Articles: nerve-block.
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Using a carrageenan inflammation rat model, we evaluated two experimental approaches to prolong sciatic nerve block on contralateral hyperalgesia. Method. We performed ipsilateral sciatic nerve block on the inflamed hind paw with bupivacaine-loaded microspheres suspended in dexamethasone (bupivacaine 12.5 mg) and with amitriptyline (6.25 and 12.5 mg) as ultralong-acting local anaesthetics. Bupivacaine (1.25 mg) was used as long-acting local anaesthetic and saline was used as a control. The sixth group received amitriptyline 6.25 mg intraperitoneally (n=10 for each group). ⋯ Because of the differential effect observed on the contralateral side, the mechanism underlying the prolongation of ipsilateral block with amitriptyline may not result only from a prolonged Na(+) channel blockade but might be explained by a local toxic effect or lack of systemic actions.
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Paediatric anaesthesia · Nov 2004
Clinical TrialVertical infraclavicular brachial plexus block in children: a preliminary study.
Brachial plexus blockade is a well-established technique in upper limb surgery. Among the infraclavicular approaches, the vertical infraclavicular brachial plexus (VIP) block is easy to perform and has a large spectrum of nerve blockade. The aim of this preliminary study was to determine the ease, effectiveness, safety, and duration of the VIP block in pediatric trauma surgery. ⋯ In this preliminary study, the VIP block was easy to perform, effective and free of major complications for pediatric trauma surgery. With the doses of ropivacaine we used it was useful for intra- and postoperative analgesia.
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Anesthesia and analgesia · Nov 2004
Adding a selective obturator nerve block to the parasacral sciatic nerve block: an evaluation.
Our aim was to objectively evaluate the efficacy of obturator nerve anesthesia after a parasacral block. Patients scheduled for knee surgery had a baseline adductor strength evaluation. After a parasacral block with 30 mL 0.75% ropivacaine, sensory deficit in the sciatic distribution (temperature discrimination) and adductor strength were assessed at 5-min intervals. ⋯ Injection of 30 mL colored latex into cadavers resulted in spread of the injectate restricted to the sacral plexus. These findings demonstrate the unreliability of parasacral block to achieve anesthesia of the obturator nerve. A selective obturator block should be considered in the clinical setting when this is desirable.
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Rev Esp Anestesiol Reanim · Nov 2004
Case Reports[Convulsions induced by ropivacaine after brachial plexus block].
Ropivacaine is a local anesthetic frequently used to provide regional blocks because its toxicity threshold is favorable and it is highly selective for sensory nerve fibers. Few reports of adverse events and complications related to use of ropivacaine have been published. We report 2 cases of central nervous system toxicity. Each occurred after a brachial plexus block with 0.75% ropivacaine, one performed by an axillary approach and one by an infraclavicular approach with nerve stimulation.
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Case Reports
[Inadvertant epidural placement of a psoas compartment catheter. Case report of a rare complication].
Due to total knee replacement, a 67-year-old female patient had received a combination of general anesthesia and continuous psoas compartment block. An epidural block was detected postoperatively. An X-ray after the injection of contrast medium showed a typical epidurography with the catheter tip projecting into the epidural space. ⋯ We would recommend not to place the catheter further than 5 cm over the tip of the needle. After the first injection the quality of monitoring should correspond with that of an epidural anesthesia. In doubtful cases an injection of contrast medium and an X-ray can be performed.