Articles: nerve-block.
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Postherpetic neuralgia (PHN) remains a difficult pain problem for patients and physicians alike. This review describes the epidemiology and pathophysiology of PHN and discusses proposed mechanisms of pain generation and the various treatments currently available. Evidence is scant for the value of surgical and procedural interventions in general, although there are numerous small studies supporting the use of specific interventions such as nerve blocks, neurosurgical procedures and neuroaugmentation. ⋯ Interventions with low risk, such as TENS are appropriate. Although prevention of postherpetic neuralgia appears to be an appropriate strategy, there is little evidence to support the position that medical or interventional approaches (nerve blocks) will prevent PHN after a patient develops acute herpes zoster (HZ). Although antivirals are appropriate for acute HZ, and the use of neural blockade and sympathetic blockade may be helpful in reducing pain in selected patients with HZ, there is little evidence that these interventions will reduce the likelihood of developing PHN.
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Randomized Controlled Trial Comparative Study Clinical Trial
Sciatic nerve blockade improves early postoperative analgesia after open repair of calcaneus fractures.
To determine the effectiveness of analgesia, with or without sciatic nerve blockade, after open repair of calcaneus fracture. ⋯ Sciatic nerve blockade confers significant benefit over morphine alone for analgesia after open repair of calcaneus fractures. Postsurgical sciatic nerve blockade provides the longest possible postoperative block duration.
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Randomized Controlled Trial Comparative Study Clinical Trial
The radial nerve should be blocked before the ulnar nerve during a brachial plexus block at the humeral canal.
The brachial plexus block through the humeral canal as described by Dupré is indicated in hand and forearm surgery. This block requires a multi-stimulation technique that emphasizes the necessity of a rigorous and safe technique. Nerve injury associated with regional anesthesia can entail significant morbidity for patients. Thus, we investigated the brachial block sequence in terms of unintended nerve stimulation as a surrogate of potential nerve injury. ⋯ Our results indicate that the radial nerve should be blocked before the ulnar nerve when performing a brachial plexus block at the humeral canal.
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Acta Anaesthesiol Scand · Apr 2004
Randomized Controlled Trial Clinical TrialAnalgesia and discharge following preincisional ilioinguinal and iliohypogastric nerve block combined with general or spinal anaesthesia for inguinal herniorrhaphy.
Preincisional ilioinguinal and iliohypogastric nerve block (IINB) reduces postoperative analgesics after inguinal herniorrhaphy. The effect of an IINB on postoperative pain and discharge profile was therefore studied in day-surgery patients undergoing inguinal herniorrhaphy with general or spinal anaesthesia. ⋯ Only a relatively short immediate analgesic benefit could be demonstrated by a combination of IINB with spinal anaesthesia compared with IINB combined with general anaesthesia. The use of general anaesthesia facilitated an earlier postoperative discharge than spinal anaesthesia.
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Am J Phys Med Rehabil · Apr 2004
Case ReportsTibial nerve block with anesthetics resulting in achilles tendon avulsion.
Diagnostic tibial nerve block with anesthetics is a common and safe procedure for the management of the spastic equinovarus foot. Side effects have been rarely reported. We present the case of a hemiplegic patient with a spastic equinovarus foot who presented with an avulsion fracture of the calcaneum at the insertion of the Achilles tendon consecutive to a diagnostic tibial nerve block with anesthetic agents. Although rare, such a complication should be considered when the Achilles tendon is shortened and when the patient is suspected of bone osteoporosis or dystrophy.