Articles: nerve-block.
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The Journal of pediatrics · Jun 1978
Neonatal circumcision and penile dorsal nerve block--a painless procedure.
Circumcision is the only surgical procedure, excluding cord-clamping and cutting, which is routinely performed on normal, healthy newborn infants, usually during the first two or three days of life. Apparently no analgesic technique has been described nor suggested in association with neonatal circumcision. This is the first description of a technique of penile dorsal nerve block in neonatal circumcision. In 52 instances using 0.5 ml of 1% lidocaine (Xylocaine) and a 1.2 cm number 27 gauge needle PDNB was successfully and safely introduced with consistent elimination of pain, rendering NC a painless surgical procedure.
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Comparative Study Clinical Trial Controlled Clinical Trial
Value of hyaluronidase in ocular surgical akinesia.
In a study of 27 cases of surgery for cataract extraction, mepivacaine 2% with hyaluronidase was found to shorten the induction times of facial nerve and retrobulbar blocks when compared to injections of mepivacaine 2% alone. The mean induction time of facial nerve blocks with hyaluronidase was 1.3 +/- 0.4 minutes. ⋯ The median induction time with hyaluronidase was three minutes, whereas that without hyaluronidase was ten minutes. However, the use of hyaluronidase did not significantly (.25 less than P less than .50) alter the success rate of retrobulbar blocks.
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Convulsions developed in two patients after retrobulbar block. The amount of local anesthetic agent that was used was considerably less than the intravenous toxic dose in both cases. No retrobulbar hemorrhage resulted. The probable cause of seizures was inadvertent injection of local anesthetic directly to the CNS via the ophthalmic artery or its sheath.
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The time from the end of surgery to the administration of the first post-operative analgesic has been measured in 86 patients following brachial plexus block with bupivacaine, lignocaine, nepivacaine or prilocaine. A signficant increase in time occurred with bupivacaine; the combination of regional and general anesthesia significantly increased the time when compared with general anaesthesia in the same patient. In children, the use of regional anaesthesia almost removed the need for analgesia after surgery.