Articles: nerve-block.
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The incidence of failed local anesthetic axillary blockade varies but can be as high as 20-30%. The authors propose to evaluate the safety of supplementing an axillary block with mepivacaine 30 min after the initial injection. An axillary blockade was performed on 10 healthy patients scheduled for forearm or hand surgery using a new catheter technique. ⋯ Plasma levels of mepivacaine were estimated at frequent intervals for 5 h after the initial injection. There were no symptoms or signs of local anesthetic toxicity, and plasma levels of mepivacaine remained below those that usually caused symptoms. In conclusion, the authors conclude that mepivacaine 1% with epinephrine (10.5 mg/kg) can be safely administered in divided doses into the axillary sheath within a 31-min period.
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J Am Podiatr Med Assoc · Mar 1989
Randomized Controlled Trial Clinical TrialThermographic evaluation of the autonomic effects of nerve blocks in the foot.
The authors evaluated regional skin temperatures of the foot following the administration of a variety of local anesthetic nerve blocks with either Xylocaine (lidocaine hydrochloride) or Sensorcaine (bupivacaine hydrochloride). The study was carried out on ten randomized parallel groups of five subjects, each group being tested with one drug and one regional nerve block. The results indicated that both Xylocaine and Sensorcaine, when administered as a posterior tibial block, result in a significantly increased blood flow to the foot. Nerve blockade of the remaining nerves of the foot did not significantly increase the sympatholytic effect obtained by posterior tibial nerve block alone.
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Anesthesia and analgesia · Mar 1989
Comparative StudyExtent of blockade with various approaches to the lumbar plexus.
The extent of blockade when four different techniques were used for blocking the lumbar plexus was prospectively evaluated in 80 adult patients. The extent of blockade was measured by testing motor function of all nerves except the lateral and posterior femoral cutaneous nerves, which were evaluated by pinprick response. ⋯ None of the four techniques produced blockade of the sacral plexus. Perhaps our means of assessing blockade (motor) is what produced the difference between our findings and those of others.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of continuous paravertebral and extradural infusions of bupivacaine for pain relief after thoracotomy.
Pain was controlled in 20 post-thoracotomy patients using a continuous infusion of 0.25% bupivacaine through an extradural or para-vertebral catheter. Both techniques provided good analgesia. Hypotension and urine retention occurred significantly less frequently in the paravertebral than in the extradural group.
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparison study of vecuronium bromide and atracurium besylate for rapid sequence induction.
Rapid sequence induction is necessary in emergency surgical operations to lessen the chance of aspiration of stomach contents. Succinylcholine usually is the relaxant of choice, because of its rapid onset. However, succinylcholine has side effects which may result in potentially life-threatening conditions. ⋯ Group I subjects showed a significantly faster time to 80-90% neuromuscular block when compared with subjects in Group II and III, but no difference in the time to 80-90% block was revealed between Group II and Group III subjects. Conditions for intubation at 80-90% neuromuscular blockade were the same for all three groups. It was concluded that the administration of vecuronium and atracurium using the priming principle did not allow onset times similar to succinylcholine and that the intubating conditions were similar among all three groups at 80-90% neuromuscular blockade.