Articles: nerve-block.
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Reg Anesth Pain Med · Sep 2003
Clinical TrialLateral approach to the sciatic nerve block in the popliteal fossa: correlation between evoked motor response and sensory block.
The purpose of this study was to identify which of two motor responses of the foot (plantar flexion versus dorsiflexion) best predicts complete sensory blockade of the sciatic nerve when is used for lateral popliteal sciatic nerve block. ⋯ After stimulation of the sciatic nerve, plantar flexion better predicts complete sensory blockade of the foot than dorsiflexion when using the lateral approach to the popliteal fossa. The findings of the present study apply to a single injection of 30 mL of ropivacaine 0.75%.
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Ambulatory perineural local anesthetic infusion is a relatively new method for providing postoperative analgesia, and many aspects of this technique remain in the domain of conjecture and speculation. This retrospective chart review and survey was undertaken to investigate patients' opinions on various aspects of their ambulatory perineural infusion experience. ⋯ This investigation suggests that perineural local anesthetic infusion is generally well tolerated by ambulatory patients.
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Best Pract Res Clin Anaesthesiol · Sep 2003
Case Reports Comparative StudyIntrathecal neurolytic blocks for the relief of cancer pain.
Intrathecal neurolytic blocks for the treatment of chronic pain were first described by Dogliotti in 1931. Since then, many authors have described the intrathecal injection of various neurolytic substances for the treatment of oncologic pain. In recent years, alcohol and phenol have been the substances most commonly used for this purpose. ⋯ Four cases of cancer patients whose intractable pain was treated by the authors using intrathecal neurolysis are presented. Pertinent literature is reviewed. In this account, the emphasis is on proper selection of patients and techniques.
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Reg Anesth Pain Med · Sep 2003
Computed tomography scanning of the sciatic nerve posterior to the femur: Practical implications for the lateral midfemoral block.
Using computed tomography (CT) scans of the thighs, this study addresses sciatic nerve anatomy at the injection site for the lateral midfemoral sciatic nerve block. It addresses the recommendation of neutral leg rotation to facilitate block placement. ⋯ The characteristics of sciatic nerve anatomy described in this study support observations and clinical recommendations regarding lateral midfemoral sciatic nerve block.
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Anesthesia and analgesia · Sep 2003
Case ReportsAn indication for continuous cervical paravertebral block (posterior approach to the interscalene space).
We present a patient who required perioperative analgesia with continuous nerve block for shoulder disarticulation, for whom the only approach possible to the brachial plexus was from posterior. A 51-yr-old woman was suffering from intractable upper extremity pain and dysfunction as a result of severe lymphedema after metastatic spread of breast cancer to the axilla. Her pain was poorly controlled despite aggressive treatment with oral, systemic, and intrathecal opiates. ⋯ In order to provide optimal postoperative analgesia, continuous peripheral nerve block was selected in consultation with the patient, and due to anatomic disfigurement and tumor invasion, a continuous cervical paravertebral block was placed preoperatively and shoulder disarticulation was performed using a combined regional/general anesthesia technique. The patient had an uneventful recovery without pain for the 6 postoperative days that the catheter was in place and 0.25% bupivacaine was infused at 5 mL/h. Because of anatomic considerations, which precluded the use of all other approaches to the brachial plexus, the posterior cervical paravertebral approach provided an effective means of pain control in this difficult clinical situation.