Articles: nerve-block.
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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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Anaesth Intensive Care · Dec 1993
Randomized Controlled Trial Clinical TrialWarm local anaesthetic--effect on latency of onset of axillary brachial plexus block.
A double-blind, controlled trial was conducted to determine whether warming local anaesthetic reduces the onset time of axillary brachial plexus block. Forty patients were randomised into two groups. ⋯ A solution of 40 ml of lignocaine 1.5% with adrenaline 1:200,000 was used for all patients. Warming the local anaesthetic was not demonstrated to reduce the latency of onset of blockade.
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Randomized Controlled Trial Clinical Trial
Orbicular muscle akinesia in regional ophthalmic anaesthesia with pH-adjusted bupivacaine: effects of hyaluronidase and epinephrine.
The success rate and duration of lid akinesia after adding hyaluronidase and/or epinephrine to pH-adjusted bupivacaine was examined in a double-blind fashion in patients undergoing cataract surgery under local anaesthesia. A two-injection-site technique was used. For globe akinesia all patients (n = 120) received an inferolateral intraconal injection (3 ml) of pH-adjusted bupivacaine 0.75% and hyaluronidase. ⋯ No differences in the success rate or duration of the block among the other groups were seen. The duration of the block was longer in the epinephrine groups than in the two other groups (P < 0.01) and longer in the epinephrine and hyaluronidase group than in the group receiving only hyaluronidase (P < 0.05). We conclude that the best initial results and longest duration of blocks were shown in the groups receiving epinephrine or epinephrine and hyaluronidase.
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Randomized Controlled Trial Clinical Trial
Dose-response relationships for edrophonium and neostigmine antagonism of mivacurium-induced neuromuscular block.
We have studied the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by mivacurium chloride. Sixty-four ASA group I or II adults were given mivacurium 0.15 mg kg-1 during fentanyl-thiopentone-nitrous oxide-isoflurane anaesthesia. Train-of-four stimulation (TOF) was applied to the ulnar nerve every 10 s, and the force of contraction of the adductor pollicis muscle was recorded. ⋯ The doses of neostigmine required to achieve 50% (ED50) and 70% (ED70) recovery of the first twitch after 10 min were 2 (1.5-2.5) micrograms kg-1 and 4.7 (4.1-5.4) micrograms kg-1 (mean (95% confidence intervals)), respectively. Corresponding ED50 and ED70 values for edrophonium were 2.8 (0.75-10.2) micrograms kg-1 and 9.2 (3.6-23.6) micrograms kg-1, respectively. These values corresponded to neostigmine:edrophonium potency ratios of 1.4 (0.4-2.4) and 1.95 (0.9-2.9) for first twitch ED50 and ED70 height, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)