Articles: nerve-block.
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Regional anesthesia · Nov 1995
The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1,000 consecutive patients.
The present study was performed at the Crystal Clinic Surgery Center, an outpatient free-standing surgicenter specializing in orthopedic surgery, to determine the incidence of both neurologic and vascular sequelae associated with exclusive use of a transarterial approach to axillary brachial plexus block in order to assess the technique's safety and efficacy. ⋯ This study demonstrated the safety and efficacy of the transarterial technique in achieving brachial plexus block.
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Regional anesthesia · Nov 1995
Letter Clinical TrialDiaphragmatic motion during continuous interscalene brachial plexus block.
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Anesthesia and analgesia · Oct 1995
Randomized Controlled Trial Clinical TrialA new axillary approach for continuous brachial plexus block. A clinical and anatomic study.
Catheter insertion in the neurovascular space by axillary approach allows a continuous brachial plexus block and/or postoperative analgesia. We developed a perivenous technique whereby the approach to the neurovascular sheath is guided under fluoroscopy by a preopacified axillary vein. A randomized study compared this technique to the technique of Selander in ASA grade I-II patients scheduled for surgery or painful physiotherapy of the hand. ⋯ The concentrations were higher (P < 0.01) in failed blocks; the median value was 1.69 micrograms/mL (95% confidence interval: 0.58-2.8). A complementary anatomic study of three arms from fresh cadavers allowed verification of the correct localization of the Teflon cannula and flexible catheter, as well as homogeneous diffusion of the methylene blue inside the brachial plexus. The perivenous technique for continuous axillary brachial plexus block may improve the success rate due to its radiologic and accurate location of the neurovascular sheath.
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Anesthesia and analgesia · Oct 1995
Randomized Controlled Trial Multicenter Study Clinical TrialIntravenous regional guanethidine in the treatment of reflex sympathetic dystrophy/causalgia: a randomized, double-blind study. Guanethidine Study Group.
This double-blind, randomized, multicenter study was designed to determine the short-term and long-term efficacy of intravenous regional block with guanethidine in patients with reflex sympathetic dystrophy (RSD)/causalgia. Sixty patients were enrolled to receive four intravenous regional blocks at 4-day intervals with either guanethidine or placebo in 0.5% lidocaine. Each patient was randomized to receive either one, two, or four blocks with guanethidine. ⋯ At 4 days after the initial block, the group treated with placebo experienced a greater decrease in pain scores than those treated with guanethidine, although this difference was not statistically significant. On long-term followup there was no difference in pain scores between groups receiving one, two, or four guanethidine blocks. Overall, only 35% of patients experienced clinically significant relief on long-term followup even though all were treated early in the evolution of RSD.