Articles: nerve-block.
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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.
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Anaesth Intensive Care · Feb 1993
Comparative StudyOne hundred sciatic nerve blocks: a comparison of localisation techniques.
One hundred sciatic nerve blocks performed for surgery related to lower limb vascular disease were prospectively audited with respect to the techniques used for sciatic nerve localisation and the success rates achieved. Utilising a 22 gauge Quincke point needle, sciatic nerve localisation was performed by initially searching for paraesthesia, followed by the use of a low powered peripheral nerve stimulator. ⋯ A positive response to the nerve stimulator was achieved in 95 cases of which 87 went on to have successful blocks. Our findings suggest that either eliciting paraesthesia or a positive response to the peripheral nerve stimulator carries a high correlation with subsequent successful block, but that the use of the nerve stimulator provides a more consistent and reliable technique for nerve localisation.
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Plasma concentrations of bupivacaine have been measured in 12 patients given bupivacaine through a paravertebral catheter placed under direct vision at thoracotomy. After an initial bolus of 0.5% bupivacaine 20 ml, mean (SEM) Cpmax was 1.45 (0.32) micrograms ml-1 and median (range) tCpmax was 25 (10-60) min. ⋯ No symptoms or signs of toxicity occurred. Separate measurement of R- and S-bupivacaine concentrations demonstrated significantly different concentration-time profiles.
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Arthroscopic shoulder surgery can be performed under regional or general anesthesia. The objective of this study was to demonstrate that regional anesthesia has several benefits over general anesthesia for this type of surgery, particularly in the ambulatory patient. ⋯ It provided excellent intraoperative analgesia and muscle relaxation. Postoperatively, regional anesthesia resulted in fewer side effects, fewer hospital admissions, and a shorter hospital stay than did general anesthesia.