Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Saphenous nerve anaesthesia--a nerve stimulator technique.
This two part study was undertaken to assess both the feasibility of identifying the saphenous nerve with a nerve stimulator and to assess the efficacy of saphenous nerve anaesthesia with electrical isolation of the nerve. ⋯ (Part I): The first part of the study established the feasibility of electrical identification of the saphenous nerve and demonstrated that the NS technique could be utilized to provide superior anaesthesia of the saphenous nerve when compared with a previously validated LOR technique. (Part II): The clinical utility of the NS technique of saphenous nerve block was successfully demonstrated.
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The heads from 6 mature male wapiti and 8 mature male fallow deer were dissected to provide a description of the nerves supplying the antler pedicles. Innervation in both species was found to resemble that of the red deer, with major contributions coming from the infratrochlear and zygomaticotemporal nerves. ⋯ The dorsal branches of the 2nd cervical nerve were isolated in each head but could not be traced to the pedicles. Failure to induce anesthesia of the antler employing specific nerve blocks on the infratrochlear and zygomaticotemporal nerves can occur if the dorsal branch of the auriculopalpebral nerve is not blocked.
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Anaesth Intensive Care · Aug 1996
Comparative StudyAxillary brachial plexus block in two hundred consecutive patients.
Two hundred consecutive, minimally-sedated patients presenting for upper limb surgery were audited prospectively to determine the overall clinical success rate, extent of cutaneous neural blockade, reliability and complication rate of each indicator of axillary sheath entry, and degree of patient satisfaction. The axillary sheath was identified, using a 22 gauge, short-bevelled needle, by one of four indicators, whichever was elicited first (paraesthesia, arterial or venous puncture, or tethering by the axillary sheath). Alkalinized mepivacaine 1.2%, 50 ml then was injected. ⋯ Complete anaesthesia distal to the elbow was achieved in 85% of patients. Complications were common, but generally mild and transient: mild acute local anaesthetic toxicity, 3.5%; axillary tenderness and bruising, 12%; and dysaesthesias, 12.5%. Despite this, patient satisfaction was high (97%).
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Anesthesia and analgesia · Aug 1996
Randomized Controlled Trial Clinical TrialDigital pressure during interscalene block is clinically ineffective in preventing anesthetic spread to the cervical plexus.
The application of digital pressure above the injection site during interscalene block has been advocated to prevent cephalad spread of local anesthetic. In prior studies, radiographs taken immediately after interscalene injection of radiographic contrast have supported this concept. However, the clinical efficacy of digital pressure has not been previously tested. ⋯ Peak sensory level of anesthesia to pinprick was not significantly different between groups, each group having mean levels of C-2 to C-3. Digital pressure was ineffective in limiting the flow of local anesthetic into the cervical plexus. Digital pressure influenced neither the incidence of diaphragmatic paresis nor the resulting large decreases in pulmonary function that result from interscalene block.
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J Orthop Sports Phys Ther · Aug 1996
Glenohumeral gliding manipulation following interscalene brachial plexus block in patients with adhesive capsulitis.
Previous studies describing nonconservative treatment of shoulder adhesive capsulitis include distention arthrography, brisement techniques, arthrotomy of the anterior/inferior axillary fold and subscapularis tendon, and manipulation under general anesthesia. The purpose of this study was to develop and describe an alternative treatment method that utilizes glide manipulation under interscalene brachial plexus block. Eight patients (four females and four males), age 31-55 years, with a mean age of 44 years, were treated conservatively for adhesive capsulitis of the shoulder and failed to produce increased measurable objective active or passive ranges of motion. ⋯ At the time of discharge, average increases in passive range of motion/active range of motion for flexion, abduction, external rotation, and internal rotation were 76/67 degrees, 82/73 degrees, 50/44 degrees, and 49/40 degrees, respectively. All patients manipulated showed increases in function, such as overhead activities, dressing activities, and hair care. These preliminary findings show that effective gliding manipulation can be carried out under regional blockade and performed in an office setting by practitioners knowledgeable in manipulation techniques.