Articles: nerve-block.
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Comment Letter Randomized Controlled Trial Clinical Trial
The needle and the brain: psychophysiological factors involved in nerve blocking for chronic pain. In response to article by Drs. Brena, Chapman, and Sanders.
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We present our experience with the use of regional anesthesia in 1295 of 1862 (69.5%) surgical procedures of the foot and ankle between 1986 and 1989. Regional anesthesia was used for surgical procedures of the forefoot, midfoot, hindfoot, and ankle in the setting of elective surgery and trauma. ⋯ There were four (0.3%) minor complications, one being lidocaine toxicity. With increasing experience, the expanded indications and uses of regional anesthesia for foot and ankle surgery are proving to be simple, safe, reliable, and well tolerated by the patient.
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Case Reports
Caudal blockade in the management of aortic thrombosis following umbilical artery catheterisation.
A neonate, with a postconceptual age of 29 weeks, suffered thrombosis of the aorta as a consequence of umbilical artery catheterisation. This resulted in ischaemic lesions of the lower limbs and buttocks. Part of the management consisted of the insertion of an extradural catheter, via the caudal route, which provided good pain relief and may have improved lower limb blood flow.
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Six children with a mean age of 10.6 years (range, 7 to 16 years) underwent thoracotomy for pulmonary and esophageal procedures. Postoperatively, continuous paravertebral block using an infusion of bupivacaine via an extrapleural catheter was used. ⋯ There were no pulmonary complications and no complications related to the continuous extrapleural infusion. We conclude that continuous paravertebral block is an effective and safe method for ++post-thoracotomy pain relief in children.