Articles: nerve-block.
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Anesteziol Reanimatol · Jan 2001
Comparative Study[Combined anesthesia with blockade of nn.dorsalis penis and inhalation anesthetics in surgery of the penis in children].
The studies were carried out in 21 patients with abnormalities of the penis (coronal and penile hypospadia, webbed penis) aged 5-15 years. Central hemodynamics, heart rate, and arterial pressure were evaluated at 6 stages of anesthesia and surgery. ⋯ The nn. dorsalis penis was blocked with 0.25% marcaine in a dose of 0.1 ml/kg for each side. The results indicate that penile blockade in combination with inhalation anesthesia is an effective method for anesthesiological protection of children operated on the penis.
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Single-injection paravertebral block offers adequate unilateral analgesia for thoracic and upper abdominal surgery. This technique is easy to learn but there is a risk, albeit low, of pleural puncture. The aim of the study was to determine whether sonographic measurements of the distances from the skin to the transverse process and to the parietal pleura are useful for calculating the required depth of needle insertion. ⋯ Puncture of the paravertebral space failed in one obese woman. There was a very close correlation between needle insertion depth from the skin to the transverse process and the distance measured by ultrasound if angle correction was used (adjusted r2=0.95). Similarly, there was excellent correlation between the angle-corrected ultrasound distance from the skin to the parietal pleura and the distance from the skin to the paravertebral space (adjusted r2=0.92).
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Regional anaesthesia plays an important role in day case surgery because it combines reliable effects with low risk and the possibility of local postoperative analgesia without systemic side-effects. Fast-track regional anaesthesia allows short-term postoperative surveillance or even bypassing the post-anaesthesia care unit. ⋯ Multiple peripheral nerve stimulation and injection techniques may help to realize differential blockades with a pronounced analgesic rather than a motor blocking effect. Nerve blocks with local anaesthetics in combination with alpha2-adrenoceptor agonists or non-steroidal anti-inflammatory drugs and short-acting parenteral opioids represent an effective multimodal concept for ambulatory surgery.
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Anesthesia and analgesia · Dec 2000
Randomized Controlled Trial Clinical TrialInterscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump.
Continuous interscalene brachial plexus blockade traditionally requires a hospital stay for local anesthetic infusion, and achieving consistent catheter insertion may be difficult. Incorporating long-acting pain relief from a continuous peripheral nerve block, with a reliable method of catheter insertion, and a self-contained infusion system would be a valuable asset for short-stay care. We compared the efficacy of single injection interscalene brachial plexus blockade to a continuous peripheral nerve block, with an insulated Tuohy system and a disposable infusion pump. ⋯ In addition, initial interscalene blockade was successful in all patients and all redosed catheters were functional after 24 h with the continuous catheter insertion system. We conclude that it is possible to achieve a high rate of successful catheter placement and analgesia by using the continuous catheter insertion system and a disposable infusion pump in the ambulatory setting. This method of analgesia may offer improved pain relief after outpatient rotator cuff repair.