Articles: nerve-block.
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This study included 20 children (average 8.5 years) undergoing surgery of the upper limb under brachial plexus block. A method of blocking the brachial plexus using an infraclavicular approach is described. Eighteen brachial plexus block were performed under general anesthesia. ⋯ Post-operative analgesia was satisfactory in all cases. In 10 cases a nerve stimulator was used. It is not necessary for the realization of a brachial plexus block, but the punction is easier under general anesthesia with this instrument.
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Scand J Plast Recons · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialBilateral infraorbital block with 0.5% bupivacaine as post-operative analgesia following cheiloplasty in children.
Various studies have shown that bupivacaine nerve blocks provide prolonged post-operative analgesia. We studied the efficacy of a 0.5% bupivacaine infraorbital nerve block as post-operative analgesia in a random, prospective, double blind manner in children undergoing cleft lip repair. Following the induction of anesthesia with ketamine 2-4 mg/kg im, 60 patients, aged 2-13 years, ASA I and II were equally divided: Group A received 1-1.5 ml bupivacaine, 0.5% with 1:200,000 epinephrine; Group B received 1-1.5 ml saline injected into the vicinity of the infraorbital foramina. ⋯ Group A required no other analgesic whereas a total of 17 patients in Group B required analgesic medication starting at four hours post-operatively, (p less than 0.001). Both the nurses and the parents confirmed that those who received infraorbital block were more comfortable than those who did not. One-way analysis of variance indicates that the mean scores for both groups differs significantly at all levels of comparison, (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Belg · Jan 1991
Intermittent femoral nerve blockade for anterior cruciate ligament repair. Use of a catheter technique in 208 patients.
The duration of postoperative analgesia following femoral nerve block with a catheter technique was studied. Intermittent doses of bupivacaine were given to 208 consecutive patients presenting for open repair of the anterior cruciate ligament, initially 0.5% and thereafter 0.25% 0.4 ml/kg 2-4 times daily. Supplementary analgesia with piritramide 0.15 mg/kg I. ⋯ Based on the duration of analgesia and on the number of analgesic demands required, good or satisfactory analgesia was obtained in 88% of the patients. The catheter remained an average of 2.8 days in position and no infectious or irreversible neurological complications were seen. It is concluded that femoral nerve block using a catheter technique, provides safe and reliable analgesia, improves patient mobility, has a high patient acceptance and is capable of reducing systemic analgesic demand following anterior cruciate ligament repair.
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Thirty-eight consecutive patients with neuralgia after peripheral nerve injury were treated with one or two series of peripheral local anesthetic blocks. All patients experienced an initial total relief of ongoing pain for 4-12 h. Evoked pain (hyperalgesia or allodynia), which occurred in 17 patients, was blocked simultaneously with the spontaneous pain. ⋯ Thus these experiments provided no evidence in support of this hypothesis. Various alternative peripheral and central mechanisms are discussed. Further studies specifically directed to these alternatives and with longitudinal controls are prompted.
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The purpose of this study was to determine the pharmacokinetic properties of the local anaesthetic ropivacaine used with or without epinephrine for brachial plexus block. Seventeen ASA physical status I or II adult patients undergoing elective orthopaedic surgery received a single injection of 33 ml ropivacaine for subclavian perivascular block and 5 ml to block the intercostobrachial nerve in the axilla. One group (n = 8) received 0.5 per cent ropivacaine without epinephrine (190 mg) and the other (n = 9) received 0.5 per cent ropivacaine with epinephrine 1:200,000 (190 mg). ⋯ The terminal phase of the individual plasma concentration-time curves showed a varying and sometimes slow decline possibly indicating a sustained systemic uptake of ropivacaine from the brachial plexus. No central nervous system or cardiovascular symptoms attributed to systemic plasma concentrations of the drug were observed, with the dose (1.90-3.28 mg.kg-1) of ropivacaine used. It is concluded that the addition of epinephrine does not alter the pharmacokinetic properties of ropivacaine when used for subclavian perivascular brachial plexus block.