Articles: nerve-block.
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Reg Anesth Pain Med · Jul 1999
Comparative StudyThe endoneurial response to neurolytic agents is highly dependent on the mode of application.
The variability and predictability of neurolytic neural blocks were studied using an experimental rat sciatic nerve model. The goal of the study was to compare endoneurial and clinical responses to commonly used neurolytic agents. ⋯ There were no differences in the effects of clinically used neurolytic agents after intraneural injections. Although the perineurally applied 7% phenol-aqua induced marked endoneural damage, the destructive effect of glycerol and phenol-glycerol injections seemed to be prevented by the perineurium; phenol-glycerol and glycerol treatments induced subperineural damage only after perineural injections. The ability to penetrate the perineurium favors the use of 7% phenol-aqua in peripheral perineural blocks when complete neurolysis is the goal.
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Clinical Trial
Popliteal fossa block for postoperative analgesia after foot surgery in infants and children.
The efficacy of a popliteal fossa block (PFB) was evaluated after foot and ankle surgery in children. With the child still anesthetized, a PFB was performed with 0.75 ml/kg of 0.2% ropivacaine. Postoperative analgesia was assessed by using an objective pain score, assigned at 2-h intervals. ⋯ Eight patients required no analgesic agents during the first 12 postoperative hours. The duration of the analgesia varied from 8 to 12 hours. PFB provides effective analgesia after foot and ankle surgery in children.
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Randomized Controlled Trial Clinical Trial
Low dose axillary block by targeted injections of the terminal nerves.
To compare anesthetic time, success rate and adverse effects of axillary block by single or multiple injections of local anesthetic. ⋯ Small targeted injections of MEPE reduce total anesthetic time, give better spread of analgesia in the hand and forearm, and may be safer than a single large injection.
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Acta Anaesthesiol Scand · Jul 1999
Block of the brachial plexus branches by the humeral route. A prospective study in 503 ambulatory patients. Proposal of a nerve-blocking sequence.
Brachial plexus is usually approached by the supraclavicular or axillary route. A technique for selective blockade of the branches of the plexus at the humeral canal using electrolocation has recently been proposed. The aim of the present study was to assess the feasibility of this technique in the ambulatory patient and to determine the optimal sequence of nerve-blocking. ⋯ This study shows that the nerve block at the humeral canal is an efficient and safe technique. Considering the onset times of nerve blocks, the following sequence for blockade can be recommended: median, ulnar, radial, musculocutaneous, medial (brachial and antebrachial) cutaneous nerves. The selective blockade of the main nerves of the upper limb at the humeral canal can be recommended for surgery of the forearm and the hand in the ambulatory patient.
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Anesteziol Reanimatol · Jul 1999
Comparative Study[Prolonged blocking of the brachial plexus by axillary approach in children].
Surgical interventions were carried out under combined total anesthesia with prolonged blocking of the brachial plexus via axillary approach in 40 children aged 4-14 years with surgical diseases of the arms. Prolonged axillary blockade maintained adequate analgesia in the lower third of the brachial bone, ulnar joint, forearm, and hand for 24-48 h. The proposed protocols of lidocaine and bupivacaine infusion into the axillary space of the brachial plexus caused no toxic reactions in children of this age group. The method can be used in children during and after surgery.