Articles: nerve-block.
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Ann Chir Main Memb Super · Jan 1991
Review[Local and regional anesthesia of the upper limb in emergency hand surgery].
The very conditions of the emergency led the authors to define the indications for the various modalities of local and regional anaesthesia: intravenous regional anaesthesia, nerve trunk blocks, plexus blocks, interdigital block and local infiltration. The parallel development of anaesthetic drugs with variable systemic toxicity and a duration of action inversely proportional to the toxicity now allows precise adaptation of the anaesthesia to the type of lesion, the patient's general condition, the practical conditions of the emergency and the surgical technique selected, provided the anaesthetist is fully aware of the traps to be avoided, which can only be based on a long practice of local and regional anaesthesia in elective surgery.
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[Alkalinization of mepivacaine for axillary plexus anesthesia using a catheter].
One disadvantage of perivascular axillary block using a catheter technique is delayed temporal development of the blockade. Some clinical studies have concluded that pH-adjusted solutions of local anesthetics produce a more rapid onset of blockade. Alkalinization of mepivacaine for brachial block produced conflicting results. ⋯ RESULTS. The bicarbonate and saline groups were similar with respect to age, height, weight, and sex distribution. Significantly more patients in the bicarbonate group showed onset of motor blockade (grade 1) after 2 min with respect in the axillary, musculocutaneous, radial, and median nerves as well as onset of sensory blockade in the same nerves with a significant difference in blockade of the radial nerve. (ABSTRACT TRUNCATED AT 400 WORDS)
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Ann Fr Anesth Reanim · Jan 1991
[Peripheral nerve block during ambulatory surgery of varicose veins].
This retrospective study of the 46 operations, carried out over a one year period for lower limb varicose veins using peripheral nerve blocks, included 45 patients (35 women and 10 men, mean age 49.3 years), all ASA 1 or 2, except for 4 elderly patients with a varicose ulcer (ASA 2 or 3). In 40 procedures, a sciatic nerve block combined with a "3 in 1" lumbar plexus block at the level of the groin (as described by Winnie) were used. In the remaining six, either a sciatic nerve block (short saphenous vein crossectomy; n = 3), or a "3 in 1" lumbar plexus block alone (short stripping of the long saphenous vein; n = 3) were required. ⋯ During the same period, nine similar procedures were carried out under general anaesthesia, and two under epidural anaesthesia. They included seven bilateral varicose veins, three patient refusals for peripheral nerve blocks, and one allergy to lidocaine. Already used for some procedures in orthopaedic and casualty surgery, peripheral nerve blocks seem to be well suited for surgery of unilateral varicose veins.
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Regional anesthesia · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialIntercostal nerve block for minor breast surgery.
Two anesthetic procedures, intercostal nerve block (ICNB) and general anesthesia, were evaluated in 45 female patients scheduled for minor breast surgery. The study was designed to compare ICNB with general anesthesia for breast surgery with respect to efficacy, surgical stress and postoperative analgesia and to evaluate epinephrine and ornipressin as vasoconstrictors in the local anesthetic solution. Thirty patients received ICNB of T3-T7 unilaterally using 2% lidocaine plus epinephrine (15 patients, Group A) and 2% lidocaine plus ornipressin (15 patients, Group B). ⋯ Before and during surgery, epinephrine and norepinephrine plasma levels were highest in the epinephrine group, whereas, postoperatively, the plasma levels of both catecholamines were highest in the patients receiving general anesthesia. The latter patients experienced significantly more nausea and vomiting than the regional anesthesia groups. Patients with regional anesthesia required significantly less analgesics postoperatively than the patients receiving general anesthesia.
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A number of chronic pain syndromes in the perineal area can be related to pudental nerves suffering. The constancy of symptoms among various patients, and in duration for a particular one, alterations revealed by electrophysiologic studies, pain relief by diagnostic blocks, data from anatomic studies, preliminary results of medical and surgical applied therapies, give consistent arguments for possible organic lesions of pudental nerves.