Articles: nerve-block.
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Reg Anesth Pain Med · Nov 2002
Assessment of lower extremity nerve block: reprise of the Four P's acronym.
Successful performance of lower-extremity regional anesthesia includes sensory and/or motor block assessment of up to 4 major peripheral nerves. This brief report describes a methodology for the rapid evaluation of lower-extremity anesthesia before surgical incision. ⋯ Accurate assessment of lower-extremity regional anesthesia can be achieved rapidly using The Four Ps evaluation tool.
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Peripheral nerve blocks are associated with minimal haemodynamic disturbance. It is perhaps ideal for high-risk surgical patients who cannot tolerate the adverse consequences of even the slightest attenuation of haemodynamic response. ⋯ In this report, a 56-year-old man with severe sepsis and recent myocardial infarction presents for an urgent above knee amputation. We present the practical benefits of a combined sciatic-femoral nerve block on such a patient.
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Upper limb trauma occurs frequently in elderly patients for whom peripheral nerve blocks are often preferred for anesthesia. The characteristics of such regional blocks have, however, never been described in an elderly population. Therefore, the authors assessed prospectively the onset and duration of upper extremity peripheral nerve block (the mid-humeral block) in elderly and young patients undergoing emergency upper extremity surgery. ⋯ Age is a major determinant of duration of complete motor and sensory blockade with peripheral nerve block, perhaps reflecting increased sensitivity to conduction failure from local anesthetic agents in peripheral nerves in the elderly population.
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Mandibular nerve block allows surgery to be performed on the mandible. However, pain in the postoperative period needs to be treated with opioids or non-steroidal anti-inflammatory agents which have undesirable side effects. We examine the feasibility of continuous mandibular nerve block with 0.25% bupivacaine top-ups using a catheter for intraoperative and postoperative pain relief in two patients with a fracture of the mandible. ⋯ Continuous mandibular nerve block with 2-4 mL 0.25% bupivacaine top-ups injected twice a day through a catheter provides excellent pain relief in patients with a fracture of the mandible. This method may have implications for the management of pain of other etiology in the mandibular region.
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Letter Clinical Trial Controlled Clinical Trial
Sciatic nerve block and the improvement of femoral nerve block analgesia after total knee replacement.