Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Varying anatomical injection points within the thoracic paravertebral space: effect on spread of solution and nerve blockade.
The factors responsible for the spreading pattern of a single paravertebral injection are still uncertain. In this study, 28 patients were randomly assigned to receive a paravertebral injection of radio-opaque dye (10 ml, with or without co-administration of 20 ml of local anaesthetics) either dorsal or ventral to the endothoracic fascia. ⋯ Injections made in the more ventral part of the thoracic paravertebral space, supposedly anterior to the endothoracic fascia, resulted in a multisegmental longitudinal spreading pattern, whereas injections made dorsal to the endothoracic fascia resulted in a less predictable cloud-like spreading pattern, with only limited distribution over adjacent segments. The use of a nerve stimulator-guided technique appears to enhance the likelihood of achieving the more desirable longitudinal spreading pattern.
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Reg Anesth Pain Med · May 2004
Case ReportsThe use of cervical paravertebral block as the sole anesthetic for shoulder surgery in a morbid patient: a case report.
The purpose of this case report is to describe the use of the cervical paravertebral block as the sole anesthetic for shoulder surgery in a patient unable to tolerate general anesthesia. Recent literature describes the continuous cervical paravertebral block as an effective alternative to the interscalene block for the management of postoperative pain after shoulder surgery. ⋯ Continuous cervical paravertebral block provided excellent surgical conditions and postoperative pain relief for this patient and allowed gradual and intermittent dosing of the catheter and continuous assessment of the anesthetic impact on respiratory function.
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Lumbar facet nerve (medial branch) block for pain relief in facet syndrome is currently performed under fluoroscopic or computed tomography scan guidance. In this three-part study, the authors developed a new ultrasound-guided methodology, described the necessary landmarks and views, assessed ultrasound-derived distances, and tested the clinical feasibility. ⋯ Ultrasound guidance seems to be a promising new technique with clinical relevance and the potential to increase practicability while avoiding radiation in lumbar facet nerve block.
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Knee Surg Sports Traumatol Arthrosc · May 2004
Randomized Controlled Trial Clinical TrialBTB ACL reconstruction: femoral nerve block has no advantage over intraarticular local anaesthetic infiltration.
Fifty patients were randomly recruited to receive either femoral nerve block (0.375% Bupivacaine) or an intraarticular local anaesthetic injection for pain control for arthroscopically-assisted ACL reconstruction. Both groups were evenly matched for age ( t-test p >0.05). Tourniquet time did not differ significantly between the groups ( t-test p=0.24). ⋯ All patients but one were discharged home on the first postoperative morning. Our study demonstrates that pain levels can be sufficiently controlled by intraarticular infiltration of bupivacaine coupled with oral analgesia. The level of pain relief achieved could allow this procedure to be performed in a day surgery setting.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective, randomized, double-blinded comparison of ropivacaine 0.5%, 0.75%, and 1% ropivacaine for peribulbar block.
To evaluate the efficacy of three different concentrations of ropivacaine (0.5%, 0.75%, and 1%) together with a single concentration of hyaluronidase administered for peribulbar block. ⋯ While confirming that ropivacaine is a good option for peribulbar anesthesia, this study demonstrated that the use of 0.75% or 1% concentrations are preferred in that they produce quick and deep sensory and motor block of the operated eye. If recovery of normal motor function is important after surgery, the 0.75% concentration probably represents the best compromise.