Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Efficacy of continuous extrapleural intercostal nerve block on post-thoracotomy pain and pulmonary mechanics.
To assess the efficacy of continuous extrapleural intercostal nerve block on postoperative pain and pulmonary function, a prospective, randomized, double-blind, placebo-controlled trial was conducted on 56 patients undergoing elective thoracotomy. Infusion was started before closing the chest and was continued for 5 days. Subjective pain relief was assessed on a linear visual analogue scale. ⋯ Restoration of pulmonary function was superior in the bupivacaine group (P less than 0.01). There were no infusion-related complications. After thoracotomy, continuous intercostal blockade with bupivacaine is a safe and effective method of pain relief which reduces the early loss of postoperative pulmonary function significantly and more rapidly restores respiratory mechanics.
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Thorac Cardiovasc Surg · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialIntrapleural bupivacaine for early post-thoracotomy analgesia--comparison with bupivacaine intercostal block and cryofreezing.
54 patients who had posterolateral thoracotomy were prospectively studied to compare the efficacy of intrapleural bupivacaine with that of bupivacaine intercostal block and cryofreezing. Patients were randomized into three groups. The intrapleural catheter group included 16 patients who had intermittent intrapleural instillation of 20 ml of 0.25% bupivacaine for forty-eight hours postoperatively. ⋯ No complications related to the use of the intrapleural catheter or to bupivacaine toxicity were encountered. In conclusion, the technique of intermittent intrapleural bupivacaine is safe and comparable in efficacy to bupivacaine intercostal block and cryofreezing. Narcotic requirements may be reduced when this technique is used.
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Eighty-four cases of inguinal hernioplasty by Bassini's modified technique were performed using 1% lidocaine in regional infiltration block. The report analyzes the use of local anesthesia in the treatment of inguinal hernias. All patients had small reducible and non-recurrent inguinal hernia. ⋯ The rate of complication was low, but pain was a common complaint. In general, there was a good acceptance of this kind of anesthesia. The authors concluded that local anesthesia is a valuable method for the treatment of inguinal hernia.
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Ann Chir Main Memb Super · Jan 1990
Case Reports[Local complications after axillary block anesthesia].
The authors treated a local complication after axillary block, probably after intraneural injection of lidocaine. At the operation severe epineural fibrosis was found and released. The result was good after some months. ⋯ This technique axillary block, is very reliable technique, but very few local complications can occur, and it's necessary to know them. It's possible to avoid this local problem with a serious technique to realize axillary block. Never intraneural injection and never many punctures to research paresthesia from the nerves of the brachial plexus.