Articles: nerve-block.
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Case Reports Randomized Controlled Trial Clinical Trial
Comparison of the effectiveness of bilateral ilioinguinal nerve block and wound infiltration for postoperative analgesia after caesarean section.
We have studied the effects of bilateral ilioinguinal nerve block and wound infiltration with 0.5% bupivacaine on postoperative pain and analgesic requirements in 62 patients undergoing Caesarean section under general anaesthesia. A control group received no local anaesthetic supplementation. Both ilioinguinal block and wound infiltration reduced significantly the pain scores and analgesic requirements in the immediate postoperative period (P < 0.05). The differences in pain scores and analgesic requirements between the study groups were not statistically significant (P > 0.05).
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Randomized Controlled Trial Clinical Trial
Retrobulbar block fails to prevent an increase in serum cortisol concentration on emergence from anaesthesia after cataract surgery.
We have studied 30 elderly patients undergoing cataract surgery, allocated randomly to receive general anesthesia, local anaesthesia by retrobulbar block or general anaesthesia combined with retrobulbar block given after induction. Retrobulbar block alone prevented the increases in circulating cortisol and glucose values which occurred in those patients receiving general anaesthesia alone. Retrobulbar block given after induction of general anaesthesia, however, suppressed the cortisol and glucose response during surgery, but did not prevent a marked increase in cortisol concentrations during the immediate postoperative period. The results suggest a hormonal response to emergence from anaesthesia which has hitherto been masked by the stress response to surgery itself.
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Langenbecks Arch Chir · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[A concept for decreasing postoperative pain after inguinal hernia operation].
In Germany approximately 150,000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. ⋯ An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intercostal nerve block for lumpectomy: superior postoperative pain relief with bupivacaine.
To investigate whether equipotent doses of lidocaine and bupivacaine were equally effective for intercoastal nerve blockade (ICNB) and whether a lower amount of lidocaine would be comparably effective. To see whether plasma levels of lidocaine with and without epinephrine and of plain bupivacaine would reach toxic ranges. Finally, to evaluate the duration of postoperative analgesia following general anesthesia and regional anesthesia with two different local anesthetics. ⋯ ICNB is an alternative to general anesthesia for female breast surgery. Both lidocaine with epinephrine and plain bupivacaine in the doses used did not raise venous plasma concentrations to levels considered potentially toxic. With respect to duration of postoperative pain relief and analgesic drug request, the local anesthetics (in particular, bupivacaine) were found to be superior to general anesthesia.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialSciatic nerve block. A comparison of single versus double injection technique.
Two techniques, single versus double injection, for blocking the sciatic nerve via the classical (Labat) approach were prospectively evaluated for onset and efficacy of block in 50 adult patients undergoing lower extremity surgery. The tibial, common peroneal, and posterior femoral cutaneous nerves were evaluated at 5, 10, 15, 20, 30, and 45 minutes after the initial injection of local anesthetic. Motor function was used to assess the block of the tibial and common peroneal nerves while pinprick response was used to assess block of the posterior femoral cutaneous nerve. ⋯ The double injection technique for sciatic nerve block via the classical approach results in a more rapid onset and increased efficacy of block than that of the single injection technique.