Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Intraoperative intercostal nerve blockade for postthoracotomy pain.
Epidural analgesia is widely employed as a means to control postthoracotomy pain, but is sometimes inadequate. The purpose of this study is to evaluate the effectiveness of intraoperative, temporary, intercostal nerve blockade in addition to epidural analgesia for control of postthoracotomy pain. ⋯ Additional intraoperative intercostal nerve blockade provides an additive benefit for postthoracotomy pain relief, especially early after operation.
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Anesthesia and analgesia · Aug 2002
Comparative StudyDistal nerve blocks at the wrist for outpatient carpal tunnel surgery offer intraoperative cardiovascular stability and reduce discharge time.
Carpal tunnel release is often performed as an outpatient procedure. We designed this retrospective study to assess the effect of different anesthesia techniques on intraoperative cardiovascular stability and discharge time. According to the anesthesia technique received, 62 consecutive patients were categorized in Group BIER (IV regional anesthesia), Group BLOCK (distal nerve blocks), and Group GENERAL (general anesthesia). Incidences of intraoperative periods of tachycardia or bradycardia and hyper- or hypotension were studied, as were tourniquet, surgical, operating room, and discharge times. Cardiovascular stability was better achieved in Group BLOCK, as indicated by a significantly smaller incidence of periods of hypertension compared with Group BIER (5% vs 25%) and a significantly less frequent incidence of periods of hypotension compared with Group GENERAL (14% vs 42%). Patients in Group BLOCK spent significantly less time in the hospital after surgery than patients in Group BIER (65 vs 88 min) or patients in Group GENERAL (65 vs 133 min). We conclude that distal nerve blocks for outpatient carpal tunnel surgery are associated with greater intraoperative cardiovascular stability than general anesthesia. After surgery, patients in Group BLOCK could be discharged earlier than patients who received IV regional anesthesia or general anesthesia; this could be related to the superior postoperative analgesia provided by this technique. ⋯ This retrospective analysis of three different anesthetic techniques for ambulatory carpal tunnel surgery shows that nerve blocks performed at the wrist provided excellent intraoperative cardiovascular stability and allowed for earlier discharge.
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Peripheral nerve blocks are almost always performed as blind procedures. The purpose of this study was to test the feasibility of seeing individual nerves of the brachial plexus and directing the block needle to these nerves with real time imaging. ⋯ The use of ultrasound appears to permit accurate deposition of the local anaesthetic perineurally, and has the potential to improve the success and decrease the complications of infraclavicular brachial plexus block.
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Case Reports
[A case report of hemidiaphragmatic paresis caused by interscalene brachial plexus block].
A 76-yr-old woman was scheduled for left upper extremity orthopedic procedure. Preoperative examinations were within normal limits except forced vital capacity. Interscalene brachial plexus block with 0.25% bupivacaine 15 ml, was performed under general anesthesia. ⋯ A chest X-ray demonstrated the elevation of hemidiaphragm. She was diagnosed as ipsilateral hemidiaphragmatic paresis, treated with oxygen inhalation under deep breathing for approximately one hour, and then transferred to the common ward. We conclude that respiratory movement should be carefully observed following interscalene brachial plexus block especially in geriatric patients.
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Oral Surg Oral Med O · Aug 2002
A new method of continuous maxillary nerve block with an indwelling catheter.
We describe continuous maxillary nerve block at the pterygopalatine fossa and investigate the efficacy of this technique for perioperative pain control in oral surgery. ⋯ Indwelling maxillary nerve catheter methods decrease anesthetic consumption and provide good postoperative analgesia.