Articles: nerve-block.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialA paravenous approach for the saphenous nerve block.
This study assesses a paravenous approach for saphenous nerve block at approximately the level of the tibial tuberosity, and compares it with the conventional technique of blind subcutaneous infiltration between the tibial tuberosity and the gastrocnemius muscle. ⋯ The saphenous nerve can be blocked effectively by a paravenous approach using only 5 mL of local anesthetic solution. This approach is advantageous because of its easily identifiable landmark.
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Reg Anesth Pain Med · Nov 2001
Multicenter Study Clinical TrialAnatomic considerations in relation to the maxillary nerve block.
To determine the length of the needle that should be used to reach the maxillary nerve after the lateral pterygoid plate has been contacted. ⋯ The needle should not be advanced by more than approximately 0.25 cm beyond the distance to the pterygoid plate while performing maxillary nerve block by the lateral extraoral approach.
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Reg Anesth Pain Med · Nov 2001
Case ReportsContinuous brachial plexus block at the cervical level using a posterior approach in the management of neuropathic cancer pain.
Neuropathic cancer pain due to tumor growth near the brachial plexus is often treated with a combination of nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, anticonvulsants, and oral or transdermal opioids. We propose placement of a catheter along the brachial plexus using a posterior approach for patients not responding to the above-mentioned treatment. ⋯ Continuous brachial plexus block should be considered in patients with severe neuropathic cancer pain in the arm and shoulder. To achieve sufficient pain relief for prolonged periods of time, a catheter was inserted to block the brachial plexus using a posterior approach. This technique may be a valuable alternative to the interscalene approach because of the improved fixation of the catheter in the muscle sheet of the trapezius, splenius cervicus, and levator scapulae muscles, and the decreased likelihood of catheter dislodgment during neck movements.
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Anesthesia and analgesia · Nov 2001
Randomized Controlled Trial Clinical TrialScalp nerve blocks decrease the severity of pain after craniotomy.
Up to 80% of patients report moderate to severe pain after craniotomy. In this study, we assessed the efficacy of scalp block for decreasing postoperative pain in brain surgery. Thirty patients scheduled for supratentorial craniotomy were enrolled. They were randomly divided into two groups: Ropivacaine (scalp block with 20 mL of ropivacaine 0.75%) and Saline (scalp block with 20 mL of saline 0.9%). Anesthesia was standardized. The scalp block was performed after skin closure and before awakening. Postoperative pain was assessed at 4, 8, 12, 16, 20, 24, and 48 h by using a 10-cm visual analog scale. Analgesia was provided with sub- cutaneous codeine as requested by the patient. Average visual analog scale scores were higher in the Saline group as compared with Ropivacaine (3.7 +/- 2.4 vs 2.0 +/- 1.6; P = 0.036). The total dose of codeine did not differ, nor did the duration of time before the first dose of codeine was required in the Ropivacaine (571 +/- 765 min) versus Saline (319 +/- 409 min; P = 0.17) group. In conclusion, we found that postoperative scalp block decreases the severity of pain after craniotomy and that this effect is long lasting, possibly through a preemptive mechanism. ⋯ Up to 80% of patients report moderate to severe pain after craniotomy. This randomized double-blinded study demonstrated that ropivacaine scalp block decreases the severity of pain after supratentorial craniotomy.