Articles: nerve-block.
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Rev Esp Anestesiol Reanim · Oct 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Axillary brachial plexus anesthesia. How many nerve stimulation responses do we look for?].
To determine whether axillary block with nerve stimulation involving the location of four motor responses is more effective than other techniques using fewer locations, without increasing patient discomfort or the rate of complications. ⋯ Locating 4 responses gives the greatest degree of assurance of obtaining full sensory block without increasing patient discomfort or rate of complications.
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This is the sixth in our series of regional nerve blocks. Femoral nerve blocks by a lateral approach, have the potential to block the lumbar plexus if sufficient volume is used.
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Anesthesia and analgesia · Oct 2001
Clinical TrialThe continuous femoral nerve block catheter for postoperative analgesia: bacterial colonization, infectious rate and adverse effects.
We investigated the incidence of bacterial and vascular or neurological complications resulting from femoral nerve catheters used for postoperative analgesia. Patients requiring continuous femoral blockade were consecutively included. Using surgical aseptic procedure, 211 femoral nerve catheters were placed (short-beveled insulated needle, peripheral nerve stimulator). After 48 h, each catheter was removed and semiquantitative bacteriological cultures were performed on each distal catheter tip. Postoperative analgesia and antibiotics were standardized. All complications during the insertion of the catheters and postoperatively (after 48 h and 6 wk) were noted. Few initial complications with no immediate or delayed complications were noted (20 difficult insertions, 3 impossible injections, 3 ineffective catheters, and 12 vascular punctures). After 48 h, 208 catheters were analyzed; 57% had positive bacterial colonization (with a single organism in 53%). The most frequent organisms were Staphylococcus epidermidis (71%), Enterococcus (10%), and Klebsiella (4%). Neither cellulitis nor abscess occurred. Three transitory bacteremias likely related to the catheter occurred. After 6 wk, no septic complications were noted. One femoral paresthesia, partially recovered 1 yr later, was noted. We conclude that the risk of bacterial complications is small with femoral nerve catheters, although the rate of colonization is frequent. ⋯ In this prospective study, continuous femoral nerve catheters were effective for postoperative analgesia but had a frequent rate of bacterial catheter colonization. We found no serious infections after short-term (2-day) infusion. Side effects were few, but one nerve injury occurred.
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Acta Anaesthesiol Scand · Oct 2001
ReviewNerve blocks in chronic pain therapy--are there any indications left?
Although diagnostic imaging is now highly developed, neural blockade provides another opportunity to test for a source of pain that may frequently leave no signature. Likewise, many neuropathic pains can not be tested by neurodiagnostic methods. ⋯ In particular, the example of autonomic blocks and blocks of the axial spine are emphasized. Nerve blocks require an understanding of the anatomy, physiology, pharmacology, and the ability to interpret critically their results.
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Ann Fr Anesth Reanim · Oct 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison between 1.5% lidocaine with adrenaline and 1.5% plain mepivacaine in axillary brachial plexus block].
To evaluate the distribution of sensory blockade, the onset time and the duration of the axillary plexus block obtained after the administration of 40 mL of 1.5% lignocaine with adrenaline or 40 mL of plain 1.5% mepivacaine. ⋯ Following axillary plexus block, 1.5% mepivacaine improves neither the extension nor the duration of sensory blockade achieved by 1.5% lignocaine with adrenaline.