Articles: nerve-block.
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Anesthesia and analgesia · Aug 1992
Randomized Controlled Trial Clinical TrialContinuous low-dose 3-in-1 nerve blockade for postoperative pain relief after total knee replacement.
We have investigated the value of a 3-in-1 nerve block, followed by a continuous low-dose infusion of bupivacaine into the femoral nerve sheath for postoperative analgesia after total knee replacement. Thirty-seven patients were randomly allocated to either a control group or a study group. The study group had a catheter placed in the ipsilateral femoral nerve sheath. ⋯ This was followed by a continuous infusion of 0.125% bupivacaine at 6 mL/h. The study group had significantly lower pain scores 4 and 24 h postoperatively (P less than 0.01) and required less postoperative opioid analgesic medication (P less than 0.01) than the control group. The authors conclude that a continuous low-dose infusion into the femoral nerve sheath results in better pain relief than conventional intramuscularly administered narcotics after total knee arthroplasty.
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Randomized Controlled Trial Comparative Study Clinical Trial
[General anesthesia vs. retrobulbar anesthesia in cataract surgery. A randomized comparison of patients at risk].
Several studies comparing retrobulbar block (RB) and general anaesthesia (GA) for cataract surgery in the elderly have been published. Most of them were retrospective. Our prospective study was designed in order to determine the benefits or disadvantages using RB or GA. ⋯ Intravenous acetazolamide did not influence ABG in a significant manner. With regard to the preference of each patient, we recommend both RB and GA for cataract surgery in high-risk patients on the assumption of sufficient preoperative treatment of co-existing diseases. In conclusion, cardiovascular and ABG stability were maintained during both anaesthetic techniques.
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Randomized Controlled Trial Clinical Trial
Perineuronal morphine in intercostal block.
In a double-blind, randomised study the potential benefits of combining low-dose morphine with bupivacaine for intercostal nerve blocks for analgesia after biliary surgery were investigated. There was no significant improvement in pain scores or consumption of supplementary analgesics when morphine was added to bupivacaine. This investigation supports the findings of other workers who showed that perineural morphine was ineffective for postoperative pain relief.
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Anesthesia and analgesia · Jul 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison between clonidine and epinephrine admixture to lidocaine in brachial plexus block.
The admixture of clonidine or epinephrine to lidocaine for brachial plexus block was studied with regard to duration of block, postoperative analgesia, and plasma concentrations of lidocaine. Thirty-three patients of ASA physical status I and II received an admixture of either clonidine (150 micrograms; n = 15) or epinephrine (200 micrograms; n = 18) to 40 mL of 1% lidocaine in a randomized, double-blind fashion. Bone surgery predominated in those patients receiving clonidine and soft-tissue surgery in those receiving epinephrine (P less than 0.05). ⋯ In patients who had received clonidine, peak plasma concentrations of lidocaine were higher (10.29 +/- 2.96 mumol/L) and occurred earlier (23.7 +/- 9.3 min; mean +/- SD) than in those treated with epinephrine (6.9 +/- 1.71 mumol/L; 72.5 +/- 56.2 min; P less than 0.05). This indicates the absence of a local vasoconstrictor effect of clonidine and implies a reduced margin of safety with regard to local anesthetic toxicity. Although clonidine does not offer advantages compared with epinephrine, it may be a useful adjunct to local anesthetics in those patients in whom the administration of epinephrine is contraindicated.