Articles: nerve-block.
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Acta Anaesthesiol. Sin. · Jun 1997
Case ReportsDyspnea resulting from phrenic nerve paralysis after interscalene brachial plexus block in an obese male--a case report.
Phrenic nerve paralysis is a common complication in interscalene brachial plexus block. This complication is often ignored by most anesthesiologists because no clinical symptoms occur in patients who have no underlying lung disease. ⋯ The decreased respiratory reserve and direct compressing effect of the abdominal organs on the diaphragm in the supine position are thought to be the risk factors in this obese patient. Also discussed are the incidence, diagnostic methods, clinical presentation and treatments of phrenic nerve paralysis during interscalene brachial plexus block.
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Klin Monbl Augenheilkd · Jun 1997
Case Reports[Endophthalmitis after intra-oral block of the infraorbital nerve].
Most penetrating needle puncture injuries occur in retro- or peribulbar anesthesia. Hereby only a small percentage of patients develop endophthalmitis. Ocular penetration after enoral infraorbital nerve block has not yet been reported in literature. ⋯ Careful anamnesis would have prevented this accidental globe penetration. Right upper palate is absent presumably due to congenital cleft malformation or surgery. This allowed needle penetration through smooth tissue into the right globe. Fortunately, endophthalmitis develops only in a small percentage after needle puncture. We recommend immediate pars-plana-vitrectomy and intravitreal antibiotics in case of endophthalmitis after ocular penetration.
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Randomized Controlled Trial Clinical Trial
The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution.
Ninety patients undergoing scheduled upper limb orthopaedic surgery were studied to determine the optimal anaesthetic dose using the 'orthogonal two-needle technique'. The patients were randomly assigned to one of three groups to receive one of three different volumes (20, 30 and 40 mL) (n = 30) of anaesthetic solution (a mixture of equal parts of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine). A significant correlation was found between the volume injected and the anaesthetic spread for all tested areas. ⋯ The comparisons between the 20 mL group and the other two groups are significant in all the tested areas, as well as the comparisons between 30 and 40 mL groups in the areas innervated by radial and musculocutaneous nerves. Only the area innervated by the axillary nerve showed a weaker volume-analgesia relation, confirming the elusiveness of this area to anaesthesia in the axillary approaches. The improved results observed using greater amounts of anaesthetic solution might result from a higher intrasheath pressure with disruption of sheath septa, or from a greater availability of drug for all the terminal branches of brachial plexus, or both.
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Case Reports
Transient diplopia as a result of block injections. Mandibular and posterior superior alveolar.
Anesthetic "accidents" can and do happen as a result of maxillary and/or mandibular injections. The family practitioner has little or no control now. The anatomical pathways are discussed, but are not clear.