Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the Mogen and Gomco clamps in combination with dorsal penile nerve block in minimizing the pain of neonatal circumcision.
1) To compare the Mogen and Gomco clamps with regard to pain experienced during neonatal circumcision, and 2) to assess neonatal circumcision pain with and without dorsal penile nerve block (DPNB). ⋯ DPNB is effective in reducing neonatal circumcision pain with either the Mogen or the Gomco clamp. For a given anesthesia condition, the Mogen clamp is associated with a less painful procedure than the Gomco. The Mogen clamp with DPNB causes the least discomfort during neonatal circumcision.
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Randomized Controlled Trial Comparative Study Clinical Trial
Respiratory effects of low-dose bupivacaine interscalene block.
In this double-blind study, interscalene brachial plexus (ISBP) block was performed in 11 volunteers using 10 ml of either 0.25% (n = 6) or 0.5% (n = 5) bupivacaine with epinephrine 1:200,000. Diaphragmatic excursion, respiratory function and neural function were assessed for 90 min. ⋯ Sensory anaesthesia in the upper limb was found consistently in both groups, although biceps paralysis occurred earlier after 0.5% bupivacaine. We conclude that ISBP block using 10 ml of 0.25% bupivacaine provided upper limb anaesthesia to pinprick in C5-6 dermatomes with only occasional interference with respiratory function.
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Anesthesia and analgesia · Feb 1999
The risk of persistent paresthesia is not increased with repeated axillary block.
Neurologic deficits are noted on physical examination in approximately 0.2%-19% of patients after regional anesthetic techniques. Laboratory and clinical studies suggest that a subclinical neuropathy occurs much more often. Performing a regional anesthetic technique during this period may result in additional nerve trauma. We evaluated the frequency of neurologic complications in patients undergoing repeated axillary block. A total of 1614 blocks were performed on 607 patients. The median number of blocks per patient was two (range 2-10 blocks). The median interval between blocks was 12.6 wk, including 188 (31%) patients who received multiple blocks within 1 wk. Sixty-two neurologic complications occurred in 51 patients for an overall frequency of 8.4%. Of the 62 nerve injuries, 7 (11.3%) were related to the anesthetic technique; the remaining 55 (88.7%) were a result of the surgical procedure. Patient age and gender, the presence of preexisting neurologic conditions, a surgical procedure to a nerve, and total number of blocks did not increase the risk of neurologic complications. No regional anesthetic technique risk factors, including elicitation of a paresthesia, selection of local anesthetic, or addition of epinephrine, were identified. The success rate was higher with the paresthesia technique than with nerve stimulator technique or transarterial injection, and with use of mepivacaine versus bupivacaine. We conclude that the frequency of neurologic complications in patients undergoing repeated axillary block is similar to that in patients receiving a single regional technique. These patients are not likely to be at increased risk of neurologic complications. ⋯ The risk of neurologic complications was not increased in patients who underwent multiple axillary blocks, even within a 1-wk interval. No risk factors for anesthetic-related complications were identified. However, block success rate was increased with the paresthesia technique and the injection of mepivacaine versus bupivacaine.
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Comment Letter Comparative Study
Comparison of intrathecal morphine and continuous femoral 3-in-1 block for pain after major knee surgery under spinal anaesthesia.
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Arch Orthop Trauma Surg · Jan 1999
Combined sciatic and femoral nerve block for knee arthroscopy: 4 years' experience.
Selective block of the femoral and sciatic nerves was performed on 601 patients undergoing knee arthroscopy. The results were good in 87%, adequate in 12%, and poor in 1%. ⋯ No correlation was observed between the effectiveness of the anesthesia and type of surgery performed. The technique described thus proved adequate for knee arthroscopic surgery, reproducibility was excellent, costs and hospital stays were reduced with respect to general anesthesia, and surgeon and patient satisfaction was high.