Articles: nerve-block.
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Rev Esp Anestesiol Reanim · Mar 2003
[Platelet count and hematic punction with epidural block in obstetrics].
The reference value for and the significance of mild thrombocytopenia associated with pregnancy remain undetermined, and therefore the timing, validity and meaning of coagulation tests before a regional block may vary. ⋯ A complete clinical history must be obtained during the anesthetist's interview with the patient in the last month of pregnancy, and detailed information on the risk of regional blocks during labor must be offered. When blood tests at the time of the interview are normal and the clinical history indicates low risk, repeating tests immediately before the block is unjustified, provided the clinical situation does not change.
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Acta Anaesthesiol Scand · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialLidocaine versus ropivacaine for continuous interscalene brachial plexus block after open shoulder surgery.
This study compared the postoperative infusion of 1% lidocaine and 0.2% ropivacaine for continuous interscalene analgesia in patients undergoing open shoulder surgery. ⋯ Although 1% lidocaine can be effectively used for postoperative patient-controlled interscalene analgesia, 0.2% ropivacaine provides better pain relief and motor function.
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Reg Anesth Pain Med · Mar 2003
Case Reports Clinical TrialContinuous lumbar plexus block: Use of radiography to determine catheter tip location.
The purpose of this article is to document where a lumbar plexus catheter introduced by the posterior approach will track and to evaluate the benefit of using systematic radiographic verification of catheter placement. ⋯ Epidural spread of local anesthetic during lumbar plexus block should be expected to be relatively common. It can be easily identified clinically with fractionated doses of local anesthetic. The catheter tip was identified in the epidural space by radiographic verification in only 1.8% of cases. This expensive procedure is therefore unnecessary except when an unusual location is suspected, but not necessary to confirm a catheter assumed to be correctly positioned.
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Int J Clin Pharm Th · Mar 2003
Clinical TrialSteady state bupivacaine plasma concentrations and safety of a femoral "3-in-1" nerve block with bupivacaine in patients over 80 years of age.
Fracture of the upper femur is a common injury in the elderly. Several anesthetic techniques exist for surgery of traumatic hip fracture. The aim of this investigation was to study plasma concentrations and safety of 2 mg/kg bupivacaine in a femoral "3-in-1" nerve block in patients older than 80 years of age. ⋯ A femoral 3-in-1 nerve block, using 2 mg/kg bupivacaine with epinephrine, provides prolonged pain reliefwithout local anesthetic toxicity in elderly patients. It is a satisfactory supplementary analgesic technique for hip and knee surgery in the elderly.
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Reg Anesth Pain Med · Mar 2003
Case ReportsCentral nervous system toxicity following the administration of levobupivacaine for lumbar plexus block: A report of two cases.
Central nervous system and cardiac toxicity following the administration of local anesthetics is a recognized complication of regional anesthesia. Levobupivacaine, the pure S(-) enantiomer of bupivacaine, was developed to improve the cardiac safety profile of bupivacaine. We describe 2 cases of grand mal seizures following accidental intravascular injection of levobupivacaine. ⋯ Although levobupivacaine may have a safer cardiac toxicity profile than racemic bupivacaine, if adequate amounts of levobupivacaine reach the circulation, it will result in convulsions. Plasma concentrations sufficient to result in central nervous system toxicity did not produce manifestations of cardiac toxicity in these 2 patients.