Articles: nerve-block.
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Reg Anesth Pain Med · Jan 2004
Comparative Study Clinical TrialThigh rotation and the anterior approach to the sciatic nerve: a magnetic resonance imaging study.
The anterior approach to the sciatic nerve block may be associated with a high failure rate because the nerve lies posterior to the lesser trochanter of the femur at the level of needle insertion. However, previous work using cadavers demonstrated that internal rotation of the leg renders the nerve more accessible to the anterior approach. ⋯ The results confirm that, as the thigh is moved from an externally to an internally rotated position, the sciatic nerve becomes more accessible by the anterior approach at the level of the lesser trochanter, and the risk of femoral artery or nerve puncture is reduced but not eliminated.
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Reg Anesth Pain Med · Jan 2004
Clinical TrialLower lobe collapse during continuous interscalene brachial plexus local anesthesia at home.
We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic infusion administered at home. This case highlights the need for patient education and postoperative communication. ⋯ Good communication must be maintained with the patient at all times. Doctors from other specialties may be unaware of the potential complications of an interscalene block.
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Reg Anesth Pain Med · Jan 2004
Case ReportsAccidental subdural injection during attempted lumbar epidural block may present as a failed or inadequate block: radiographic evidence.
Until now, case reports after accidental subdural injection during attempted epidural block have usually described extensive neuraxial blocks with a delayed onset, after low doses of local anesthetic, with a characteristic radiographic appearance on contrast injection. Our radiographic investigation of atypical "epidural" blocks has revealed that subdural injection may go unrecognized clinically and may be a cause of inadequate blocks. The mechanism is explored. ⋯ Accidental subdural injection may now be added to the list of causes of failed or inadequate "epidural" block. Clinicians should be aware of the diagnosis of a possible subdural injection, if a poor quality block with restricted spread and slow onset is associated with pain on postoperative reinjection of the catheter.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Intercostal nerve blockade with alcohol during operation for postthoracotomy pain].
Purpose of this study was to evaluate the effectiveness of intraoperative intercostal nerve blockade with alcohol in addition to epidural analgesia with morphine for control of postthoracotomy pain syndrome. ⋯ Additional intraoperative intercostal nerve blockade with alcohol provides an additional benefit for postthoracotomy pain relief, especially for at least one month following the thoracotomy.