Articles: nerve-block.
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Anesthesia and analgesia · Jun 1991
Effect of pH of bupivacaine on duration of repeated sciatic nerve blocks in the albino rat. Local Anesthetics for Neuralgia Study Group.
Tachyphylaxis has been ascribed to tissue acidification after repeated injections of acidic local anesthetic solutions. We studied the effect of pH on the duration of action of bupivacaine to determine the validity of this proposed mechanism of tachyphylaxis by injecting bupivacaine solutions adjusted to pH 4.2 or 6.8 into a surgically implanted system created to permit in vivo irrigation of rat sciatic nerves with local anesthetic. Tachyphylaxis developed at both pH values. The results fail to support the acidification hypothesis as there was no statistically significant effect of a 400-fold difference in hydrogen ion concentration on the development of tachyphylaxis or the duration of motor dysfunction.
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Mayo Clinic proceedings · May 1991
Brachial plexus anesthesia for outpatient surgical procedures on an upper extremity.
We retrospectively reviewed 543 brachial plexus blocks performed on 526 outpatients. Most (98%) of the blocks were performed by means of the axillary approach. ⋯ No persistent neurologic deficit was ascribed to the anesthetic technique. This review indicates that brachial plexus block, especially with use of the axillary approach, is a safe and effective option for outpatient surgical procedures on an upper extremity.
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The plasma concentrations of bupivacaine and the latency and duration of anaesthesia after supraclavicular block with 30 ml of 0.5% bupivacaine were measured in 10 patients with chronic renal failure and in 10 patients with normal renal function. No significant difference was found between the two groups in respect of pharmacokinetic parameters, or in block latency or duration.