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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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.
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Oral Surg Oral Med O · Jun 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe use of ultrasound for guiding needle placement for inferior alveolar nerve blocks.
The degree of pulpal anesthesia obtained with an ultrasound-assisted inferior alveolar nerve block was compared to that obtained with a conventional inferior alveolar nerve block for mandibular teeth to determine whether needle placement assisted by ultrasound results in more successful anesthesia. ⋯ It was concluded that accurate needle placement with ultrasound for the inferior alveolar nerve block did not result in more successful pulpal anesthesia in the mandible. Therefore, accuracy of needle placement is not the primary reason for pulpal anesthetic failure with this block.