Articles: nerve-block.
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Obstetrics and gynecology · May 1990
Randomized Controlled Trial Comparative Study Clinical TrialAnesthesia for neonatal circumcision: local anesthesia is better than dorsal penile nerve block.
Several studies document the benefit of dorsal penile nerve block for neonatal circumcision, but the literature does not address the use of local anesthesia. A randomized, controlled, prospective study was conducted to compare the efficacy of dorsal penile nerve block versus local anesthesia. Thirty infants were randomly divided into three equal groups (N = 10): an unanesthetized control group, a group given dorsal penile nerve block, and a group given local anesthesia. ⋯ Dorsal penile nerve block had no effect on postoperative cortisol levels. No complications occurred. Although both types of anesthesia attenuated the physiologic responses to circumcision, local anesthesia demonstrated greater efficacy than dorsal penile nerve block while being simpler to perform.
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Randomized Controlled Trial Clinical Trial
Latency of brachial plexus block. The effect on onset time of warming local anaesthetic solutions.
A double-blind study was set up to investigate the effect of warming local anaesthetic solutions on the latency of onset of subclavian perivascular brachial plexus blocks. Twenty-four adult patients were randomly allocated into two equal groups. ⋯ The speed of onset of sensory blockade was significantly increased when the temperature of the local anaesthetic solution was increased to 37 degrees C. There were no adverse side effects in either group.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between bupivacaine instillation versus ilioinguinal/iliohypogastric nerve block for postoperative analgesia following inguinal herniorrhaphy in children.
This study compared the postoperative pain relief provided by simple instillation of bupivacaine into a hernia wound with that provided by ilioinguinal/iliohypogastric (IG/IH) nerve block. Sixty children undergoing inguinal hernia repair under general anesthesia were randomized to receive 0.25 ml/kg of 0.25% bupivacaine for either IG/IH nerve block or up to 0.5 ml/kg of the same solution for instillation nerve blocks. In the postanesthesia care unit (PACU), a trained blinded observer evaluated the patient's level of postoperative pain using a standardized 10-point objective pain scale. ⋯ The two groups were not significantly different in age, duration of surgery, or anesthesia. There was no significant difference between patients who received the two treatment modalities in their pain scores, analgesic requirements in the PACU, recovery times, and discharge times. These results demonstrate that the simple instillation of local anesthetics into a wound provides postoperative pain relief following hernia repair, which is as effective as that provided by intraoperative IG/IH nerve block.
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Randomized Controlled Trial Clinical Trial
Efficacy of continuous extrapleural intercostal nerve block on post-thoracotomy pain and pulmonary mechanics.
To assess the efficacy of continuous extrapleural intercostal nerve block on postoperative pain and pulmonary function, a prospective, randomized, double-blind, placebo-controlled trial was conducted on 56 patients undergoing elective thoracotomy. Infusion was started before closing the chest and was continued for 5 days. Subjective pain relief was assessed on a linear visual analogue scale. ⋯ Restoration of pulmonary function was superior in the bupivacaine group (P less than 0.01). There were no infusion-related complications. After thoracotomy, continuous intercostal blockade with bupivacaine is a safe and effective method of pain relief which reduces the early loss of postoperative pulmonary function significantly and more rapidly restores respiratory mechanics.
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Thorac Cardiovasc Surg · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialIntrapleural bupivacaine for early post-thoracotomy analgesia--comparison with bupivacaine intercostal block and cryofreezing.
54 patients who had posterolateral thoracotomy were prospectively studied to compare the efficacy of intrapleural bupivacaine with that of bupivacaine intercostal block and cryofreezing. Patients were randomized into three groups. The intrapleural catheter group included 16 patients who had intermittent intrapleural instillation of 20 ml of 0.25% bupivacaine for forty-eight hours postoperatively. ⋯ No complications related to the use of the intrapleural catheter or to bupivacaine toxicity were encountered. In conclusion, the technique of intermittent intrapleural bupivacaine is safe and comparable in efficacy to bupivacaine intercostal block and cryofreezing. Narcotic requirements may be reduced when this technique is used.