Articles: nerve-block.
-
Reg Anesth Pain Med · Sep 2003
Altered perceptions after upper and lower extremity blocks: an initial investigation.
Nerve blocks frequently produce unusual altered perceptions in the extremities. We examined perceptual changes experienced after peripheral blocks. ⋯ The results of this study confirm and quantify the perceptions experienced by patients undergoing upper and lower extremity blocks. These perceptions are prevalent. This knowledge is helpful in providing patients with accurate preoperative preparation. Further investigation is warranted to determine the neurologic etiology of these observations.
-
Anesthesia and analgesia · Sep 2003
Clinical TrialPerioperative continuous peripheral nerve blocks with disposable infusion pumps in children: a prospective descriptive study.
Continuous peripheral nerve blocks (CPNB) after pediatric major orthopedic surgery are not widely used. We conducted a prospective descriptive study to evaluate the effectiveness of disposable elastomeric pumps for CPNB in children. After inducing general anesthesia, 25 consecutive children scheduled for major orthopedic surgery received a 0.5-mL/kg bolus of a mixture of 1% lidocaine with epinephrine and 0.25% bupivacaine in axillary, femoral, or popliteal catheters. ⋯ Sensory and motor block were noted at H1 and decreased from the sixth hour. No adverse events were noted. We concluded that the use of elastomeric disposable pumps for CPNB in children was an effective technique.
-
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.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2003
Review["Pre-warming" - how can perioperative hypothermia be avoided?].
Perioperative hypothermia is a well known problem in general and neuroaxial anaesthesia. Some years ago effective therapeutic means as e. g. forced air systems and infusion heaters were introduced into clinical routine. If these systems are used intraoperatively only, hypothermia is solely treated symptomatically. ⋯ Pre-warming is a simple, effective and cheap way to reduce perioperative hypothermia. This article gives a short overview on pathophysiology of perioperative hypothermia. Published clinical experiences are discussed and practical guidelines for everyday-use given.
-
Apart from conventional epidural analgesia (EA), the combined spinal-epidural (CSE) modality is fast becoming a popular technique for treating labour pain. In this study, we investigated the differences in the patient profile and outcome between CSE and EA for labour pain in KK Women's and Children's Hospital. ⋯ CSE is a safe and good alternative to EA as a technique of neuraxial block for labour analgesia.