Articles: nerve-block.
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Eur J Cardiothorac Surg · Jun 2002
Randomized Controlled Trial Comparative Study Clinical TrialIs intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia?
Currently epidural anesthesia is the gold standard for postoperative pain management in thoracic surgery. In a prospective randomised study, the effect of an intercostal nerve block applied at the end of the operation was compared to that of epidural anesthesia. ⋯ Pain management by intercostal block was superior during the first 24h after surgery whereas on the second day after surgery pain control was significantly better achieved by the epidural catheter in relaxed position. A combination of both forms of anaesthesia seems to be an ideal pain management in patients undergoing thoracic surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled regional analgesia (PCRA) at home: controlled comparison between bupivacaine and ropivacaine brachial plexus analgesia.
The aim of this randomized, double-blinded study was to compare the analgesic efficacy of bupivacaine versus ropivacaine brachial plexus analgesia after ambulatory hand surgery. An additional aim was to study the feasibility and safety of patient-controlled regional analgesia (PCRA) outside the hospital. ⋯ This double-blinded study has demonstrated the feasibility of self-administration of local anesthetic to manage postoperative pain outside the hospital. Ropivacaine and bupivacaine provided effective analgesia, and patient satisfaction with PCRA was high. Patient selection, follow-up telephone call, and 24-h access to anesthesiology services are prerequisites for PCRA at home.
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Rev Esp Anestesiol Reanim · Jun 2002
Randomized Controlled Trial Comparative Study Clinical Trial[Duration and quality of postoperative analgesia after brachial plexus block for shoulder surgery: ropivacaine 0.5% versus ropivacaine 0.5% plus clonidine].
Some authors have found that nerve blocks with local anesthetics may last longer if clonidine is added. The present study analyzed the duration and quality of analgesia provided by an interscalene brachial plexus block for shoulder surgery using 0.5% ropivacaine or 0.5% ropivacaine with added clonidine. ⋯ Adding 40 micrograms of clonidine to 200 mg of 0.5% ropivacaine does not prolong the sensory-motor block or improve the quality of analgesia in the early postoperative period.
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Randomized Controlled Trial Clinical Trial
Epidural bolus injection with alkalinized lidocaine improves blockade of the first sacral segment--a brief report.
It has been reported that the addition of epinephrine and/or bicarbonate to local anesthetic enhances the depth of epidural blockade and that initial partial bolus injection results in greater caudal spread. We evaluated the anesthetic effects of lidocaine with epinephrine and/or bicarbonate injected into the epidural space by bolus or catheter injection. ⋯ Epidural bolus injection of lidocaine-bicarbonate with epinephrine improves the pain threshold and speeds the onset of the blockade of the first sacral region.
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Middle East J Anaesthesiol · Jun 2002
Clinical TrialBlockade of branches of the ophthalmic nerve in the management of acute attack of migraine.
The aim of this study was the evaluation of the blockade of branches of ophthalmic nerve in the management of the acute attack of migraine headache localized to the ocular region. The study included 70 female patients 23-60 years old who presented to the pain clinic at our hospital with an acute attack of migraine headache localized to the ocular and retro-ocular region. A targeted history and a neurologic examination were performed in all patients to confirm the diagnosis and at the same time to rule out life-threatening neurological dysfunction. ⋯ The migraine acute attack was relieved in 58/70 patients (82%), while in 12/70 patients (18%) the results were poor. The pain relief started 3-4 min after the injection and was completed in 10-15 min. Our results support that the blockade of the branches of the ophthalmic nerve seems to be a safe and effective technique in the management of the acute attack of migraine localized to the ocular and retro-ocular region.