Articles: nerve-block.
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Intensive care medicine · Jan 1992
Review Case ReportsRare procedures during delivery room resuscitation--cardioversion of ventricular tachycardia in an asphyctic neonate.
Successful cardioversion of ventricular tachycardia in a full-term male infant, born severely depressed by emergency Cesarean section 9 min after the mother was given bilateral paracervical bupivacaine blocks for pain relief during normal labor, is described. The apparently stillborn baby was resuscitated by conventional means until electronic heart monitoring revealed transition from asystole to rapid ventricular tachycardia 14 min after birth. ⋯ The child recovered rapidly and neurological status at 12 months was normal. Obviously, active search and aggressive management of rapid ventricular arrhythmias are indicated during neonatal resuscitation, if potentially arrhythmogenic drugs are used in perinatal care.
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Randomized Controlled Trial Clinical Trial
Effect of addition of hyaluronidase to bupivacaine during axillary brachial plexus block.
We have studied in 22 patients the effect of adding hyaluronidase to bupivacaine during axillary brachial plexus block (BPB) in a double-blind design. Patients received BPB using bupivacaine 2 mg kg-1 with adrenaline 1 in 200,000, either with or without hyaluronidase 3000 iu, in a volume of 0.5 ml per 2.54 cm of the patient's height. ⋯ Hyaluronidase produced a significant reduction in the duration of anaesthesia. Changes in grip strength and skin temperature were useful in assessing the onset and progress of BPB.
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Three cases are reported where continuous lumbosacral block was performed using a catheter through an epidural needle technique. Good unilateral lower limb surgical anaesthesia was achieved in all three cases with successful blockade of the lumbar and sacral plexuses. A 17-gauge Tuohy needle was positioned between the transverse processes of L4 and L5 and an epidural catheter inserted into the space between the quadratus lumborum and psoas muscles. ⋯ Experience in a further 12 cases is also reported. There were no side-effects. The technique is successful and is recommended when unilateral lower limb anaesthetic is required and when spinal and epidural anaesthesia are contraindicated.
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Minerva anestesiologica · Jan 1992
[How many interscalene blocks are there? Reflections on 109 cases studied with various techniques].
The effects of interscalene block were studied on 109 patients undergoing upper extremity elective orthopaedic surgery. Blocks were performed in a non-randomized manner with three different techniques, the site where anaesthetic solution was injected being the main distinguishing mark. The anaesthetic solution was injected into the interscalenic compartment both in the case of patients where classic technique had been carried out and in the group where the nerve stimulator had been used. ⋯ When the block was performed within the interscalenic compartment, the analgesic cover was usually restricted to the area supplied by the primary superior trunk of the brachial plexus. The different results were explained by the presence of fibrous sheaths within the interscalenic compartment limiting spread of the anaesthetic, which are absent close to the vertebral column. Therefore two types of interscalene block were postulated: an intrascalene or troncular block within the interscalenic compartment and a radicular or paravertebral block close the vertebral column.
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Ann Chir Main Memb Super · Jan 1992
[Techniques of continuous nerve block at the level of the wrist].
Functional treatment without pain is a condition for good results after operations at gliding structures (tendons) or periarticular structures. Good analgesia of the arm and hand is obtained with continuous axillary nerve blocks. Often there is concomitant paralysis and active motion is not possible. ⋯ We use a prefabricated catheter set to introduce the polyethylene catheter and to place it near the nerve as in single shot wrist block. This technique for continuous analgesia of the hand can be used for functional treatment after tenolyses, arthrolyses and stable osteosyntheses of fingers. Median, radial and ulnar nerves can be blocked all at the same time or alone.