Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
No enhancement of sensory and motor blockade by neostigmine added to mepivacaine axillary plexus block.
Intrathecal neostigmine induces analgesia but also several side effects. Recently, 500 microg neostigmine administered intraarticularly was shown to produce postoperative analgesia without side effects. The authors' goal was to determine whether 500 microg neostigmine added to mepivacaine in axillary plexus block prolongs postoperative analgesia. In addition, they wanted to determine the incidence of side effects in patients undergoing hand surgery. ⋯ This study suggests that 500 microg neostigmine added to mepivacaine in axillary plexus block does not prolong postoperative sensory block, but it does cause a relatively high incidence of side effects. These two findings raise doubts about the use of neostigmine associated with local anesthetics for plexus neural block.
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Randomized Controlled Trial Clinical Trial
Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery.
Continuous passive motion after major knee surgery optimizes the functional prognosis but causes severe pain. The authors tested the hypothesis that postoperative analgesic techniques influence surgical outcome and the duration of convalescence. ⋯ Regional analgesic techniques improve early rehabilitation after major knee surgery by effectively controlling pain during continuous passive motion, thereby hastening convalescence.
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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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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.