Articles: nerve-block.
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Two hundred patients with upper-abdominal malignancy were treated with oral morphine sulfate (OMS) during a 2-year period. Twenty-five of these patients experienced left-sided dragging pain and epigastric discomfort following a few months of adequate pain relief. An increase in the OMS did not relieve the pain. ⋯ All of these patients continued to receive OMS without reduction in dose. Three patients required repeat block after 90 days. This experience documents the value of unilateral celiac plexus block as an adjuvant technique for the management of pain due to upper abdominal cancer.
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Comparative Study
[Efficacy of continuous intercostal analgesia versus epidural analgesia on post-thoracotomy pain].
The authors compare the efficacy of epidural morphine analgesia with continuous intercostal extrapleural block using bupivacaine 0.5% after thoracotomy. They affirm that antalgic treatment in thoracotomised patients is the most important factor in preventing the onset of major complications that may negatively influence the results of surgery. The efficacy of the analgesic techniques examined was evaluated using El-Baz's visual analogic scale of pain, through the analysis of spirometric values and on the incidence of postoperative complications. The authors demonstrate that the extrapleural continuous nerve block is a reliable method of post-thoracotomic analgesia.
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We report on the use of Biers Block in an accident and emergency department carried out during the period 1987 to 1994. A total of 915 procedures were carried out, of which 815 (98%) involved emergency procedures. ⋯ Acceptability by the patients was uniformly good. We feel it is a useful method of producing analgesia in the limb that does require training but no extensive experience or anaesthetists' expertise.