Articles: nerve-block.
-
Randomized Controlled Trial Clinical Trial
Modified transthecal digital block versus traditional digital block for anesthesia of the finger.
This study compared the modified transthecal digital block (MTDB) technique with the traditional digital block (TDB) according to the degree of discomfort caused by injection and to the onset and the duration of anesthesia. ⋯ The effect of MTDB is equal to that of TDB in terms of pain perception. For the dorsal and radial proximal zones, the TDB appears to have better distribution of anesthesia. The MTDB has slower onset to anesthesia than the TDB.
-
Selective nerve root blocks are valuable diagnostic and therapeutic procedures in patients with radicular symptoms. Understanding the anatomy, benefits, and risks, as well as precise needle placement, are important factors in performing successful nerve root blocks. The techniques we describe come from our training and ongoing experience. There are other acceptable methods as well.
-
Reg Anesth Pain Med · Jan 2004
Editorial CommentRestricting spinal block to the operative side: why not?
-
Comparative Study Clinical Trial
Brachial plexus anesthesia compared to general anesthesia when a block room is available.
Regional anesthesia is often felt to be beneficial to patient care but detrimental to operating room (OR) efficiency. In this report we compare how a block room (BR) affects OR time (ORT) utilization for brachial plexus anesthesia (BPA) in a busy upper limb practice. We also compare how anesthetic technique, BPA or general anesthesia (GA), impacts on the time to recovery and discharge in patients having outpatient upper limb surgery. ⋯ The use of a BR reduces the anesthesia ORT associated with BPA. Secondly, BPA improves the recovery time phase of outpatients undergoing surgery on the upper limb.
-
Anesthesia and analgesia · Jan 2004
Clinical TrialA novel infraclavicular brachial plexus block: the lateral and sagittal technique, developed by magnetic resonance imaging studies.
A new infraclavicular brachial plexus block method has the patient supine with an adducted arm. The target is any of the three cords behind the pectoralis minor muscle. The point of needle insertion is the intersection between the clavicle and the coracoid process. The needle is advanced 0 degrees -30 degrees posterior, always strictly in the sagittal plane next to the coracoid process while abutting the antero-inferior edge of the clavicle. We tested the new method using magnetic resonance imaging (MRI) in 20 adult volunteers, without inserting a needle. Combining 2 simulated needle directions by 15 degrees posterior and 0 degrees in the images of the volunteers, at least one cord in 19 of 20 volunteers was contacted. This occurred within a needle depth of 6.5 cm. In the sagittal plane of the method the shortest depth to the pleura among all volunteers was 7.5 cm. The MRI study indicates that the new infraclavicular technique may be efficient in reaching a cord of the brachial plexus, often not demanding more than two needle directions. The risk of pneumothorax should be minimal because the needle is inserted no deeper than 6.5 cm. However, this needs to be confirmed by a clinical study. ⋯ A new infraclavicular brachial plexus block method was investigated using magnetic resonance imaging without inserting needles in the volunteers. The study suggests two needle directions for performance of the block and that the risk of lung injury should be minimal. Expectations need to be confirmed by a clinical study.