Articles: nerve-block.
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Orthopaedic nursing · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialPreventive pain management in the postoperative hand surgery patient.
The purpose of this quasi-experimental clinical study was to investigate differences in postoperative pain management within the hand surgical population. The research question proposed: Is there a difference in the pain experience between postoperative patients who receive an analgesic upon onset of sensation and those who receive an analgesic upon onset of pain? The effectiveness of pain management was compared for two groups of randomly assigned, adult, orthopaedic patients who had undergone elective hand surgery using axillary block anesthesia. The results of this study concluded that more effective pain control was achieved when patients were medicated upon onset of sensation versus onset of pain.
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Southern medical journal · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia after major shoulder surgery with interscalene brachial plexus blockade: etidocaine versus bupivacaine.
Postoperative pain is commonly treated with significant doses of narcotics, occasionally resulting in side effects including nausea, pruritus, and respiratory depression. One potential advantage of regional anesthesia is profound postoperative analgesia that reduces exposure to potent narcotics. To evaluate the efficacy of two long-acting local anesthetics, bupivacaine and etidocaine, in providing pain relief after major shoulder surgery, we randomized 20 patients to receive either bupivacaine or etidocaine for brachial plexus block as the primary anesthetic for shoulder surgery. ⋯ Bupivacaine, however, possesses significant cardiotoxicity and has a relatively delayed onset in peripheral neural blockade. Etidocaine is less cardiotoxic and also has a more rapid onset of effect. Thus etidocaine may be a preferable agent for interscalene block for major shoulder surgery.
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Clinical TrialUltrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus.
We prospectively studied 40 patients (ASA grades I-III) undergoing surgery of the forearm and hand, to investigate the use of ultrasonic cannula guidance for supraclavicular brachial plexus block and its effect on success rate and frequency of complications. Patients were randomized into Group S (supraclavicular paravascular approach; n = 20) and Group A (axillary approach; n = 20). Ultrasonographic study of the plexus sheath was done. ⋯ Because of the direct ultrasonic view of the cervical pleura, we had no cases of pneumothorax. An accidental puncture of subclavian or axillary vessels, as well as neurologic damage, was avoided in all cases. An ultrasonography-guided approach for supraclavicular block combines the safety of axillary block with the larger extent of block of the supraclavicular approach.
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Randomized Controlled Trial Clinical Trial
Ketorolac as a component of balanced analgesia after thoracotomy.
Ketorolac 10 mg or 30 mg i.m., 6 hourly or placebo was given to 75 patients who had undergone thoracotomy, in a randomized double-blind study. All subjects were given intercostal nerve blocks with bupivacaine and had access to i.v. patient-controlled morphine. I.m. ketorolac improved the success rate of the analgesic regimen, with fewer patients withdrawing from the study because of inadequate pain relief.
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Anesthesia and analgesia · Feb 1994
Randomized Controlled Trial Clinical TrialDose-response relationships for edrophonium and neostigmine antagonism of pipecuronium-induced neuromuscular block.
We have studied the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by pipecuronium bromide. Fifty-six ASA physical status I or II adults were given pipecuronium 70 micrograms/kg during fentanylthiopental-nitrous oxide-halothane anesthesia. Train-of-four (TOF) stimulation was applied to the ulnar nerve every 10 s, and the force of contraction of the adductor pollicis muscle was recorded. ⋯ Corresponding ED50 and ED80 values for endrophonium were 84.1 (72.9-96.9) and 233 (215.7-253.3) microgram/kg, respectively. These values corresponded to neostigmine:edrophonium potency ratios of 9.89 (7.4-12.3) and 13.4 (11.8-14.9) for first twitch ED50 and ED80 height, respectively. The calculated doses producing 50% (ED50) recovery of the TOF ratio at 10 min were 18.8 (17.5-20.2) and 271.3 (246.5-298.6) microgram/kg for neostigmine and edrophonium, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)