Articles: nerve-block.
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Arch Phys Med Rehabil · May 2002
Randomized Controlled Trial Comparative Study Clinical TrialSuprascapular nerve block for pain relief in adhesive capsulitis: comparison of 2 different techniques.
To evaluate the clinical effectiveness of 2 suprascapular nerve block techniques in adhesive capsulitis. ⋯ The near-nerve electromyography technique for suprascapular nerve block was more successful in providing and maintaining pain relief for up to 60 minutes.
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J Bone Joint Surg Am · May 2002
Scalene regional anesthesia for shoulder surgery in a community setting: an assessment of risk.
A retrospective review of shoulder procedures using scalene block anesthesia was performed. ⋯ Informed consent discussions regarding scalene block anesthesia should include information on the prevalence of complications and the efficacy of the technique.
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Comparative Study
Safety and efficacy of the popliteal fossa nerve block when utilized for foot and ankle surgery.
The popliteal fossa nerve block (PFNB) offers numerous advantages that make it a suitable anesthetic technique for foot and ankle surgery. In this retrospective study, we investigated the acute and long-term safety and efficacy of this relatively underutilized anesthetic technique for foot and ankle surgery. A review of 834 patients who underwent foot and/or ankle surgery by the coauthor (NAA) was conducted. ⋯ There were no incidents of postoperative neuralgia or neuropraxia. Only 12% of patients with a successful block required analgesics in the PACU, while 60% of patients with a failed block required systemic analgesics for surgical site pain (p<0.01). These results suggest that the performance of the PFNB with the guidance of a peripheral nerve stimulator is a safe and effective anesthetic technique for foot and ankle surgery.
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The infraclavicular vertical brachial plexus block, first described by Kilka and coworkers, offers a more proximal spread of anaesthesia for the upper extremity than the classic axillary approach. In this technique, the puncture site is defined as lying at the exact centre of an infraclavicular line (k) between the jugular fossa and the ventral process of the acromion. Our study was designed to determine whether the point so defined (P) corresponds with the optimal puncture site determined sonographically (S) and to develop an improved prediction model. ⋯ The suggested modification should help to increase the success rate of the infraclavicular vertical brachial plexus block while decreasing the rate of potentially severe complications, although individual ultrasonographic guidance is to be recommended whenever possible.
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Anesthesia and analgesia · May 2002
Comparative StudyA comparison of intertendinous and classical approaches to popliteal nerve block using magnetic resonance imaging simulation.
The classical approach to sciatic nerve block in the popliteal fossa (popliteal block) often requires multiple attempts to localize the sciatic nerve. Recently, it has been suggested that an intertendinous approach to popliteal block may result in a more consistent localization of the sciatic nerve. In the current study, we compared anatomical landmarks for the intertendinous and classical approaches to popliteal block with respect to the accuracy in localizing the sciatic nerve using magnetic resonance imaging simulation. Two anesthesiologists experienced in popliteal block drew landmarks for the intertendinous and classical approaches on 10 volunteers; a 1.5 Tesla superconducting magnet was used to obtain simultaneous, 10-mm thick, fast-spin echo proton density transverse axial sequences of the lower extremities. Using these acquired images, the two approaches were simulated off-line using previously identified landmarks. The spatial relationships of the simulated needle paths to the nerves and vessels in the popliteal fossa, as well as other relevant structures, were measured and compared. Simulation of the intertendinous approach to popliteal block resulted in needle-to-sciatic nerve contact in 14 legs (70%) versus 5 legs (25%) when the classical approach was used (P < 0.05). We conclude that the intertendinous approach might result in a more consistent localization of the sciatic nerve and may decrease the risk of sciatic vessel puncture. ⋯ A simulation of popliteal block using magnetic resonance imaging in volunteers suggests that using tendons of the hamstring muscles as the anatomical landmarks yields a more consistent localization of the sciatic nerve.