Articles: nerve-block.
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Ann Fr Anesth Reanim · Dec 2002
Case Reports[Multitruncular block at the elbow for a major hand trauma for prehospital care].
Upper limb peripheral nerve blocks offer many advantages but they are not widely used in prehospital care. We report the case of a multitroncular block at the elbow made by the emergency department team out of the hospital after a major hand trauma. A successful axillary brachial plexus block was done two hours later, without any problem. This case report allows us to discuss about different analgesia techniques useful in prehospital care.
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Rev Esp Anestesiol Reanim · Dec 2002
[Posterior block of lumbar plexus for postoperative analgesia after hip arthroplasty].
To describe early postoperative analgesic quality from a posterior lumbar plexus block in the psoas compartment, located by neurostimulation. We used a single paramedial puncture at L4, following Chayen's approach, in patients undergoing uncemented hip arthroplasty under subarachnoid anesthesia with 0.5% bupivacaine. ⋯ A posterior lumbar plexus block using a single shot gives effective analgesia in the first 12 hours after surgery performed with spinal anesthesia. Continuous infusion through a catheter may provide better analgesia than that observed in this study.
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Neurotoxicity manifesting as convulsions is a recognised complication of the administration of local anaesthetic drugs as part of a regional anaesthetic technique. We describe a case of self-limiting convulsions following the institution of an axillary brachial plexus block with levobupivacaine. Although the occurrence of convulsions following the administration of racemic bupivacaine is a well-recognised complication, there have been no clinical case reports published describing convulsions following the use of levobupivacaine in regional anaesthesia.
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Most local anaesthetic blocks are placed blindly, based on a sound knowledge of anatomy. Very often the relationship between the site of deposition of local anaesthetic and the nerve to be blocked is unknown. Large motor neurons may be stimulated with the aid of an electrical current. ⋯ The accuracy of local anaesthetic blocks can be improved by this technique. By using the lowest possible current a needle could be positioned with in 2-5 mm of a nerve. The correct duration of stimulation ensures that stimulation of sensory nerves does not occur The use of electrical nerve stimulation in veterinary medicine is a novel technique that requires further evaluation.