Articles: nerve-block.
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Reg Anesth Pain Med · Jan 2000
Case ReportsProlonged suppression of tinnitus after peripheral nerve block using bupivacaine and lidocaine.
The local anesthetic lidocaine has been shown to suppress tinnitus, albeit very temporarily, when administered intravenously. Long-term suppression by local anesthetics has not been reported. Bupivacaine has not been studied. Here we report a case of prolonged (1-month) suppression of tinnitus following a peripheral nerve block performed with lidocaine and bupivacaine. ⋯ There are no reports regarding the use of bupivacaine for suppression of tinnitus. Although previous reports studying lidocaine for this purpose have shown only a brief effect, the use of bupivacaine or a combination of lidocaine and bupivacaine, as in this case, may represent a treatment for tinnitus that is worth further investigation. There currently is no effective long-term therapy for this debilitating problem.
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Reg Anesth Pain Med · Jan 2000
Clinical Trial1,001 subclavian perivascular brachial plexus blocks: success with a nerve stimulator.
Among the supraclavicular approaches to the brachial plexus, the subclavian perivascular technique is a well-established method of anesthesia of the upper extremity. Ever since Kulenkampf described his technique, eliciting a paresthesia has been almost mandatory ("no paresthesia, no anesthesia"). Lately, nerve stimulators have become more popular. However, up to the present time, clinical studies involving the nerve stimulator have failed to show success rates comparable to paresthesia techniques. ⋯ The subclavian perivascular block consistently provides an effective block for surgery on the upper extremity. At the site of injection with this technique, the plexus is reduced to its smallest components and the sheath is reduced to its smallest volume, which explains in great part the success obtained with this block. We believe that we have demonstrated a nerve stimulator technique that is both highly successful and safe; no clinical pneumothorax was found nor did any other major complications develop.
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Foot and ankle operations are being performed with greater frequency as outpatient procedures. Although the surgical procedure remains the same whether the operation is done in an inpatient or an outpatient setting, the anesthesia and postoperative analgesia are greatly affected when patients must be discharged soon after their operation. ⋯ This was the sole anesthetic technique for both the operation and the immediate postoperative period. This technique appears to have several advantages: 1) Excellent anesthesia during the operation and for about ten hours postoperatively; 2) Use of a proximal calf tourniquet, and 3) Absence of systemic or local complications as might be seen with general, spinal or epidural anesthesia.
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Ann Fr Anesth Reanim · Jan 2000
[Sciatic nerve block: an new lateral mediofemoral approach. The value of its combination with a "3 in 1" block for invasive surgery of the knee].
To describe a new midfemoral lateral approach for the sciatic nerve block. Its combination with the "3 in 1" block was tested for postoperative analgesia following major surgery of the knee. ⋯ The new lateral midfemoral sciatic block is easy to master. Combined with a continuous "3 in 1" block, it provides excellent analgesia during the early postoperative period after major surgery of the knee.
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The technique of coracoid block described by Whiffler has been improved by use of neurostimulator (Stimuplex--B. Braun) and changing the angle of insertion of the neurostimulation needle (Stimuplex needle A150, 0.90 x 150 mm). ⋯ The acquired results of the alteration of the sensitivity and motor function prove an effective block within all the regions distally of the upper brachium in 91.4 of the patients and no complications. The proposed technique of coracoid block is a safe and easily performed method for regional anesthesia routinely applied in planned, urgent and outpatient surgery of the upper extremity.