Articles: nerve-block.
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Acta Anaesthesiol Belg · Jan 1982
Sciatic nerve block by the anterior and posterior approach for operations on the lower extremity. A comparative study.
The results of the analgesic block of the lower extremity by means of an anterior (150 patients) or a posterior (114 patients) approach to the sciatic nerve, associated to a "3 in 1 block" were compared. The anterior approach technique was associated with a higher incidence of failures, insufficient analgesia and hence a higher demand for intraoperative analgesic and sedative drugs. ⋯ However, the sciatic nerve block by anterior approach granted a more prolonged analgesia. This technique was suitable for trauma patients immobilized in the supine position, for patients with skeletal traction on Zupinger frame, both for surgery and for closed reduction of lower extremity fractures.
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Regional-Anaesthesie · Jan 1982
[Morphological changes after permanent nerve block by freezing and ethanol injection of the sciatic nerve of the rabbit (author's transl)].
Permanent nerve blocks by intraneurally injected alcohol are often complicated by alcohol-neuritis. Encouraging clinical experiences with permanent blocks by freezing raises the question whether morphological differences between the nerve lesions could explain the difference in their side effects. On 30 rabbits both sciatic nerves were blocked after surgical preparation. ⋯ The nerve lesions of both types of blockade were complete. That produced by the cryoprobe was limited to the small area of local freezing, whereas the alcohol-block produced the same type of nerve degeneration but with a wide-spread extension reaching the sacral plexus. We discuss whether this slight morphological difference might be sufficient to explain the higher complication rate of alcohol blocks.
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The concept of a closed peri-neurovascular space surrounding the cervicobrachial plexus, introduced by A. Winnie, allows the blockade of the cervical and brachial plexuses by means of a single puncture technique. The single puncture has positive advantages: 1. ⋯ A new indication seems to be the implantation of a cardiac pacemaker. Complications often quoted in literature are Horner syndrome-a minor complication-and blockade of the ascending branches of the recurrent laryngeal nerve and of the phrenic nerve. The risk of a pneumothorax is almost nil.