Articles: nerve-block.
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Anesthesia and analgesia · Jun 1997
Case Reports Randomized Controlled Trial Clinical TrialGlossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial.
A regional anesthetic technique formerly used in adults for tonsillectomy was adapted to provide posttonsillectomy pain relief in children. Injection of 3-10 mL of 0.25%-0.5% bupivacaine into each lateral pharyngeal space appeared to provide good postsurgical analgesia. A retrospective chart review failed to link the technique to airway-related complications. ⋯ We conclude that the volume and concentration of bupivacaine were sufficient to block the vagus nerves proximal to the take off of the recurrent laryngeal nerves and/or the hypoglossal nerves, resulting in severe UAO. The short distance between the hyoid and jugular foramen would predispose children and adults with a short neck to the development of this complication. In conclusion, bilateral local anesthetic injection into the lateral pharyngeal space may result in severe UAO and loss of protective reflexes.
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Randomized Controlled Trial Clinical Trial
ORG 9487 neuromuscular block at the adductor pollicis and the laryngeal adductor muscles in humans.
ORG 9487 is a new steroidal nondepolarizing muscle relaxant with a rapid onset of action. This study was designed to determine the neuromuscular blocking profile of ORG 9487 at the adductor muscles of the larynx and the adductor pollicis. ⋯ ORG 9487 has a rapid onset of action at the laryngeal adductor and the adductor pollicis muscles. Onset and duration of action are faster at the vocal cords than at the adductor pollicis muscle. However, the maximum block obtained at the laryngeal muscles was less than at the adductor pollicis, regardless of the dose of ORG 9487.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of axillary block techniques: is there a difference in success rates?
This study compared the success rates between two accepted methods of performing axillary blocks, the peripheral nerve stimulator (PNS) and the transarterial (TA) techniques. Success was based on blocking the nerves involved in the surgery. Following institutional review board approval and informed consent, 57 patients between the ages of 18 and 86 years of age scheduled for elective upper extremity surgery were studied. ⋯ There were no significant side effects reported by the patients postoperatively. The axillary nerve was the only nerve with an increased success rate using the TA technique. This indicates that both techniques are equally acceptable.
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Comparative Study
Recovery times from subarachnoid blocks using bupivacaine hydrochloride and tetracaine hydrochloride with and without epinephrine.
This retrospective study examined the length of time patients spent in the postanesthesia care unit (PACU) recovering from a subarachnoid block with either bupivacaine hydrochloride or tetracaine hydrochloride with and without epinephrine after total knee replacement surgery or total hip replacement surgery. One hundred subjects' charts were reviewed with 50 subjects receiving a subarachnoid block with bupivacaine (25 had epinephrine added to the bupivacaine) and 50 subjects receiving a subarachnoid block with tetracaine (25 had epinephrine added to the tetracaine). ⋯ Patient who received tetracaine stayed longer in the PACU (64.44 minutes) and took longer to bend their knees (73.17 minutes), flex their hips (99.65 minutes), and have return of sensation (68.88 minutes), compared to those who had received bupivacaine (P < .05). When epinephrine was added to the local anesthetic, it prolonged the time until the return of knee flexion, hip flexion, and sensation by 66.82, 87.65, and 76.77 minutes respectively (P < .05).