Articles: nerve-block.
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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).
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Randomized Controlled Trial Comparative Study Clinical Trial
Priming with rocuronium accelerates the onset of neuromuscular blockade.
To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. ⋯ Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.
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The clinical utility of a new parasacral approach for conduction block of the sciatic nerve was investigated, with critical examination of onset, extent, and success rates when this block was used for surgical procedures below the knee. ⋯ The parasacral approach to the sciatic nerve exhibits a high success rate, resulting in anesthesia of the entire sacral plexus and generally in motor block of the obturator nerve was an interesting observation.
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Anesthesia and analgesia · May 1997
Clinical Trial Controlled Clinical TrialQuantitative assessment of differential sensory blockade after lumbar epidural lidocaine.
A cutaneous current perception threshold (CPT) sensory testing device measures both large and small diameter sensory nerve fiber function and may be useful in evaluating differential neural blockade. Eight subjects received both lumbar epidural saline and lumbar epidural lidocaine. Five milliliters of normal saline was administered and the CPTs were measured. ⋯ There was a significant decrease in touch, pinprick, and cold sensation at the umbilicus and knee and a significant decrease in the cold sensation at the great toe. There was no effect on any measurements made at the mastoid. Epidural lidocaine resulted in a differential neural blockade as measured by a CPT monitor but not with crude sensory measurements.