Articles: nerve-block.
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Reg Anesth Pain Med · Nov 2001
Multicenter Study Clinical TrialAnatomic considerations in relation to the maxillary nerve block.
To determine the length of the needle that should be used to reach the maxillary nerve after the lateral pterygoid plate has been contacted. ⋯ The needle should not be advanced by more than approximately 0.25 cm beyond the distance to the pterygoid plate while performing maxillary nerve block by the lateral extraoral approach.
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Paediatric anaesthesia · Jul 2001
Multicenter Study Clinical TrialPharmacokinetics and analgesic effect of ropivacaine following ilioinguinal/iliohypogastric nerve block in children.
The aim was to investigate the efficacy, tolerance and pharmacokinetics of ropivavcaine when administered for ilioinguinal/iliohypogastric block in children. ⋯ A dose of 3 mg.kg-1 of ropivacaine given as a single ilioinguinal/iliohypogastric nerve block in 1-12-year-old children provides satisfactory postoperative pain relief, and is well tolerated.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A multicentre trial of ropivacaine 7.5 mg x ml(-1) vs bupivacaine 5 mg x ml(-1) for supra clavicular brachial plexus anesthesia.
To compare the efficacy of ropivacaine 7.5 mg x ml(-1) with bupivacaine 5.0 mg x ml(-1) for subclavian perivascular brachial plexus block. ⋯ Thirty ml ropivacaine 7.5 mg x ml(-1) (225 mg) produced effective and well tolerated brachial plexus block of long duration by the subclavian perivascular route. In this study, the results were similar to those of 30 ml bupivacaine 5.0 mg x ml(-1).
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Randomized Controlled Trial Multicenter Study Clinical Trial
Ropivacaine or 2% mepivacaine for lower limb peripheral nerve blocks. Study Group on Orthopedic Anesthesia of the Italian Society of Anesthesia, Analgesia, and Intensive Care.
Intra- and postoperative clinical properties of sciatic-femoral nerve block performed with either ropivacaine at different concentrations or mepivacaine have been evaluated in a multicenter, randomized, blinded study. ⋯ This study suggests that 0.75% ropivacaine is the most suitable choice of local anesthetic for combined sciatic-femoral nerve block, providing an onset similar to mepivacaine and prolonged postoperative analgesia.
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Anesthesia and analgesia · Apr 1999
Multicenter Study Clinical TrialNerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia.
To evaluate the failure rate, patient acceptance, effective volumes of local anesthetic solution, and incidence of neurologic complications after peripheral nerve block performed using the multiple injection technique with a nerve stimulator, we prospectively studied 3996 patients undergoing combined sciatic-femoral nerve block (n = 2175), axillary blocks (n = 1650), and interscalene blocks (n = 171). The success rate and mean injected volumes of local anesthetic were: 93% with 22.6 +/- 4.5 mL in the axillary, 94% with 24.5 +/- 5.4 mL in the interscalene, and 93% with 28.1 +/- 4.4 mL in the sciatic-femoral nerve blocks. Patients receiving combined sciatic-femoral nerve block showed more discomfort during block placement and worse acceptance of the anesthetic procedure than patients receiving brachial plexus anesthesia. During the first month after surgery, 69 patients (1.7%) developed neurologic dysfunction on the operated limb. Complete recovery required 4-12 wk in all patients but one, who required 25 wk. The only variable showing significant association with the development of postoperative neurologic dysfunction was the tourniquet inflation pressure (<400 mm Hg compared with >400 mm Hg, odds ratio 2.9, 95% confidence intervals 1.6-5.4; P < 0.001). We conclude that using the multiple injections technique with a nerve stimulator results in a success rate of >90% with a volume of <30 mL of local anesthetic solution and an incidence of transient neurologic complication of <2%. ⋯ Based on a prospective evaluation of 3996 consecutive peripheral nerve blocks, the multiple injection technique with nerve stimulator allows for up to 94% successful nerve block with <30 mL of local anesthetic solution. Although the data collection regarding neurologic dysfunction was limited, the withdrawal and redirection of the stimulating needle was not associated with an increased incidence of neurologic complications. Sedation/analgesia should be advocated during block placement to improve patient acceptance.