Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
A double-blind randomised controlled trial of laparoscopic uterine nerve ablation for women with chronic pelvic pain.
To determine the effectiveness of laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain in women with endometriosis and women with no laparoscopic evidence of endometriosis. ⋯ LUNA is effective for dysmenorrhoea in the absence of endometriosis, although there is no evidence of effectiveness of LUNA for non-dysmenorrhoeic chronic pelvic pain or for any type of chronic pelvic pain related to endometriosis.
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Haemostatic deficiencies, common among cirrhotic patients, may deteriorate further after hepatectomy, increasing the bleeding risk associated with the use of thoracic epidural analgesia. We describe two patients who enjoyed immediate post-operative tracheal extubation and satisfactory analgesia using mainly right thoracic paravertebral analgesia after right lobe hepatectomy.
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Reg Anesth Pain Med · Sep 2004
A study of the characteristics of single-injection insulated block needles in a biologic model.
Single-injection block needles are manufactured in many different lengths, diameters, and tip designs, but the literature contains no reports of methods to assess clinical characteristics of regional-block needles. A novel animal model for the assessment of the characteristics of single-injection regional anesthesia needles is described. ⋯ This type of biologic model can be used for the quantifiable and repeatable assessment of different needle tip designs. Needles with moderate resistance and high feel were preferred.
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Reg Anesth Pain Med · Sep 2004
Combination of intraneural injection and high injection pressure leads to fascicular injury and neurologic deficits in dogs.
Unintentional intraneural injection of local anesthetics may cause mechanical injury and pressure ischemia of the nerve fascicles. One study in small animals showed that intraneural injection may be associated with higher injection pressures. However, the pressure heralding an intraneural injection and the clinical consequences of such injections remain controversial. Our hypothesis is that an intraneural injection is associated with higher pressures and an increase in the risk of neurologic injury as compared with perineural injection. ⋯ High injection pressures at the onset of injection may indicate an intraneural needle placement and lead to severe fascicular injury and persistent neurologic deficits. If these results are applicable to clinical practice, avoiding excessive injection pressure during nerve block administration may help to reduce the risk of neurologic injury.