Articles: nerve-block.
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A case of transient sympathetic block of the arm following percutaneous intercostal nerve injections is described and the possible aetiology discussed.
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Twenty-one patients scheduled to undergo thoracotomy or median sternotomy had intercostal catheters inserted pre-operatively. During thoracotomy, under direct vision, the spread of 20 ml of a solution containing bupivacaine and methylene blue was followed. ⋯ In three cases, dye was seen crossing the anterior surface of the vertebrae to reach the contralateral aspect. It is concluded that a major component of dermatomal block during intercostal catheterisations may be secondary to paravertebral spread.
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The aim of this study was to demonstrate that the under-used technique of femoral nerve block (F. N. B.) (Berry, 1977) has excellent analgesic action for femoral shaft fractures when performed by junior staff. ⋯ N. B. using a different agent (10 ml 0.5% bupivacaine) was performed and the same parameters were assessed. Both agents gave effective analgesia of varying duration at all levels of fracture site.