Articles: nerve-block.
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Acta Anaesthesiol Scand · Feb 1984
Perivascular axillary block III: blockade following 40 ml of 0.5%, 1% or 1.5% mepivacaine with adrenaline.
Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. All blockades were performed by the same anaesthetist, who practised perivascular axillary blockade three or four times a day. The patients were randomly allocated to three groups. ⋯ All three groups showed a high incidence of analgesia (70%-100%) in all cutaneous segments, and none of the blockades showed total failure of the sensory blockade. The lowest incidence of sensory blockade was found in the areas innervated by the axillary, the radial and the musculocutaneous nerves, but no difference was found between the groups. However, the motor blockade was found to improve with increasing concentration of local anaesthetic solution.
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Acta Anaesthesiol Scand · Feb 1984
Perivascular axillary block IV: blockade following 40, 50 or 60 ml of mepivacaine 1% with adrenaline.
Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. The patients were randomly allocated to receive either 40, 50 or 60 ml of 1% mepivacaine with adrenaline 1:200,000. Blood concentrations of mepivacaine were measured up to 90 min after injection in seven, eight and ten of the patients from the three groups. ⋯ None of the 90 patients showed any signs of systemic toxic reactions. The mean peak values of blood concentrations were 0.5-1.0 microgram/ml higher in the groups given 50 ml and 60 ml than in the group given 40 ml. On the basis of the present and two previous investigations on the dose response in perivascular axillary blockade, a dose of 50 ml 1% mepivacaine with adrenaline or another equivalent drug with vasoconstrictor is recommended.
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Comparative Study
Differential peripheral nerve block by local anesthetics in the cat.
Controversy still surrounds the differential susceptibility of nerve fibers to local anesthetic conduction block. In order to help resolve this controversy, we developed an in vivo model of peripheral nerve blockade in the cat that closely reproduced the clinical state. Using this model, differential rate of nerve blockade of A-alpha, A-delta, and C fibers by 2-chloroprocaine, lidocaine, bupivacaine, and etidocaine was observed and quantitated. ⋯ Etidocaine blocked A-delta fibers first. A-alpha fibers always were blocked last. Of the four local anesthetics tested, 2-chloroprocaine produced the greatest differential rate of block of the nerve fibers, and etidocaine produced the least.
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Case Reports
Superior laryngeal nerve block: an aid to intubating the patient with fractured mandible.
Awake nasotracheal intubation in the patient with a fractured mandible may be facilitated by combining bilateral superior laryngeal nerve block with topical application of local anesthetic to the nose, mouth, and trachea. Successful use of this technique is described in two such patients.