Articles: nerve-block.
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Regional nerve blocks are a valuable skill for general practitioners and surgeons who perform surgical procedures under local anaesthetic. Once mastered, these injections provide rapid anaesthesia with minimal pain, little distortion of the tissues and improved aesthetic results. This paper describes techniques applicable to lesions of the face, upper and lower limbs, and to achieve anaesthesia after a fractured rib.
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Acta Anaesthesiol. Sin. · Sep 1996
[Clinical experience in interscalene brachial plexus block combined with Ho's method of C3-4 block for shoulder and proximal upper extremity surgeries].
Brachial plexus block, first performed in 1889 by Halsted, has been widely used for surgery of shoulder and upper third of upper extremity. But the level of block is inadequate for surgery of the deeper tissue. If high volume of local anesthetic (40 ml) is used to block C3-4, complications like Horner's syndrome and phenic nerve palsy would be frequent. The landmark of C-3 and C-4 nerve root is difficult to identify. The purpose of this study was to design a new method to block easily the C-3 and C-4 nerve roots for surgery of shoulder deep tissue. ⋯ Interscalene brachial plexus block combined with Ho's method of C3-4 block is technically safe and economical for patients receiving shoulder and proximal third of upper extremity surgery. We must make selection of patients carefully and exclude those whose anatomical landmarks are difficulty identified. As such, good result is expected.
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Regional anesthesia · Sep 1996
Case ReportsPeripheral nerve catheterization in the management of terminal cancer pain.
Peripheral nerve catheterization techniques were used in two patients with severe pain associated with the terminal stages of metastatic cancer. The first patient had severe upper limb pain and lymphedema secondary to breast carcinoma, and the second patient had an acutely ischemic leg secondary to pelvic obstruction from an ovarian tumor. The goal of treatment was to relieve the pain, which was resistant to opioid drugs, and to optimize the quality of life that remained, estimated to be only a few weeks. ⋯ Peripheral nerve catheterization proved beneficial in two patients who presented with difficult pain management problems and should be more widely considered for the relief of severe cancer-related pain in both the upper and lower limbs.
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Randomized Controlled Trial Clinical Trial
Dorsal penile nerve block in children undergoing circumcision in a day-care surgery.
Circumcision is performed under general anaesthesia (GA) with dorsal penile nerve block (DPNB) as an analgesic technique for postoperative pain. The purpose of this study was to compare DPNB as the sole anaesthetic procedure vs GA and DPNB for circumcision in children as an outpatient procedure. ⋯ These data confirm that DPNB has advantages over GA + DPNB for paediatric circumcision in day-care surgery.
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Sciatic nerve block in the popliteal fossa (popliteal nerve block, PNB) is an anaesthetic technique well-suited for operations below the knee. However, difficulty with positioning the patient in the prone position often precludes the classical, posterior approach to the block. In this report, an alternative approach to PNB that can easily be performed with a patient in the supine position is described. ⋯ The supine approach to PNB allows the use of the block in patients that cannot be positioned in the prone position. Flexion of the leg at the knee greatly facilitates identification of the anatomical landmarks. When combined with a block of the femoral or saphenous nerve, this technique provides excellent anaesthesia for patients undergoing foot and ankle surgery.