Articles: nerve-block.
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Insertion of a needle into the dorsum of the foot for lower-extremity venography is painful for many patients, and several attempts at puncture may be necessary. A regional anesthetic technique, superficial peroneal nerve block, has been devised to alleviate this pain. ⋯ Discomfort from performance of the block was minimal in all 20 cases in which it was performed. The block was effective in eliminating or significantly reducing pain in 17 of the 20.
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Comparative Study
Differential use-dependent (frequency-dependent) effects in single mammalian axons: data and clinical considerations.
The potential clinical scope of use-dependent block of conduction (UDB) was assessed by studying characteristics of UDB in vitro in individual mammalian axons. Single and repetitive stimulation was applied to rabbit cervical sympathetic and vagus nerves exposed to solutions containing lidocaine 0, 0.3, or 0.6 mmol/l (9.1 or 18.2 mg/dl) at 37 degrees C. Unit responses were recorded in dissected filaments or extracellularly in the vagus nodose ganglion. ⋯ With lidocaine 0.6 mM, the incidence of equilibrium conduction block was too high among sympathetic axons to assess UDB, and significantly higher than among nonsympathetic myelinated and unmyelinated units. The observations support the hypothesis that the differential block of sympathetics observed clinically with spinal anesthesia may be, at least in part, a use-dependent (frequency-dependent) effect. UDB seems unlikely to contribute to local anesthetic block of pain impulses.
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For decades it has been known that the combined sciatic and femoral nerve block could be used for operations on the leg. Nevertheless, it is used in very few hospitals as a routine method for surgical anesthesia and only few publications exist in this area. To highlight some practical aspects, we have produced a retrospective study of 660 cases of femoral and sciatic nerve blocks used exclusively for operating purposes. ⋯ The most important factor influencing the failure rate was the anesthesiologist. The individual failure rate of the first 30 blocks of each anesthesiologist (V30) was nearly equal to the overall individual failure rate (Fig. 3). The form and time of premedication and the extent of sedation did not influence the results.(ABSTRACT TRUNCATED AT 250 WORDS)