Articles: nerve-block.
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J Hand Surg Eur Vol · Jun 1994
Randomized Controlled Trial Clinical TrialThe "mini-Bier's block": a new technique for prevention of tourniquet pain during axillary brachial plexus anaesthesia.
Tourniquet cuff pain is a significant cause of morbidity following regional anaesthesia of the upper limb. We describe a simple new technique for effectively anaesthetizing the area under a pneumatic tourniquet (the "mini-Bier's block"), which permits comfortable surgery under axillary block anaesthesia even if the local block is incomplete. We report a controlled study of 40 patients in whom statistically significant tourniquet cuff pain relief was obtained in patients receiving an additional low-dose intravenous injection of local anaesthetic localized beneath the cuff. This technique ensures that the safe axillary approach to the brachial plexus can always be used with avoidance of pain from the pressure of the tourniquet cuff.
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Case Reports
Transient paraplegia from intraoperative intercostal nerve block after transthoracic discectomy.
To present two patients with transient paraplegia from intercostal nerve blocks after transthoracic discectomy. ⋯ Because of the inherent risk of neurologic injury after thoracic discectomy, the authors discourage the use of intercostal nerve blocks for relieving postoperative pain after transthoracic discectomy.
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Pain relief in children during the perioperative period can be provided by means of peripherally or centrally acting analgesics or of regional anaesthetic techniques. Narcotics or regional blockde are indicated when peripherally acting analgesics prove inadequate to abolish pain. Side effects of narcotics must be taken into account: opioids must not be administered unless continuous safety monitoring of the child's respiration is assured. ⋯ All advantages and drawbacks of the various techniques that might be appropriate must be considered: the technique involving the least risk and side effects is the anaesthetic technique with a broad margin of safety when applied by an anaesthesiologist who has experience with paediatric regional blocks include topical anaesthesia, local infiltration, peripheral nerve blocks (e.g. nervi dorsalis penis, plexus axillaris) and caudal epidural blockade. Caution must be exercised whenever narcotics are administered systemically or epidurally; side effects must not be underestimated, even under conditions of intensive care observation. The provision of effective pain relief is a rewarding task-and particularly in little children.
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J Philipp Dent Assoc · Jun 1994
Comparative StudyA comparative study: classical, Akinosi, and Gow-Gates techniques of mandibular nerve block.
This study was conducted to compare the effectiveness and the degree of patient acceptability of the three techniques of mandibular nerve block, namely the classical, the Akinosi and the Gow-Gates. Forty five patients with mandibular posterior tooth/teeth indicated for extraction were chosen and divided equally into three groups to represent the three techniques of mandibular nerve block. ⋯ Tabulation and analysis of the collected data followed. Results show that the Gow-Gates technique was the most effective in inducing anesthesia while the Akinosi technique appeared to be the most acceptable among the patients.
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The number of AIDS patients is steadily increasing. According to the literature these patients are often in severe pain. ⋯ The high incidence of complicated neuropathic pain syndromes in AIDS patients requires a sophisticated therapeutic approach. Closer cooperation between AIDS specialists and pain specialists, comparable to that already existing for other patient groups, is therefore desirable.