Articles: nerve-block.
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Reg Anesth Pain Med · Sep 1998
Case ReportsContinuous sciatic nerve infusion: expanded case report describing a new approach.
Severe pain following extensive reconstructive foot surgery is difficult to manage effectively. Sciatic nerve block provides excellent analgesia for a limited duration. I wanted to determine an approach to sciatic nerve block enabling an infusion of a local anesthetic for a prolonged period without loss of efficacy due to catheter displacement. ⋯ The described "in line" technique of continuous sciatic nerve infusion of a local anesthetic solution gives prolonged and effective analgesia following foot surgery.
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Randomized Controlled Trial Clinical Trial
Intercostal nerve blockade with a mixture of bupivacaine and phenol enhance the efficacy of intravenous patient-controlled analgesia in the control of post-cholecystectomy pain.
Prolonged nerve conduction blockade has been proposed to result from the summed effects of charged and neutral local anaesthetics. Thirty-seven patients were randomly allocated to receive intravenous patient-controlled analgesia alone or combined with intercostal blockade (T7-T11) with a mixture of 0.45% bupivacaine and 0.6% phenol for post-cholecystectomy analgesia. ⋯ However, in the combined treatment group, a significantly lower total consumption of morphine (P < 0.05), associated with a shorter duration of patient-controlled analgesia (P < 0.02) and a decreased mean number of unsuccessful demands (P < 0.001) were recorded. Intercostal blockade with bupivacaine-phenol supplements intravenous patient-controlled analgesia for post-cholecystectomy pain relief.
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Letter Case Reports
Peripheral blocks of the lower limb for repair of fractured neck of femur.
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Case Reports
Chronic pain management--upper visceral malignancies coeliac plexus block with CT scanning--a case report.
Coeliac plexus block has been described more than seventy years ago and is widely used for chronic pain management in upper visceral malignancies. The technique described here is a posterior approach using CT scan guidance with absolute ethyl alcohol. A case illustration of a patient with carcinoma of pancreas managed with coeliac plexus block for pain control is presented.
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Femoral nerve blocks and 3-in-1 blocks are simple and useful alternatives to other regional or general anesthetic techniques for selected surgeries. These blocks also may provide postoperative analgesia that may be a useful alternative to epidural or parenteral analgesia. Understanding the techniques of blockade, its appropriate applications, and the relevant anatomy may provide the anesthetist with a valuable alternative.