Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Buffered versus plain lidocaine for digital nerve blocks.
To test whether buffered lidocaine is less painful to administer as a digital nerve block than plain lidocaine. ⋯ Because it causes less pain and is equally efficacious, buffered lidocaine is preferable to plain lidocaine for digital nerve blocks in adults.
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Randomized Controlled Trial Clinical Trial
Continuous intercostal analgesia with 0.5% bupivacaine after thoracotomy: a randomized study.
This study was undertaken to evaluate the effectiveness of 0.5% bupivacaine (360 mg/day) as a continuous infusion through an indwelling intercostal catheter inserted intraoperatively in the management of pain after thoracotomy. Eighty-six patients were randomized into three groups: group 1 = intercostal bupivacaine, group 2 = intercostal saline solution, and group 3 = fixed-schedule intramuscular buprenorphine. Supplementary buprenorphine was given as required. ⋯ No between-group differences in pulmonary function were observed. Respiratory complications occurred in no patients in groups 1 and 3 versus 5 in group 2 (p < 0.05). Continuous intercostal bupivacaine provided similar early pain control as compared with fixed-schedule narcotics but induced better analgesia with fewer complications than on-demand narcotics alone (group 2).
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Anesthesia and analgesia · Feb 1993
Randomized Controlled Trial Clinical TrialOnset, intensity of blockade and somatosensory evoked potential changes of the lumbosacral dermatomes after epidural anesthesia with alkalinized lidocaine.
The onset and intensity of blockade of the lumbosacral dermatomes after epidural anesthesia with alkalinized lidocaine were investigated in a randomized, double-blind study in 26 patients. Control subjects (n = 13) received 20 mL of 1.37% lidocaine (1.5% lidocaine plus 1 mL saline per 10 mL lidocaine) with added 1:200,000 epinephrine; the solution pH was 6.20 +/- 0.08. Patients in the alkalinized lidocaine group (n = 13) were given 20 mL of 1.37% lidocaine plus added bicarbonate (1 mL sodium bicarbonate per 10 mL 1.5% lidocaine) and 1:200,000 epinephrine; the solution pH was 7.18 +/- 0.10. ⋯ Motor blockade was significantly more profound in the alkalinized lidocaine group. Thirteen of 78 PTN and L5 and S1 dermatomal SSEPs were abolished in the alkalinized lidocaine group compared to 4 of 78 SSEPs in the nonalkalinized group. Alkalinization of lidocaine is recommended to shorten the time to block the L5-S1 dermatomes when epidural anesthesia is planned for lower extremity surgery.
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Twenty pancreatic cancer patients were studied to assess the effectiveness and duration of celiac plexus block compared to traditional treatment with analgesics by considering the previous and subsequent consumption of narcotics until their death. After 1 week of therapy with NSAID-narcotic sequence according to the WHO method, 10 patients were continued on this treatment, while the other 10 patients underwent celiac plexus block. ⋯ Celiac plexus block made pain control possible with a reduction in opioid consumption for a mean survival period of about 51 days. Administration of only analgesics resulted in an equal reduction in VAS pain score until death, but with more unpleasant side effects than when using celiac plexus block.