Articles: nerve-block.
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This prospective study consisted of mechanical stimulation of cervical nerve roots C4 to C8 in patients with cervical radicular symptoms undergoing diagnostic selective nerve root block. ⋯ The current study demonstrates a distinct difference between dynatomal and dermatomal maps.
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An increasing number of therapeutic spinal injections are performed each year despite little validation in randomized controlled trials. Additional injections are performed for diagnostic purposes of localizing symptomatic nerve roots, again without detailed evaluation of accuracy, specificity, or sensitivity. Drs. Slosar and White argue that selective nerve root blocks are extremely useful; Dr Wetzel believes that selective nerve root blocks have no role in selecting patients for surgery.
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Anaesth Intensive Care · Oct 1998
Randomized Controlled Trial Multicenter Study Clinical TrialA comparison of 0.5% ropivacaine and 0.5% bupivacaine for axillary brachial plexus anaesthesia.
The purpose of this study was to compare the use of 0.5% ropivacaine with 0.5% bupivacaine for axillary brachial plexus anaesthesia. Sixty-six patients undergoing upper limb surgery were enrolled in a double-blind, randomized, multicentre trial. Five patients were subsequently excluded for various reasons. ⋯ These parameters were not statistically different. The duration of partial motor block at the wrist (6.8 v 16.4h) and hand (6.7 v 12.3h) was significantly longer with bupivacaine. Ropivacaine 0.5% and bupivacaine 0.5% appeared equally efficacious as long-acting local anaesthetics for axillary brachial plexus block.
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Anesthesia and analgesia · Oct 1998
Comment Letter Case ReportsRelief of chronic refractory hiccups with glossopharyngeal nerve block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Differential onset of median nerve block: randomized, double-blind comparison of mepivacaine and bupivacaine in healthy volunteers.
We have compared the delay in onset of 1% mepivacaine and 0.33% bupivacaine in different nerve fibre types in 10 volunteers undergoing median nerve blocks, in a randomized, double-blind, crossover study. Hot, cold, pinprick and light touch sensations, compound motor action potentials (CMAP), sensory nerve action potentials (SNAP) and skin temperature were recorded at 2-min intervals. Hot, cold, pinprick, light touch sensations, SNAP and CMAP were significantly inhibited, and skin temperature was significantly increased after administration of both agents. ⋯ Bupivacaine and mepivacaine inhibited SNAP and CMAP with a similar time delay to steady-state. Bupivacaine produced steady-state inhibition of hot and cold sensations significantly later than mepivacaine; nevertheless, the sequence that sensory modalities failed, with few exceptions, and the extent of anaesthesia at 40 min were similar for both agents. Our technique provides a novel, multi-modal method of comparing local anaesthetics and related agents over time.