Articles: nerve-block.
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Neurolytic blockade is one of the therapeutic possibilities to treat spasticity of various muscles. In patients with spasticity of the adductor thigh muscles, a percutaneous approach to the obturator nerve is often difficult. We describe a new approach to the obturator nerve and we examine its feasibility. ⋯ No complications occurred. The combined approach of the obturator nerve represents a new technique which proved to be accurate, fast, simple, highly successful and reproducible. Obturator neurolysis was confirmed as an efficient and cost-effective technique to reduce adductor muscle spasm and related pain and to improve gait and hygienic care in patients with neurological sequelae of stroke, head trauma or any lesion of the motor neurone.
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Randomized Controlled Trial Comparative Study Clinical Trial
Deep topical fornix nerve block versus peribulbar block in one-step adjustable-suture horizontal strabismus surgery.
We compared the efficacy of deep topical fornix nerve block anaesthesia (DTFNBA), which does not paralyse the extraocular muscles, with peribulbar block in patients undergoing one-step adjustable-suture horizontal strabismus surgery. Patients with a vertical, oblique squint were excluded from the study. ⋯ DTFNBA is a useful technique for intraoperative adjustable-suture strabismus surgery. It does not alter muscle tone, thus allowing the surgeon to adjust the muscle sutures intraoperatively, and reducing the incidence of under- or over-correction of the squint in the immediate postoperative period.
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Anesthesia and analgesia · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialSuprascapular nerve block for ipsilateral shoulder pain after thoracotomy with thoracic epidural analgesia: a double-blind comparison of 0.5% bupivacaine and 0.9% saline.
Despite receiving thoracic epidural analgesia, severe ipsilateral shoulder pain is common in patients after thoracotomy. We recruited 44 patients into a double-blinded randomized placebo-controlled study to investigate whether suprascapular nerve block would treat postthoracotomy shoulder pain effectively. All patients received a standard anesthetic with a midthoracic epidural. Thirty patients who experienced shoulder pain within 2 h of surgery were randomly assigned to receive a suprascapular nerve block with either 10 mL of 0.5% bupivacaine or 10 mL of 0.9% saline. Shoulder pain was assessed before nerve blockade, at 30 min, and then hourly for 6 h after the block using a visual analog scale (VAS) and a 5-point verbal ranking score (VRS). The incidence of shoulder pain before nerve block was 78%. There was no significant decrease in either VAS or VRS in the Bupivacaine group. These results suggest that this pain is unlikely to originate in the shoulder and lead us to question the role of a somatic afferent in referred visceral pain. We conclude that suprascapular nerve block does not treat ipsilateral shoulder pain after thoracotomy in patients with an effective thoracic epidural. ⋯ This randomized, double-blinded, placebo-controlled trial showed that suprascapular nerve block does not treat the severe ipsilateral shoulder pain that patients experience after thoracotomy. This has implications for established theories of referred pain and indicates that this pain is unlikely to originate in the shoulder.
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Anesthesia progress · Jan 2002
Randomized Controlled Trial Clinical TrialAnesthetic efficacy of an infiltration in mandibular anterior teeth following an inferior alveolar nerve block.
The purpose of this prospective, randomized, blinded study was to measure the degree of pulpal anesthesia obtained with an inferior alveolar nerve (IAN) block followed by an infiltration in mandibular anterior teeth. Through use of a repeated-measures design, 40 patients randomly received 3 injection combinations at 3 separate appointments: an IAN block followed by a mock lingual infiltration and a mock labial infiltration, an IAN block followed by a mock lingual infiltration and a labial infiltration, and an IAN block followed by a mock labial infiltration and a lingual infiltration. Each IAN block used 3.6 mL of 2% lidocaine with 1:100,000 epinephrine, and each infiltration used 1.8 mL of 2% lidocaine with 1:100,000 epinephrine administered over the lateral incisor apex. ⋯ For the IAN block plus labial infiltration, the success rate was 62% and the failure rate was 12% for the lateral incisor. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration. In conclusion, a labial infiltration, over the lateral incisor apex, of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine following an IAN block significantly improved pulpal anesthesia for the lateral incisor compared with the IAN block alone.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized treatment study to compare the efficacy of repeated nerve blocks with cognitive therapy for control of chronic head and neck pain.
This prospective study compared the efficacy of two antinociceptive modalities: nerve blocks and cognitive therapy. A consecutive series of patients receiving nerve block therapy was invited to take part in a six-week randomized comparison of nerve blocks and cognitive therapy. Sixty-eight of 102 patients approached by telephone agreed to participate. ⋯ Mean VAS scores in the cognitive therapy group rose during the trial. However, the mean VAS score of the remaining four in the last week was below the initial group mean. Patients who had been receiving nerve blocks proved willing to remain in the study if allocated to the nerve block group and unwilling to remain in the cognitive therapy group while foregoing their accustomed treatment.