Articles: nerve-block.
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The use of a pneumatic ankle tourniquet applied to the supramalleolar ankle region is a useful method of obtaining a bloodless field in surgery of the foot. The pneumatic ankle tourniquet allows for more accurate and reproducible control of circumferential compression than the standard Esmarch bandage, when used in conjunction with the regional ankle block. Between March 1987 and October 1990, 84 foot surgeries were performed using the pneumatic tourniquet and ankle block technique on 76 patients by one surgeon. ⋯ Neither patient required deflation of the tourniquet to complete the procedure. The clinical and electrophysiologic evidence showed that no neurologic or vascular damage occurs. The use of the pneumatic tourniquet in conjunction with regional ankle block anesthesia provides a reasonable alternative to the standard thigh tourniquet for surgery of the foot.
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Minerva anestesiologica · Jul 1992
Case Reports[Anesthesia of the brain stem after a retrobulbar block. Description of 2 cases].
The Authors report two cases of central nervous system complications after retrobulbar block. These complications have a 0.044% incidence in 4500 subsequent cases of retrobulbar blockade studied from 1981 to 1990. The Authors attribute the respiratory arrest and coma to direct access of the anesthetic to the central nervous system along the subdural space in the optic nerve sheath.
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Randomized Controlled Trial Comparative Study Clinical Trial
Facet joint injection and facet nerve block: a randomised comparison in 86 patients with chronic low back pain.
Eighty-six patients with refractory chronic low back pain were randomly assigned to receive either facet joint injection or facet nerve block, using local anaesthetic and steroid. There was no significant difference in the immediate response. ⋯ Patients who had complained of pain for more than 7 years were more likely to report good or excellent pain relief than those with a shorter history (P less than 0.005), but no other clinical feature was of value in predicting the response to infiltration. Facet joint injections and facet nerve blocks may be of equal value as diagnostic tests, but neither is a satisfactory treatment for chronic back pain.
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Because of distinct pain symptoms in the presence of an ascending partial paralysis-Brown-Sequard Syndrome-from T 5/6 upward in a 56-year-old patient, therapy with paravasalic injections of bupivacaine 0.125% in the area of the femoral artery (right) was given. The patient kept a pain diary with entries every 2 h for 61 weeks. Evaluation of the documentation demonstrates the success of the therapy and shows the possibilities of different kinds of evaluation of well-documented pain data.
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Case Reports
Cervicogenic headache: anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/C3).
In a series of 14 patients with cervicogenic headache, cervical nerve blockades (C2-C5 and facet joint C2/C3) have been carried out in order to elucidate possible underlying mechanisms and to evaluate the diagnostic potential of these procedures. Blockade of the C2 nerve resulted in freedom from pain in 5 of 10 patients and seemed to be the most informative procedure. ⋯ C4 and C5 nerve blockades are probably of little value in the work-up of such patients. When evaluating the C2/C3 facet joint injection, one has to take possible leakage of anesthetic agent from the joint into consideration, since the third occipital nerve which runs close to the facet joint may be anesthetized through the leakage.