Articles: nerve-block.
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Severe hypotension and bradycardia occurred in two patients after superior laryngeal nerve block for awake tracheal intubation. Both patients required treatment with anticholinergic drugs and i.v. infusions and made a good recovery.
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A technique for blocking the dorsal nerves of the penis was designed after reevaluation of the gross anatomy of the subpubic space and penis in children. The technique consists of inserting a short bevel needle in the two compartments of the subpubic space, where the nerves run before entering the base of the penis, and of injecting a small volume (0.1 mL/kg of body weight) of local anesthetic. This two-puncture procedure was prospectively evaluated in 100 children undergoing surgery of the penis under light general anesthesia. ⋯ No complications occurred and anesthesia was satisfactory for completion of surgery. The duration of postoperative pain relief was significantly longer in patients given bupivacaine than in those given lidocaine. It is concluded that the subpubic approach to the dorsal nerves of the penis is easy, safe, and reliable, and that 0.5% plain bupivacaine provides long-lasting postoperative pain relief.
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A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. ⋯ Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented.