Articles: nerve-block.
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Fifty-four patients developed severe intercostal neuralgia a few weeks after sternotomy. Immediate relief afforded by parasternal nerve blocks confirmed that the pain derived from scar-entrapped neuromas of the anterior rami of the first 4-6 intercostal nerves in the upper (and mainly left) interchondral spaces after insertion of the sternal wires. Permanent relief (i.e., over 6 months) followed repeated bupivacaine blocks in 57.4% of the patients, phenol blocks in another 22.2%, and alcohol blocks in a remaining 9%. Treatment was successful in 87% of the patients.
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Rev Esp Anestesiol Reanim · Jul 1989
[Continuous block of the brachial plexus with nerve stimulation. Intra and postoperative control in orthopedic surgery of the arm].
A perivascular axillary plexus block was performed to 87 patients scheduled for orthopedic surgery of hand or arm using an electric nerve stimulator. A catheter was inserted for the postoperative pain control. ⋯ Complications were: arterial puncture (3), difficulty in inserting catheter (3), injection out of the sheath (1), pain at the electric stimulation (3). No allergic reactions nor neurologic complications were founded during a year of posterior control.
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Comment Letter Clinical Trial Controlled Clinical Trial
Paravertebral block for post-cholecystectomy pain relief.
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Regional-Anaesthesie · Jul 1989
[Initial experiences with a novel nerve stimulator for use in axillary plexus anesthesia].
The advantages of an electrical nerve stimulator for detection of the axillary neurovascular sheath have been frequently described in the literature and are now well known. In most of these techniques, stimulation is achieved by a fixed electrical voltage and variable amplification. The new nerve stimulator presented here offers the possibility of measuring the current at the site of stimulation ("test" position). ⋯ Thus, disturbances in the circuit between nerve stimulator and patient, as shown in the two cases, can be detected. According to our experience, the intensity of stimulation for successful nerve blockade should be approximately 0.5 mA or lower. Consequently, universally applicable stimulating instruments with constant electrical tension should allow fine tuning of the current in 0.1-mA aliquots.
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Anesthesia and analgesia · Jun 1989
Subclavian perivascular block: influence of location of paresthesia.
Subclavian perivascular block of the brachial plexus was used in 156 adult patients undergoing orthopedic hand and forearm surgery. The location of the elicited paresthesia prior to deposition of 30 ml of a solution containing 1% mepivacaine, 0.2% tetracaine and 1.200,000 epinephrine was recorded. Twenty minutes later the quality of the block in the distribution of the superior, middle and inferior trunks of the brachial plexus was evaluated. ⋯ A superior trunk paresthesia was the paresthesia most often elicited. It resulted in a significantly lower incidence of inferior trunk anesthesia than did a middle or inferior trunk paresthesia. Complications included arterial puncture (25.6%), Horner's syndrome (64.1%), and recurrent laryngeal nerve block (1.3%), with no instances of symptomatic phrenic block or symptomatic pneumothorax.