Articles: nerve-block.
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Minerva anestesiologica · Apr 1980
Comparative Study Clinical Trial[0.75% and 0.5% bupivacaine in peridural lumbar block for surgery on the lower abdomen; a double-blind comparison and myographic study].
A double blind study has been carried out on 40 patients subjected to peridural block with 0.50% and 0.75% bupivacaine for operations on the low abdomen. While no significant differences were observed with regard to the latency and duration of anaesthetic action, 0.75% marcaine was more effective as regards the duration and degree of motor block. This result was also confirmed by an electromyographic study of the muscles of the hypothenar eminence.
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A technique employing a nerve stimulator and an insulated needle was used for supraclavicular brachial plexus block in 71 patients using 0.5% plain bupivacaine 15-20 ml. The mean minimal stimulating current to produce paraesthesia was 0.09 mA. The plexus was identified at a mean depth of 27 mm below the skin. The block was successful in 98% of patients when the stimulation was felt in the index, middle or ring finger, but was often incomplete when felt in the thumb or little finger.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cryoanalgesia for post-thoracotomy pain.
Intercostal block by a freezing technique was compared with blockade by local anaesthetics or no blockade as a method of treating post-thoracotomy pain. The 15 patients who received cryotherapy had significantly less postoperative pain than the 9 patients whose nerves were blocked by local anaesthetics or who did not receive any nerve block. The interruption of nerve function produced by cryotherapy was temporary (not more than 30 days), and there were no adverse sequelae.
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Minerva anestesiologica · Mar 1980
Case Reports[Case of high spinal anesthesia as a complication of an interscalenic brachial plexus block].
A case of high spinal anesthesia complicating an interscalene brachial plexus block is described. After an apparently straightforward location of the plexus with good paresthesias, the injection of 10 ml of local anesthetic caused a high spinal block whose main feature was apnea. The patient retained his consciousness until he was anesthetized with thiopentone and N2O-O2 and had a vivid recollection of the accident. ⋯ The clinical picture compared to previous cases reported in the literature is commented on. A possible subarachnoid spread of the local anesthetic via the perineural space following intraneural injection is discussed. The author advocates the use of needles no longer than 1 inch for the interscalene approach to the brachial plexus.