Articles: nerve-block.
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Acta Anaesthesiol Scand · May 1985
Effects of adjuvants to local anaesthetics on their duration. I. Studies of dextrans of widely varying molecular weight and adrenaline in rat infraorbital nerve block.
Local anaesthetics of the amide type were studied in a modified rat infraorbital nerve block model, with which it was possible to determine varying degrees of sensory block. Of the agents investigated, 0.5% bupivacaine tended to give a longer duration of block than 2% prilocaine or 2% lidocaine, while 0.5% etidocaine had the shortest duration. The duration of prilocaine was prolonged by addition of adrenaline, 5 micrograms/ml, more than that of the other agents. ⋯ The extent of prolongation was dependent on the degree of block, the concentration of dextrans in the local anaesthetic solution, and the Mw of the dextran although in a less uniform way. An increase in the relative viscosity of the solutions might be a factor of importance for the prolonging effect of addition of dextran to local anaesthetics. Since a formulation providing analgesia of a long duration would be of clinical value, further studies on combinations of the comparatively low-toxicity agent prilocaine and macromolecular substances are of interest.
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This study aimed to establish whether it was practical to perform sciatic nerve block by the anterior approach in a group of children of different ages and weights. A total of 82 blocks were performed of which 78 (95.2%) were judged to have been successful. ⋯ There were no immediate or late complications associated with this block in any of the patients. It is concluded that the block is easy to perform and can produce reliable postoperative analgesia for most common operations on the foot and ankle in paediatric practice.
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Acta Anaesthesiol Scand · May 1985
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory performance after upper abdominal surgery. A comparison of pain relief with intercostal blocks and centrally acting analgesics.
The respiratory capacity was studied during the first 2 days postoperatively in 94 patients, aged 19 to 75 years and undergoing surgery through an upper abdominal incision. Postoperative pain relief was randomly administered, either by intercostal block (i.c.b.) and centrally acting analgesics on demand, or by centrally acting analgesics alone. Respiratory studies comprising forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF) and analysis of arterial blood gases were made. ⋯ Thus postoperative i.c.b. following cholecystectomy performed through a subcostal incision resulted in higher FVC, FEV1 and PEF values than without i.c.b. at least during the time of effective nerve block. I.c.b. after subcostal incision also improved arterial oxygen tension. The patients undergoing cholecystectomy and receiving a second i.c.b. 8 h after the first one had better respiratory function than the patients without any block during the first 2 days postoperatively.
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Acta Anaesthesiol Scand · May 1985
Comparative StudyFactors influencing the respiratory capacity after upper abdominal surgery.
The analgesic requirement and some factors influencing the respiratory capacity after upper abdominal surgery were studied during the first 2 days postoperatively in 417 patients, aged 17 to 84 years, undergoing surgery in the upper part of the abdomen. The operations were cholecystectomy or choledocholithotomy through a subcostal incision, partial gastric resection, repair of a diaphragmatic hernia or vagotomy through a midline incision. Pain relief was achieved in a random order either by intercostal block (i.c.b.) and centrally acting analgesics on demand, or by centrally acting analgesics alone. ⋯ Thus it decreased the demand for centrally acting analgesics and resulted in higher PEF values than without i.c.b. for cholecystectomy during the period of effective nerve block and for choledocholithotomy for 2 whole days postoperatively. Smokers seemed to benefit from i.c.b. for 2 postoperative days. The reduction of PEF after cholecystectomy also seemed to be related to the duration of treatment with centrally acting analgesics.
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Anesthesia and analgesia · May 1985
Acid and alkaline solutions of local anesthetics: duration of nerve block and tissue pH.
The effect of solution pH on the duration of rat infraorbital nerve blocks produced by 1% lidocaine or 0.25% bupivacaine at pH 5.0 and 7.4, with and without epinephrine was investigated in a double-blind study. The time course of tissue pH changes subsequent to infections into the infraorbital area or abdominal musculature of rats was measured with a tissue pH microelectrode. Injectable pH had little or no effect upon the duration of block. Tissue pH was minimally changed by the injection of solutions at pH 7.4, but decreased appreciably with injections of solutions at pH 5.0, or if the injectate contained epinephrine.