Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Clonidine as coadjuvant in eye surgery: comparison of peribulbar versus oral administration.
To determine whether the administration of peribulbar or oral clonidine would enhance analgesia and anesthesia in ophthalmologic surgery. ⋯ Despite the higher intraoperative blood cortisol levels, 30 microg peribulbar clonidine decreased the onset time to anesthesia, while 15 and 30 microg peribulbar clonidine prolonged the time to first rescue analgesics in patients under peribulbar block, without increasing the frequency of adverse effects. Conversely, oral administration of clonidine alone did not enhance anesthesia or analgesia following eye block, suggesting a local mechanism of action of clonidine.
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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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Anesthesia and analgesia · Mar 2002
The antinociceptive and histologic effect of sciatic nerve blocks with 5% butamben suspension in rats.
Butamben, a lipophilic local anesthetic of the ester class, produces a differential nerve block of long duration. Epidural and peripheral nerve blocks with butamben, formulated as a 5%--10% suspension, result in prolonged analgesia without significant motor blockade. We evaluated the effect of butamben sciatic nerve block on antinociception using the rat paw formalin test, as well as withdrawal latencies to thermal stimulation, and assessed histologic changes in the nerve. After right sciatic nerve block with butamben 5% or saline, responses to intradermal injection of 5% formalin were recorded in randomly selected groups of 6 animals each on days 1, 2, 5, 10, 21, and 28. In an additional group of 8 thermal challenges to both hind paws were recorded at 1, 2, 5, 7, 10, 14, 17, 21, and 28 days after right sciatic butamben 5% blocks. Butamben injection decreased the formalin-induced flinches on days 2, 5, 10, 21 and 28 and decreased thermal challenges on days 1 through 17. Histologic changes were minimal. This study demonstrates a prolonged antinociceptive effect from butamben nerve block to both formalin-induced nociception and heat hyperalgesia, without an effect on gross motor function or histologic morphology. ⋯ Butamben 5% nerve blocks produced a prolonged antinociceptive effect to formalin-induced nociception and heat hyperalgesia, without significant motor effect or evidence of substantial histologic changes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Impact of shorter-acting neuromuscular blocking agents on fast-track recovery of the cardiac surgical patient.
Residual paralysis associated with the use of long-acting muscle relaxants can delay recovery from anesthesia and surgery. The authors tested the hypothesis that use of shorter-acting neuromuscular blocking agents is associated with reductions in tracheal extubation times and intensive care unit (ICU) length of stay in patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ The use of shorter-acting neuromuscular blocking agents in patients undergoing cardiac surgery with cardiopulmonary bypass is associated with reductions in tracheal extubation times and symptoms of residual paresis.
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A short cut review was carried out to establish whether regional nerve block is better than intravenous analgesia in reducing pain in hip fractures. Altogether 21 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.