Articles: nerve-block.
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This study was undertaken to determine whether an infusion of local anesthetic (LA) delivered through an extrapleural tunnel could provide satisfactory control of pain in the postthoracotomy period. Twelve patients undergoing thoracotomy were studied. A T-shaped tunnel was created by elevating the parietal pleura at the posteromedial end of the thoracotomy wound. ⋯ Pain was well controlled in eight patients and satisfactory in four patients. The latter required one dose of opiate analgesia each in the 48-h postoperative period. We conclude that an infusion of bupivacaine into the extrapleural space is an effective means of control of pain after thoracotomy.
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Anesthesia and analgesia · Apr 1992
Enhancement of bupivacaine sensory blockade of rat sciatic nerve by combination with phenol.
We sought to determine whether the addition of phenol would enhance a bupivacaine nerve block. The effects on nerve conduction of bupivacaine (0.125%) and phenol (0.5%), singly and combined, were evaluated in vivo on the rat sciatic nerve. Three groups of 10 animals each were used. ⋯ The analgesia score derived from the hot-plate test was more and persisted longer for the combination treatment than for either 0.125% bupivacaine or 0.5% phenol given singly; e.g., the average sensory block score after 150 min for the combination treatment was 1.0 compared with 0.1 for either bupivacaine or phenol given alone (P = 0.003). Analysis of the areas under the sensory score-time curves also demonstrated enhanced blockade from the combination treatment, which would be consistent with a synergism of the separate Na(+)-channel blocking effects of charged and uncharged local anesthetics. These findings may suggest other candidates for clinically useful combinations of amine and neutral local anesthetics.
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J Pharmacol Toxicol Methods · Apr 1992
A sciatic nerve blockade method to differentiate drug-induced local anesthesia from neuromuscular blockade in mice.
This report introduces a simple and easy technique for animal handling and drug administration into the sciatic nerve area for determining local anesthesia and neuromuscular blocking activity in mice. The drugs were injected into the popliteal space of the right hindlimb (i.e., the sciatic nerve area). The loss of motor activity of the right hindlimb was taken as a sign of producing local anesthesia. ⋯ The method reported here has been validated by reference neuromuscular blocking agents (d-tubocurarine, decamethonium, and succinylcholine). A positive neuromuscular blockade was recorded when a mouse was unable to stay on the inverted wire mesh screen. The information provides not only the local anesthetic or neuromuscular blocking potency of drugs but also duration of action of drugs.
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A new technique for regional anaesthesia for arthroscopy of the knee is presented. The method includes sciatic nerve block according to the technique proposed by Labat, through a posterior approach and the block of the femoral and lateral cutaneous nerves using a single anterior approach. Results obtained in 30 patients are presented: they include good stability of the cardiovascular and respiratory parameters, high efficiency and duration of anaesthesia resulting in a satisfactory surgical procedure.
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This study used a radionuclide imaging technique to map the spread and density contours of phenol in glycerin injected into the epidural space of cancer patients. Correlations were made between phenol injectate volume, sequence of injection, position of patient, and resultant epidural spread and analgesic outcome. Fifteen patients with cancer pain (average age of 61 years) were treated with serial epidural phenol in glycerin injections. ⋯ Good analgesia was obtained in 14 patients (93%). Epidural neurolysis using serial injections of small volumes of phenol in glycerin is an effective, safe technique for cancer pain relief. Injectate volumes larger than 3 ml may be unnecessary and potentially dangerous.