Articles: nerve-block.
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The authors evaluated the efficacy and incidence of side effects from blockade of the femoral nerve with 0.5% bupivacaine in 14 children with fracture of the middle third of the femoral shaft. In nine of these children, a pharmacokinetic analysis was also performed. The onset of analgesia occurred in 8.0 +/- 3.5 minutes after blockade of the femoral nerve. ⋯ The maximum bupivacaine plasma concentration was 0.89 +/- 0.37 microgram/ml, obtained 24.4 +/- 12.6 min after the end of the injection. The femoral nerve blockade with bupivacaine provides prompt, effective, and prolonged analgesia in children suffering from fractures of the femoral shaft, allowing transport, radiographic examination, and application of traction in optimal conditions. Although the sample size was small, the side effects appeared to be rare.
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The effect of neostigmine on neuromuscular function was examined after spontaneous recovery from an atracurium-induced neuromuscular blockade, which reached a train-of-four ratio of either 0.5 or 0.9. Two doses of neostigmine 2.5 mg were given 5 minutes apart. Neuromuscular recovery was assessed with train-of-four and tetanic stimuli. ⋯ The train-of-four measured mechanically was adversely affected to a small degree, but when measured with the electromyograph no significant change occurred. Neostigmine may adversely affect neuromuscular function after spontaneous recovery from a non-depolarising block. This is unlikely with a single modest dose and any effects are probably short-lived.
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The pathological course of the most common diseases of the shoulder includes pain as a main symptom. Besides other methods of treatment the infiltration of the suprascapular nerve can improve the therapeutic methods in many cases. ⋯ In 6 more patients it led to an significant reduction of pain. In conclusion this method of local anaesthesia can be recommended as an additional treatment of patients with pain of the shoulder because the rate of complications is low and the technique can easily be done.