Articles: nerve-block.
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Acta Anaesthesiol Scand · Sep 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of 0.5% ropivacaine and 1% mepivacaine for sciatic nerve block in the popliteal fossa.
The purpose of this study was to compare anesthetic efficacy and postoperative analgesia of 0.5% ropivacaine and 1% mepivacaine for sciatic nerve block in the popliteal fossa (popliteal block). ⋯ In this study we demonstrated that both 0.5% ropivacaine and 1% mepivacaine for popliteal block produced rapid, effective and safe anesthesia but postoperative analgesia was more long-lasting with ropivacaine.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Comparative Study Clinical Trial[S(-) bupivacaine (levobupivacaine) in peripheral blocks: preliminary results].
We have compared the onset time, anesthetic potency and adverse effects of three local anaesthetics (ropivacaine, levobupivacaine and bupivacaine) in two type of peripheral blocks (brachial plexus block for upper limb and femoral nerve block for lower limb) in adult patients in a double blind, randomized, prospective study. A total of 66 patients undergoing orthopaedic surgery were randomly allocated to receive brachial plexus block or femoral nerve blockade with 0,5% ropivacaine (group R, n=22), 0,5% levobupivacaine (group L, n=22) or 0,5% bupivacaine (group B, n=22), each groups has been divided into two subgroups (LBP n=11, RBP n=11, BPB n=11, LBF n=11, RBF n=11, BBF n=11) dipending on the type of block. The onset of sensory nerve block was similar for the three groups; the onset of motor block and onset time ready to surgery were faster in group R (-30%) if compared with group L and B. ⋯ We did not observe any adverse effect. We conclude that ropivacaine acts faster with less interpatient variability, while levobupivacaine and bupivacaine offer a prolonged postoperative analgesia. For this reason, with the exception of bupivacaine due to major cardio and neuro toxicity, we can indifferently use levobupivacaine or ropivacaine depending on the requested characteristics of the anesthetic.
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Peripheral neural blockade techniques are commonly used procedures to provide perioperative anesthesia and analgesia. Several continuous infusion catheter techniques have been described to extend the use of peripheral neural blockade into the postoperative period as an effective method of providing pain management. The analgesic benefit of continuous local anesthetic peripheral block in the management of postoperative pain is primarily related to the properties of providing intense analgesia thereby reducing perioperative opioid requirements and opioid-related side effects and promoting early recovery of postoperative activity. ⋯ The sciatic nerve is the largest nerve in the body and it lies deep in the posterior thigh. According to its anatomy, the sciatic nerve can then be reached at different levels from the parasacral space to the popliteal fossa, ideally identifying a sciatic line running from the inferior border of the gluteus maximus muscle between the greater throcanter and the ischiatic tuberosity to the popliteal fossa. A variety of continuous peripheral blocks have been described in this paper including continuous sciatic block at several levels (para-sacral nerve block, subgluteal sciatic nerve block) and popliteal nerve block.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Levobupivacaine for peripheral blocks of the lower limb: a clinical comparison with bupivacaine and ropivacaine].
The aim of this study was the comparison of clinical profile of sciatic nerve block performed with either 0,5% levobupivacaine, 0,5% bupivacaine, or 0,5% ropivacaine. ⋯ Using 0,5% levobupivacaine for sciatic nerve block results in similar clinical effects as those produced by using the same volume and concentration of either bupivacaine or ropivacaine.
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Clinical Trial
New, simple, ultrasound-guided infiltration of the pudendal nerve: ultrasonographic technique.
Anesthetic infiltration of the pudendal nerve at the ischial spine can relieve perineal pain in cases of compression or distention. The aim of our study was to look for a real-time, visually controlled infiltration technique using ultrasound. ⋯ In almost one-half of the cases a direct ultrasound-guided infiltration of the pudendal nerve is possible. In the remaining cases the nerve can be detected and blocked indirectly, using the ischial spine or the internal pudendal artery as a landmark.