Articles: nerve-block.
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Paediatric anaesthesia · Jan 1996
Case ReportsTotal spinal anaesthesia following caudal block with bupivacaine and buprenorphine.
This is a case report of an 18-month-old 10 kg child who presented for emergency repair of a recurrent diaphragmatic hernia with a history of craniofacial dystosis and was given a caudal block postoperatively with a combination of 4 ml of 0.5% bupivacaine and 2.5 micrograms.kg-1 buprenorphine made up to a total volume of 10 ml. An inadvertent dural puncture occurred resulting in total spinal block which was managed symptomatically. ⋯ The patient's exposure to a large intrathecal dose of buprenorphine did not lead to prolonged respiratory depression. The possibility of a midbrain insult due to a sudden rise in intracranial pressure is also discussed.
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Paediatric anaesthesia · Jan 1996
The rectus sheath block in paediatric anaesthesia: new indications for an old technique?
The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra- and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day-cases surgery.
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Cahiers d'anesthésiologie · Jan 1996
Randomized Controlled Trial Clinical Trial[Value of ilio-hypogastric block in appendectomy in children].
This prospective study aimed to evaluate the efficiency of ilio-hypogastric nerve block for control of post appendicectomy pain in children. Forty-two children aged 3-15 years scheduled for appendicectomy were anaesthetized in the same way. After randomization, a preoperative ilio-hypogastric nerve block was performed in 21 patients. ⋯ Five inefficient blocks were recorded. No complications were noted. Ilio-hypogastric block was found to be safe and efficient for control of post-appendicectomy pain in most children.
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This retrospective study concerns 1,373 adult patients who underwent forefoot surgery during 1988-95 under regional anaesthesia by ankle nerve blocks (of posterior tibial nerve systematically and other nerves according to the surgical site). As a rule, plain bupivacaine 0.5% (maximum 40 mL) was used, completed if necessary by lidocaine 1% (a few mL). A nerve stimulator is currently used for posterior tibial blocks. ⋯ No general anaesthesia was needed (except after one case of convulsions, likely from accidental injection of a few mL of local anaesthetic and without any sequelae). Five patients complained of temporary paraesthesias, with indication of a posterior tibial neurolysis in one case and complete recovery. Thus ankle blocks appear increasingly to be a satisfactory alternative to general anaesthesia for most surgical procedures on the forefoot, provided that all usual safety conditions are respected and the patient's acceptance of the procedure is obtained.
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Sciatic nerve block is considered difficult to perform, but very useful for lower limb anaesthesia and analgesia. The use of a nerve stimulator makes the technique easier. Functionally, it is better to consider that there are three independent sciatic nerves, namely, the posterior cutaneous nerve, the tibial nerve and the common peroneal nerve. Searching for blocking these three nerves and especially the latter two, specifically improve the reliability and quality of blockade.