Articles: nerve-block.
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Acta Anaesthesiol Scand · May 1987
Clinical Trial Controlled Clinical TrialPostoperative pain relief and bupivacaine plasma levels during continuous interscalene brachial plexus block.
Interscalene brachial plexus block was performed on 40 patients for prophylactic pain relief after shoulder surgery. A dose of 1.25 mg/kg of 0.5% bupivacaine was injected for the block (Group 1) and continued with an infusion of 0.25% bupivacaine 0.25 mg/kg/h (Group 2). If the postoperative analgesia was insufficient, the patients received i.m. oxycodone 0.15 mg/kg. ⋯ At 30 min, the mean bupivacaine plasma concentration was 1.0 microgram/ml in Group 1 and 0.9 microgram/ml in Group 2. The mean plasma level of bupivacaine increased from 0.7 microgram/ml after 180 min to 1.1 micrograms/ml (P less than 0.01) after 24 h of infusion, providing some evidence of accumulation during infusion. The dizziness and confusion experienced by three patients could be associated with the local anaesthetic, as they obtained relief after the infusion was stopped.
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A modified technique of intercostal nerve blockade is described which is suitable for use in children. Ten patients received intercostal nerve blockade on a total of 29 occasions in order to provide analgesia following liver transplantation and to facilitate weaning from artificial ventilation of the lungs. ⋯ The technique has proved to be safe in skilled hands. It is an acceptable method of postoperative analgesia in children after liver transplantation and may be a useful technique in the management of other paediatric patients.