Regional-Anaesthesie
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Regional-Anaesthesie · Jul 1982
Comparative Study[Comparative study between interscalenar and supraclavicular nerve block for the reposition of humero-scapular luxations].
We report experiences in 39 patients, on whom we carried out nerve blocks for shoulder reduction. In 20 cases we used the method described by Kulenkampff and in 19 cases we used the method described by Winnie. ⋯ There were no relevant clinical complications in our study. Because of possible serious incidents in both methods, a technical procedure and strict control of the patient should be observed.
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Regional-Anaesthesie · Apr 1982
[Studies on the effectiveness of obstetric epidural analgesia. I. Vaginal delivery (author's transl)].
In a retrospective study 1,000 women who in 1979 had undergone a delivery either under epidural-anaesthesia or without, and instead either relation training or pethidine in small doses (20-30 mg i.v.) at the Ulm Department of Obstetrics, were followed up by questionnaire. The women of the epidural group felt that they had been adequately informed about the various possibilities of pain relief during labour, while some of the control group felt that they had been inadequately or even incorrectly informed. In the epidural group, pain relief during labour was such that 90% had hardly experienced any, or only mild discomfort, similar degree of pain relief was described by a many as 68.7% of the control group. ⋯ The incidence of headache and back pain was only slightly higher in the epidural as compared to the control group, where other complaints were more frequent. 82% of the epidural group said that they would again choose this form of analgesia for future deliveries, 15% would not. In the control group 22% said that they would like an epidural for future deliveries, while 21% would not. The Apgar scoring and pH values of the newborn showed no significant differences between the groups.
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Regional-Anaesthesie · Jan 1982
Case Reports[Caudal anaesthesia in children and the danger of seizures. A case report (author's transl)].
It is necessary for the modern anaesthetist to be familiar with regional anesthetic techniques for children. When it is not possible to intubate a child, the anaesthetist can use this technique (if the extension of operation allows). ⋯ We are also made aware of the importance of the speed of injection in caudal block. A slow injection prevents development of tachycardia, hypertension, muscle cramps and even unconsciousness.
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Regional-Anaesthesie · Jan 1982
[Morphological changes after permanent nerve block by freezing and ethanol injection of the sciatic nerve of the rabbit (author's transl)].
Permanent nerve blocks by intraneurally injected alcohol are often complicated by alcohol-neuritis. Encouraging clinical experiences with permanent blocks by freezing raises the question whether morphological differences between the nerve lesions could explain the difference in their side effects. On 30 rabbits both sciatic nerves were blocked after surgical preparation. ⋯ The nerve lesions of both types of blockade were complete. That produced by the cryoprobe was limited to the small area of local freezing, whereas the alcohol-block produced the same type of nerve degeneration but with a wide-spread extension reaching the sacral plexus. We discuss whether this slight morphological difference might be sufficient to explain the higher complication rate of alcohol blocks.
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Regional-Anaesthesie · Jan 1982
[Sex difference related complication rates after spinal anaesthesia (author's transl)].
A retrospective study by questionnaire was carried out on 3056 patients (1457 female and 1599 male patients) to ascertain morbidity after spinal anaesthesia with 0,5% isobaric bupivacaine, with special regard taken to the incidence of post spinal headache. It was found that in female patients below the age of 50 the incidence of complaints was higher than in male patients, especially in the 30-50 year range. In male patients the incidence was higher in the 40-60 year group, with the highest incidence in the 50-60 year olds. ⋯ In patients over 60, the incidence dropped and there was no sex difference. There was a higher incidence of headache with larger needles used for spinal anaesthesia. 84% the headaches cleared up within 2 weeks. Only in 9% did the headache persist longer than 4 weeks.