Articles: nerve-block.
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Acta Anaesthesiol Scand · Dec 1984
Randomized Controlled Trial Comparative Study Clinical TrialPerivascular axillary block V: blockade following 60 ml of mepivacaine 1% injected as a bolus or as 30 + 30 ml with a 20-min interval.
Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. ⋯ There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.
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Randomized Controlled Trial Clinical Trial
Penile block for pain relief after circumcision in children. A randomized, prospective trial.
The value of adjunctive penile block for analgesia, after circumcision in children using 0.5 percent bupivacaine has been evaluated in this randomized, prospective trial. Significantly more children without nerve block were found to require analgesics, administered by injection orally, in the first 12 hour period when compared with children given the nerve block. Penile block is a procedure that is safe, simple to achieve, free from complications, and covers the postoperative period when analgesia is much needed.
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Acta Anaesthesiol Scand · Apr 1983
Randomized Controlled Trial Clinical TrialPerivascular axillary block II: influence of injected volume of local anaesthetic on neural blockade.
Perivascular axillary blockade was performed on 150 patients with the aid of a catheter technique. Blockade failure due to injection outside the neurovascular sheath was found in 5.7% of the subject material. The patients were randomly allocated to three groups. ⋯ Sensory and motor blockade was tested 30 min after each injection. The following results were obtained: 1) Apart from the axillary, musculocutaneous and radial nerves, a high frequency of analgesia was found in all cutaneous areas (over 85%). 2) In the axillary area, improvements were found with increasing volume. 3) Analgesia in the musculocutaneous area occurred in 52% of the patients in group 1 (20 ml) and improved to 75% in group 2 (40 ml). However, no difference was found between group 2 and group 3 (80 ml). 4) Volume had no influence on analgesia in the radial area. 5) Motor blockade was intensified with decreasing volume, i.e. with an increase of concentration of local anaesthetic solution.
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Anesthesia and analgesia · Feb 1982
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block.
The relatively new technique of epidural morphine analgesia was compared with two well established method of pain relief in 90 patients undergoing gallbladder surgery and divided randomly into three groups of 30 patients each. The first group received intramuscular narcotic analgesic ketobemidone, the second group was given 0.5% bupivacaine-epinephrine intercostal nerve block, and the third group received a single dose of 4 mg of epidural morphine for postoperative pain relief. The mean duration of analgesia after ketobemidone was 5.5 hours, and after intercostal block 11 hours. ⋯ Delayed respiratory depression was not encountered after epidural morphine. It is concluded that a single dose of 4 mg of epidural morphine provides excellent regional analgesia of long duration without drowsiness or circulatory of respiratory depression thus facilitating early ambulation. The technique is superior to more common methods of pain relief after gallbladder surgery, e.g., intercostal nerve block and intramuscular narcotics.
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Randomized Controlled Trial Clinical Trial
Intercostal nerve block with thoracoabdominal and flank incisions.
A double-blind study was done in 90 patients undergoing a rib-resecting thoracoabdominal incision for testicular cancer or a flank incision for renal surgery to determine the effect of intraoperative intercostal nerve block with bupivacaine hydrochloride on postoperative pain and complications, day of ambulation, and day of oral fluid intake. In the patients treated with bupivacaine, we found a significant reduction in the amount of postoperative analgesia required, but no difference in the day of ambulation or fluid intake. Ten of 45 patients given a placebo nerve block experienced postoperative atelectasis, whereas only 4 of 45 patients in the treated group experienced this complication. We believe that intercostal nerve block is a valuable postoperative adjuvant in patients undergoing flank surgery to reduce the postoperative analgesic requirements and incidence of atelectasis.