Articles: nerve-block.
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Plasma levobupivacaine concentrations following scalp block in patients undergoing awake craniotomy.
Levobupivacaine is an effective local anaesthetic agent for nerve blockade with less systemic toxicity than racemic bupivacaine. The safety and efficacy of levobupivacaine for scalp blockade during awake craniotomy have not been addressed previously. ⋯ This study demonstrated a relatively rapid rise of plasma levobupivacaine concentration without evidence of cardiovascular or central nervous system sequelae in a sample population of patients who may be particularly prone to perioperative seizures.
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Randomized Controlled Trial Clinical Trial
[Influence of blockades with local anesthetics on the stimulation ability of a nerve by peripheral nerve stimulation. Results of a randomized study].
In the present study we examined the influence of local anesthetics on the ability to stimulate a nerve by means of peripheral nerve stimulation. In 35 patients either 5 ml saline (group 1, n=18) or local anesthetics (group 2, n=17) were injected close to the sciatic nerve in a randomized and double-blind manner. ⋯ Therefore nerve damage might occur despite the use of peripheral nerve stimulation. Thus, the multiple injection technique in a close anatomical area has to be considered critically, because anesthetized or partially anesthetized nerves have a lower stimulating ability and could be damaged by a second or third puncture.
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Paediatric anaesthesia · Jun 2005
Psoas compartment block (PCB) in children: Part II--generation of an institutional learning curve with a new technique.
Literature concerning institutional learning processes for anesthesia procedures in pediatric anesthesia is rare. Until recently only small series of psoas compartment blocks (PCB) in children have been reported. We report on a series of 100 consecutive blocks using new landmarks and the institutional learning process. ⋯ Although the described new technique had a very high success rate with a low complication rate, PCB in children is not easily implemented into clinical practice when strict criteria of success were used, despite a well-controlled environment. Training programs could use CUSUM to track the progress of their institutional learning in order to guarantee adequate experience.
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Peripheral nerve blockade is one of the therapeutic possibilities to treat spasticity of various muscles. Percutaneous nerve stimulation allows accurate location of nerves and neurolysis can be performed using intraneural injection of 65% ethanol or 5 to 12% phenol. Spastic contraction of various muscle groups is a common source of pain and disability which prevents from having efficient rehabilitation. ⋯ No complications occurred and minor side effects are transient painful phenomena during injection. These approaches proved to be accurate, fast, simple, highly successful and reproducible. Percutaneous neurolytic procedures should be done as early as possible, as soon as spasticity becomes painful and disabling in patients with neurological sequelae of stroke, head trauma or any lesion of the motor neuron.
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Paediatric anaesthesia · Jun 2005
Psoas compartment block in children: Part I--description of the technique.
Until recently only small series of psoas compartment blocks (PCB) in children have been reported. A high incidence of epidural spread as an important side effect was noted. A series of 100 consecutive blocks using new standardized landmarks is reported. ⋯ The described new technique has a very high success rate with no relevant side effects. Although only one case of epidural spread occurred, PCB remains an invasive technique with the potential for serious complications.