Articles: nerve-block.
-
This prospective study was undertaken to evaluate the efficiency of intercostal nerve block (ICNB) with 0.5% bupivacaine (Marcaine) for pain relief in patients with rib fractures and to correlate the degree of pain relief with changes in the peak expiratory flow rate (PEFR) and oxygen saturation (Sao2). ⋯ Significant increases in Sao2 and PEFR occur after ICNB with 0.5% bupivacaine, which also provides sustained analgesia, leading to improvement in respiratory mechanics.
-
Handchir Mikrochir Plast Chir · Feb 2004
[Clinical experiences and dosage pattern in subcutaneous single-injection digital block technique].
100 patients with injuries to their fingers were treated using the subcutaneous digital block as described by Low et al.. Different dosages ranging from 2 to 3 millilitres of a local anesthetic were required to obtain appropriate anesthesia according to the location of injury. 108 finger injuries were treated, 18 thumb injuries, 90 finger injuries. The anesthetic was administered using a 0.55 x 25 mm needle and injected strictly subcutaneously into the flexor crease at the base of the finger or thumb. ⋯ Additionally, we performed a deep local nerve block (Oberst), if the patient still felt discomfort or pain. The severity or type of injury did not play a role according to our findings. The subcutaneous finger block as described by Low et al., therefore, is the method of choice treating injuries to the fingers and to the palmar aspect of the thumb, since it offers a decrease in the amount of anesthetic required and increases patient comfort.
-
Oral Surg Oral Med O · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialInjection pain and postinjection pain of the palatal-anterior superior alveolar injection, administered with the Wand Plus system, comparing 2% lidocaine with 1:100,000 epinephrine to 3% mepivacaine.
The purpose of this prospective, randomized, double-blind study was to compare injection pain and postinjection pain of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine using the computer-assisted Wand Plus injection system to administer the palatal-anterior superior alveolar (P-ASA) injection. Additionally study was done to determine if the use of topical anesthetic decreased the pain of needle insertion with the P-ASA injection. ⋯ The P-ASA injection of 1.4 mL of 2% lidocaine with 1:100,000 epinephrine or 3% mepivacaine, administered with the Wand Plus, has the potential to be a painful injection. The use of topical anesthetic did not significantly reduce pain of needle insertion when compared to a placebo. The incidence of postinjection pain, temporary numbness/paresthesia, and incisive papilla swelling or soreness would indicate that some pain and problems occur with the P-ASA technique, regardless of whether 2% lidocaine with 1:100,000 epinephrine or 3% mepivacaine is used.
-
Anesthesia and analgesia · Feb 2004
Randomized Controlled Trial Clinical TrialDoes a preemptive block of the great auricular nerve improve postoperative analgesia in children undergoing tympanomastoid surgery?
We performed a double-blinded randomized controlled trial to evaluate the efficacy of preemptive analgesia in children undergoing tympanomastoid surgery. Children were divided into two groups: group block-block (BB) received a preemptive great auricular nerve block (GAN-block) with 0.25% bupivacaine with 1:200,000 epinephrine before incision followed by a second GAN-block with 0.25% bupivacaine with 1:200,000 epinephrine 1 h before the end of the procedure. Group sham block-block (SB-B) received a preemptive GAN-block with normal saline before surgical incision followed by a GAN-block with 0.25% bupivacaine with 1:200000 epinephrine 1 h before the completion of the procedure. All patients were evaluated for pain with the objective pain score (OPS) by a blinded observer. There was no difference in pain rescue requirements in the postanesthesia care unit (BB versus SB-B, 1 of 20 versus 3 of 20, P= 0.60) or in the short-stay unit (BB versus SB-B, 5 of 20 versus 11 of 20, P = 0.107) or for the entire hospital stay (P = 0.20). There was no significant difference between groups in the time to first rescue pain medication (BB versus SB-B, 226 +/- 71 min versus 201 +/- 94 min). There was no significant difference between groups regarding vomiting in the postoperative period (P = 0.52). We conclude that a preoperative GAN-block does not offer significant advantages for postoperative pain relief in children undergoing tympanomastoid surgery. ⋯ This double-blinded randomized controlled trial compared the efficacy of preemptive analgesia with a peripheral nerve block of the great auricular nerve for decreasing postoperative pain in children undergoing tympanomastoid surgery. Preemptive analgesia did not improve the quality or duration of postoperative analgesia in our cohort.