Articles: nerve-block.
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Ann R Coll Surg Engl · Jan 1990
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of postoperative pain relief techniques in orchidopexy.
Fifty consecutive patients admitted to the Western General Hospital for orchidopexy, were randomly allocated to receive either a caudal bupivacaine block or peroperative wound instillation with bupivacaine, to provide postoperative analgesia. Bupivacaine wound instillation reduced the total operating time, gave more efficient postoperative pain relief in hospital and proved both inexpensive and simple in its application.
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Cahiers d'anesthésiologie · Jan 1990
Review[Peripheral neurologic complications of brachial plexus blocks].
Nerve injury can arise as a complication of peripheral nerve block anesthesia. From the review of the literature remain three factors which alone or in combination, are of special etiologic interest: nerve lesion due to the needle or intraneural injection; toxic effects of the agent injected overall when epinephrine is used; ischemic trauma. ⋯ These postanesthetic neuropathies may benefit from specific treatment or even surgical exploration and external neurolysis. The block should be handled with care: rough paresthesia seeking and intraneural injections should be avoided; short bevel needles and plane solutions should be preferred.
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Fortschr Ophthalmol · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Eyelid akinesia after various techniques of facial nerve block].
Lid akinesia was investigated after the application of one of three techniques to achieve facial nerve blockade in each of 32 patients undergoing cataract surgery. Modifications of the O'Brien, Atkinson and Lint block techniques were applied in twelve, ten, and ten patients, respectively. Before and 1, 3, 5 and 10 min after administration of 5 ml 1% lidocaine (Xylocain) with naphazolin nitrate 1:20,000 (Privin) voluntary muscle activity of the orbicularis oculi muscle was recorded, and the area under the EMG curve was calculated for quantitative comparison of muscular activity between the groups. ⋯ In six additional patients, the topographic distribution of a mixture of metrizamide (Solutrast) and the anesthetic solution was evaluated radiographically to assess potential causes of differences in the effectiveness of the block techniques. Within 1 min after modified O'Brien block, the voluntary activity of the orbicularis oculi muscle and the force of lid closure were significantly, lower than those after both the modified van Lint and the Atkinson techniques: furthermore, a significant decrease in the voluntary lid movement was observed within 3 min. Whereas the modified O'Brien block nearly abolished voluntary muscle activity, force of lid closure and lid movement, there was only a minor decrease in the area under the EMG curve and in the force of lid closure after the modified van Lint and Atkinson blocks (about 20%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Regional-Anaesthesie · Jan 1990
[Elimination of the obturator reflex as a specific indication for dilute solutions of etidocaine. A study of the suitability of a local anesthetic for reflex elimination in the 3-in-1 block technic].
Direct stimulation of the obturator nerve by the electroresectoscope during transurethral resection of tumors in lateral bladder regions is possible under regional or general anaesthesia without muscle relaxation. The resulting obturator reflex may lead to perforation of the bladder. Two different regional techniques can be used to interrupt the obturator reflex arc: (1) separate block of the obturator nerve; or (2) the "3-in-1 block" (Winnie). ⋯ Elimination of the obturator reflex is the only specific motor nerve block in anesthesia. Diluted etidocaine solutions seem to be adequate: irrespective the technique used for eliminating the reflex, diluted etidocaine produces a good effect and permits a dosage reduction compared with other local anesthetics. It is possible to block the obturator nerve bilaterally by "3-in-1 block" or unilaterally by "3-in-1 block" in combination with epidural analgesia within the recommended dose limits.