Articles: nerve-block.
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The aims of this study are to determine if the injection of a single large dose of local anesthetics into the paravertebral space increases the risks of inducing toxicity compared with multiple small injections and to describe ropivacaine plasma concentrations resulting from paravertebral blockade. ⋯ The injection of a single large bolus of local anesthetics into the paravertebral space does not increase its absorption. Maximal ropivacaine plasma concentrations resulting from paravertebral blockade are similar to those reported with equivalent doses of bupivacaine.
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Major shoulder surgery can be extremely painful. Interscalene brachial plexus catheters provide excellent postoperative analgesia but are technically difficult to place. A new insulated Tuohy needle system for plexus catheterisation is now available. ⋯ Mean [range] catheter insertion time was 3.6 [1-10] min. Decreased block and catheter insertion times were associated with experience with the equipment when comparing the mean (SD) times for the first seven catheters and the last seven catheters inserted (12.1 (4.2) min vs. 7.9 (2.4) min), p < 0.05). It is concluded that the insulated Tuohy needle system for interscalene catheterisation proved easy to use in the hands of someone who had not used it before, and can be recommended.
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Br J Oral Maxillofac Surg · Jun 2003
Case ReportsSurgical emphysema and Collet-Sicard syndrome after cryoblockade of the inferior alveolar nerve.
We present a case of Collet-Sicard syndrome (palsy of cranial nerves IX-XII) together with cervicofacial emphysema after cryoblockade to the mandibular division of the trigeminal nerve.
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Rev Esp Anestesiol Reanim · Jun 2003
[Possibility of nerve lesions related to peripheral nerve blocks. A study of the human sciatic nerve using different needles].
When a needle tip comes too close to a nerve axon, the mechanical effect over the nerve membrane produces paresthesia. We examined the hypothetical mechanical damage of short bevel and long bevel needles over sciatic nerve bundles under scanning electron microscopy. ⋯ Lesions that affect superficially the epineurum can cause paresthesia by compression of nerve fascicles without damaging the axons. If the perineurm is damaged, the lession will also affect the blood-nerve barrier, leading probably to posterior sequels.
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Case Reports
[Incorrect positioning of a catheter for continuous block of the nervus suprascapularis. A case report].
The case of a 55-year-old woman is described where shoulder pain was successfully treated with a suprascapular catheter. During arthroscopy of the shoulder the catheter was detected in the subacromial space. The reasons and consequences of an abnormal position of the suprascapular catheter are discussed.