Articles: nerve-block.
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J Reconstr Microsurg · Jan 1998
Continuous peripheral nerve block in replantation and revascularization.
Continuous infusion of a local anesthetic by means of a percutaneous forearm catheter and an infusion pump was studied for its utility in achieving sympathetic blockade following replantation and revascularization of the digits. The efficacy of the technique was demonstrated by cold stress testing. ⋯ The analgesia obtained from the nerve block benefited patient comfort during hospitalization, and normal sensibility in the uninjured digits returned promptly after discontinuing the anesthetic in all but one patient. The reported study indicates that continuous peripheral nerve block by means of an indwelling forearm catheter is a safe and effective adjunct in preventing neurogenically-mediated vasospasm.
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Recent evidence suggests that the duration of the nociceptive block may be an important factor in determining the effect of the block on injury-induced hyperalgesia after block resolution. The authors examined whether a tonicaine nerve block lasting for 12 to 16 h could prevent late inflammatory hyperalgesia. ⋯ A prolonged nerve block (12-16 h) can prevent the development of long-lasting (3-5 days) inflammatory hyperalgesia. Prevention of late hyperalgesia can be provided not only by the preinjury block but also by the postinjury block administered when hyperalgesia is already well established.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Total spinal anesthesia after posterior lumbar plexus block].
We report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. ⋯ One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.