Articles: nerve-block.
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Anaesth Intensive Care · Jun 2002
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine 7.5 mg/ml versus bupivacaine 5 mg/ml for interscalene brachial plexus block--a comparative study.
We investigated ropivacaine 75 mg/ml in comparison with bupivacaine 5 mg/ml in patients receiving interscalene brachial plexus block (ISB) and general anaesthesia. In this randomized, double-blind, prospective clinical trial, each patient received an ISB block according to the technique originally described by Winnie and a catheter technique as per Meier. The rapidity of onset and the quality of sensory and motor block were determined. ⋯ There were no significant differences in terms of onset and quality of sensory or motor block during the intraoperative and early postoperative period. In addition we did not identify any side-effects related to the administration of the local anaesthetics. Ropivacaine 7.5 mg/ml and bupivacaine 5mg/ml proved to be nearly indistinguishable when administered for interscalene brachial plexus block.
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Best Pract Res Clin Anaesthesiol · Jun 2002
ReviewContinuous interscalene block for ambulatory shoulder surgery.
Management of acute post-operative pain due to shoulder surgery may be successfully and consistently achieved in ambulatory patients by using continuous interscalene block. This chapter outlines the anterior and posterior approaches to the proximal brachial plexus and describes a method of precisely placing a catheter along the brachial plexus by stimulating the plexus through the needle used for placing the catheter as well as through the catheter itself. ⋯ Suggested drugs and dosages for initial boluses, continuous infusions and patient controlled interscalene analgesia are discussed. Sedation for block placement, and special precautions, are outlined.
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Best Pract Res Clin Anaesthesiol · Jun 2002
ReviewMaking an ambulatory surgery centre suitable for regional anaesthesia.
This chapter reviews a management strategy for transforming an outpatient surgery centre from that which exclusively uses general anaesthesia to one using regional anaesthesia with peripheral nerve blocks. Barriers presented by patients, nursing staff, surgeons and administrators can be notable; these might undermine the well-intended efforts of highly-skilled regionalists. ⋯ The centerpiece of the anaesthesia care process remains pre-emptive multimodal analgesia, routine multimodal antiemetic prophylaxis and avoidance of general anaesthesia (GA) with volatile agents. The remainder of the care process relies on teamwork among all healthcare providers and meaningful administrative support.