or a combination of dorsal nerve block (using the "10, 30-13, 30" or the subpubic approach) and infiltration of the frenulum. These approaches to the PB are effective anaesthetic techniques for circumcision in adults.
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Anesthesia and analgesia · Dec 1994
Randomized Controlled Trial Comparative Study Clinical TrialEffect of oral clonidine and intrathecal fentanyl on tetracaine spinal block.
We studied the effect of oral clonidine and intrathecal (IT) fentanyl on the onset and duration of a hyperbaric tetracaine-induced spinal block. Forty adult males undergoing elective surgery were studied according to a randomized, double-blind, placebo-controlled protocol involving four treatment regimens: Group I, placebo per os (PO) + tetracaine 12 mg IT; Group II, placebo PO+tetracaine 12 mg IT+fentanyl 10 micrograms IT; Group III, clonidine 200 micrograms PO+tetracaine 12 mg IT; Group IV, clonidine 200 micrograms PO+tetracaine 12 mg IT+fentanyl 10 micrograms IT. Onset time to highest sensory level was 8.5 +/- 3.1, 8.2 +/- 2.3, 6.1 +/- 1.6, and 6.8 +/- 1.4 min in Groups I, II, III, and IV, respectively. ⋯ Episodes of bradycardia and hypotension were more frequent in the clonidine-treated patients (40%-50% vs 10%). We conclude that oral clonidine (200 micrograms) shortened the onset time of tetracaine's sensory block and prolonged the duration of sensory and motor block. However, clonidine premedication increased the risk of hypotension and bradycardia.