Articles: nerve-block.
-
Anesthesia and analgesia · May 2005
Randomized Controlled Trial Clinical TrialDoes femoral nerve catheter placement with stimulating catheters improve effective placement? A randomized, controlled, and observer-blinded trial.
Continuous peripheral nerve blocks offer the benefit of extended postoperative analgesia and accelerated functional recovery after major knee surgery. Conventional nerve localization is performed over a stimulating needle followed by blind insertion of the peripheral catheter. Correct catheter placement is confirmed by testing for satisfactory analgesia. ⋯ The onset time of sensory and motor block was almost similar in both groups. There were no differences in the postoperative IV opioid consumption, and visual analog scale pain scores at rest and movement, or maximal bending and stretching of the knee joint during the 5 days after surgery. We conclude that with continuous femoral nerve blocks, blind catheter advancement is as effective as the stimulating catheter technique with respect to onset time of sensory and motor block as well as for postoperative pain reduction and functional outcome.
-
Bosn J Basic Med Sci · May 2005
ReviewPeripheral nerve blocks for perioperative management of patients having orthopedic surgery or trauma of the lower extremity.
Over the past decade several developments have lead to an increased interest in lower extremity PNBs including transient neurologic symptoms associated with spinal anesthesia, increased risk of epidural hematoma with the introduction of new antithromboembolic prophylaxis regimens, and evidence of improved rehabilitation outcome with continuous lower extremity PNBs. Simultaneously, the field of lower extremity blockade has been revolutionized through our better understanding of functional regional anesthesia anatomy, introduction of new drugs, better and more sophisticated equipment and wider teaching of lower extremity nerve block techniques. This review focuses on techniques and applications of lower extremity nerve blocks in patients having orthopedic surgery or trauma of the lower extremity, as well as potential complications and means to avoid them.
-
Reg Anesth Pain Med · May 2005
Clinical TrialClinical efficacy of the brachial plexus block via the posterior approach.
The posterior approach to the brachial plexus remains underused. We assessed the clinical effectiveness of this technique for shoulder surgery. ⋯ This study reports the clinical effectiveness of the single-injection nerve-stimulation technique for the brachial plexus block via the posterior approach in patients undergoing shoulder surgery. It appears to be effective, relatively safe, and well tolerated.
-
Despite a trend toward the use of regional anesthesia for orthopaedic procedures, there has been resistance to the use of interscalene regional block for shoulder surgery because of concerns about failed blocks and potential complications. ⋯ Interscalene regional block provides effective anesthesia for most types of shoulder surgery, including arthroplasty and fracture fixation. When administered by an anesthesiologist committed to and skilled in the technique, the block has an excellent rate of success and is associated with a relatively low complication rate.
-
Transcrural celiac block using the needle "walking off" the L1 vertebra technique may cause complications. We used patient-specific computed tomography (CT) images as a roadmap to perform the block under fluoroscopy. We present 1 case to describe the technique. ⋯ The modified technique avoided painful needle contact on the bone, reduced needle redirections, and decreased the possibility of vital organ puncture.