Articles: nerve-block.
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Distal blocks are not recommended even for a short procedure when a tourniquet is used. This study was designed to evaluate the tolerance, effectiveness, patient acceptance and safety of distal blocks at the wrist. ⋯ Blocks at the wrist are effective, well accepted by the patient and safe when a pneumatic tourniquet is used for a short procedure.
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Curr Opin Anaesthesiol · Jun 2001
New insights into regional anesthesia in children: new techniques and new indications.
The applications and indications for pediatric regional anesthesia continue to increase. Several recent advances have occurred in the understanding of this technology in children, including improved techniques, alternative drug combinations, as well as prospective investigations to understand the nature and incidence of adverse effects associated with these techniques when used in pediatric patients. The following article will review recent information from the literature concerning various regional anesthetic techniques in children, including caudal epidural block, lumbar and thoracic epidural anesthesia, and peripheral nerve blockade.
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Middle East J Anaesthesiol · Jun 2001
Comparative StudyParavertebral blockade vs general anesthesia or spinal anesthesia for inguinal hernia repair.
One hundred and fifty-five patients scheduled for inguinal hernia repair (IHR) were given the choice of either general anesthesia (GA) (n = 53) or spinal anesthesia (SP) (n = 47) or nerve stimulator guided paravertebral blockade (PVB) (n = 55). The incidence of postoperative nausea and vomiting (PONV), duration of hospital stay and need for postoperative analgesia were recorded. Apart from a difference in the age of patients in the GA group who were found to be slightly younger, all groups were found similar with regard to weight, height, duration of surgery, sex, type of hernia and ASA class. ⋯ The length of hospital stay was also found to be shorter in the PVB group (mean 1.2 days) v/s SA (mean 2.4 days) and GA (mean 2.9 days). The need for supplemental postoperative analgesics was also found to be higher in both SA and GA when compared to PVB patients who were managed without any analgesics during the first 24 postoperative hours. The described technique appears to be an attractive alternative method to provide adequate anesthesia for IHR.
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Comparative Study
Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty.
This study was designed to determine the effects of continuous femoral infusion (CFI) on total knee arthroplasty recovery. A total of 92 patients were distributed in 3 groups: Patients in group 1 received general anesthesia followed by patient-controlled analgesia (PCA) with morphine (n = 33), patients in group 2 received 3-in-1 and sciatic blocks followed by CFI (n = 29), and patients in group 3 received epidural analgesia (n = 30). Blocks reduced postoperative morphine requirement by 74% (vs group 1; P<.05) and 35% (vs group 3; P<.05). ⋯ The use of CFI was associated with a reduction of postoperative bleeding by 72% (vs group 1; P<.05) and allowed better performance on continuous passive motion. CFI was associated with a 90% decrease in serious complications and a 20% decrease in the length of hospitalization. CFI represents a better alternative than PCA or epidural analgesia for postoperative pain management and immediate rehabilitation after total knee arthroplasty.