Articles: nerve-block.
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A scheme for evaluating brachial plexus block was developed, which is based on anatomical structures and which utilizes simple neurological examination techniques. It facilitates the localization of the tip of the cannula near the plexus, gives an idea of the spread of the local anesthetic in the region of the trunks and cords, gives well timed judgement on the success of the block and allows a comparison of the development of the block when using various techniques. ⋯ With the supraclavicular technique, motor as well as sensory blockade of all nerves of the brachial plexus occurred with about the same frequency; with the interscalene technique, the centre of the block affected the caudal nerves of the cervical plexus and the cranial nerves of the brachial plexus. Following both approaches, the blockade developed from proximal to distal areas, the motor blockade preceding the sensory blockade.
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An accurate, simple and safe method, based upon cadaver studies, of obtaining a thoracic paravertebral block, suitable for repeated administration by catheter or for permanent accurate neurolytic block, and which carries significant advantages over intercostal or epidural block, is described in theory and practice.
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A technique for brachial plexus anesthesia is described consisting of the injection of 20 ml of local anesthetic solution into the lower part of the posterior triangle of the neck at a point 1.5 to 2 cm above the clavicle at the lateral border of the anterior scalene muscle. The technique is simple, safe, and produced satisfactory anesthesia of the entire extremity in 97 of the first 100 cases in which it was used. Side effects and complications were minor and transient.