Articles: nerve-block.
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Clinical Trial
Inability to consistently elicit a motor response following sensory paresthesia during interscalene block administration.
Two methods of nerve block based on eliciting neural feedback with the block needle currently exist. The paresthesia technique uses sensory feedback to ascertain that the needle tip is close to the nerve. By contrast, a peripheral nerve stimulator makes use of motor responses to electrical stimulation. The relation of motor responses to an electrical peripheral nerve stimulator and sensory nerve contact (paresthesia) had not been studied. ⋯ Elicitation of paresthesia does not translate to an ability to elicit a motor response to a peripheral nerve stimulator in the majority of patients.
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Randomized Controlled Trial Clinical Trial
Clinical perception of phantom limb sensation in patients with brachial plexus block.
Patients' perception of limb position during regional anaesthesia is frequently incorrect. The incidence and nature of this phenomenon has not yet been completely described. The aim of this prospective study was to assess phantom sensation in patients undergoing a brachial plexus block. ⋯ Patients' perception of the position of the limb after axillary block in the majority of instances was probably due to persisting sensory inputs from the shoulder joint, which is not involved in this block. This is in contrast to supraclavicular or interscalene blocks. A significant number of patients experienced phantom limb sensation. They reported an arm position in fact related to the position of their arm before the axillary block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized comparison of remifentanil-propofol with a sciatic-femoral nerve block for out-patient knee arthroscopy.
To evaluate preparation and discharge times as well as the anaesthesia-related costs of out-patient knee arthroscopy performed with a combined sciatic-femoral nerve block, or a propofol-remifentanil general anaesthetic. ⋯ In patients undergoing out-patient knee arthroscopy, the length of stay in the PACU can be shorter after a sciatic-femoral nerve block with a small volume of mepivacaine 2% compared with a propofol-remifentanil anaesthetic, and there is an increased likelihood that they will bypass the first phase of the postoperative recovery.
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Studies in normal volunteers have demonstrated that the lateral atlanto-axial joints (C1-2) are capable of causing pain in the occiput, but few clinical studies have validated this source of occipital headache. The present study tested the null hypothesis that the lateral atlanto-axial joints are not a common source of occipital headache. ⋯ The clinical features used to select patients for blocks, however, had a positive predictive value of only 60%. Further study of headaches from C1-2 seems justified in order to establish more definitively the prevalence of this condition and how it might become better recognized in practice.