Articles: nerve-block.
-
Clinical Trial
[Axillary blockade of the brachial plexus. A prospective study of blockade success using electric nerve stimulation].
Axillary block is a common anesthetic technique for operations on the hand and forearm. In our hospital, with many trainees in anaesthesia, only 250-300 axillary blocks per year are performed by about 30 colleagues. This implies a small number of blocks for each anaesthetist. ⋯ Prior to injection of the local anaesthetic, the current for nerve stimulation should be reduced to < 0.5 mA. The time between the end of injection and the beginning of surgery should be no less than 30 min because complete sensory blockade can more often be achieved. The dose of mepivacaine should be no less than 6 mg/kg body weight.
-
Comparative Study
The interpretation of pain relief and sensory changes following sympathetic blockade.
A comparative study of the effects of sympathetic blockade by stellate ganglion block (SGB) and intravenous phentolamine infusion (PhI) was carried out in 24 patients with presumed sympathetically maintained pain of an upper extremity. A total of 15 SGBs and 16 PhIs were performed, with seven patients undergoing both procedures. All patients developed a Horner's syndrome with SGB and nasal stuffiness and cardiovascular changes with PhI. ⋯ When SGB produces pain relief but PhI does not, systemic absorption of local anaesthetic and/or sensory blockade by spread to somatic nerves may be the reason. Thus, PhI appears to be a less sensitive but more specific test than SGB. These two procedures provide complementary information and both may be needed to establish the diagnosis of sympathetically maintained pain.
-
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)