Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind randomized comparison of xylocaine and saline in paracervical block for diagnostic fractional curettage.
Comparative study of the level of the reported pain between patients who received xylocaine and normal saline for paracervical block during fractional curettage was carried out in 70 patients in a double blind randomized controlled trial. One group of patients received xylocaine for paracervical block just before the procedure was performed while the other group received normal saline in the same manner. Self-reported pain intensity using visual analog scale was assessed at four time points including the first time point when Allis tissue forceps was applied on the cervix, the second and third time points when curettage was done on the endocervix and in the endometrial cavity respectively. ⋯ The explanation for this was the local anesthetic mechanism may be from distension of nerve capsules rather than blockage of specific autonomic nerves. However, this study showed that nerve capsule distension is not the only factor for pain control in paracervical block. An analgesic agent is still an important factor.
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Anesthesia and analgesia · Feb 2003
Pharmacokinetics of ropivacaine in uremic and nonuremic patients after axillary brachial plexus block.
Reports on the efficacy and pharmacokinetics of local anesthetics in uremic patients have been controversial. Our study involved 29 uremic and 28 nonuremic patients. We performed axillary block with ropivacaine 300 mg (50 mL). ⋯ The plasma concentration of PPX increased until 24 h in uremic patients whose AAG concentrations were also larger throughout the study. The free fraction of ropivacaine in plasma was smaller in the uremic group when measured 60 min and 12 h after the block, but the unbound concentration of ropivacaine was larger in the uremic group at 12 h. Enhanced absorption of ropivacaine into circulation, increased binding to AAG, and probably reduced urinary excretion of the metabolites lead to larger total plasma concentrations of ropivacaine and its main metabolites in uremic patients.
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Paediatric anaesthesia · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus anaesthesia in children: lateral infraclavicular vs axillary approach.
Brachial plexus blockade is a well-established technique in upper-limb surgery. In paediatric patients, the axillary route is usually preferred to infraclavicular approaches because of safety considerations. Recent reports on a lateral infraclavicular approach offering greater safety in adults prompted us to perform a prospective randomized study to assess the analgesic efficacy of axillary vs lateral vertical infraclavicular brachial plexus (LVIBP) blocks in paediatric trauma surgery. ⋯ We conclude that LVIBP blocks can be safely performed in children and that they add to the spectrum of sensory and motor blockade seen with the axillary approach.
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Anesthesia and analgesia · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialEMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children.
We conducted a prospective, randomized, double-blinded trial comparing preoperative application of EMLA cream and sodium chloride solution dorsal penile block (n = 31) with placebo cream and bupivacaine dorsal penile nerve block (n = 32) for postcircumcision analgesia. Pain was assessed using modified Children's Hospital of Eastern Ontario Pain Scale and the duration of block by the time to requirement of first dose of postoperative analgesic. ⋯ There were no local or systemic complications related to either technique, and there was a very small incidence of vomiting. We conclude that preoperative application of EMLA cream is an effective and simple method to produce postcircumcision analgesia with a very small incidence of adverse effects.