Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Analgesia after inguinal herniorrhaphy with laparoscopic inspection of the peritoneum in children. Caudal block versus ilioinguinal/iliohypogastric block.
The authors prospectively evaluated the efficacy of caudal epidural block versus local infiltration combined with ilioinguinal/iliohypogastric block for analgesia after inguinal herniorrhaphy with laparoscopic inspection of the peritoneum. During standardized anesthetic care, 24 children were randomized to Group I (caudal epidural block with 1.2 mL/kg of 0.25% bupivacaine) or to Group II (local infiltration with an ilioinguinal/iliohypogastric block). Postoperative pain scores were significantly lower at all four evaluation points in Group I than in Group II. ⋯ Time to extubation was 3.8 +/- 0.5 minutes in Group I and 8.2 +/- 1.1 minutes in Group II. The time from arrival in the postanesthesia care unit until discharge home was 113 +/- 3 minutes in Group I and 152 +/- 11 minutes in Group II. Caudal epidural block was more effective than local infiltration in controlling pain after herniorrhaphy with laparoscopy in children and resulted in earlier discharge home.
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Regional anesthesia · Jul 1995
Case ReportsSuprascapular nerve block by catheter for breakthrough shoulder cancer pain.
Incidental shoulder pain due to movement renders pain control difficult because it requires high basal dosages or additional doses of opioids. Shoulder pain can be alleviated by suprascapular nerve block, and the placement of a catheter can permit the injection of local anesthesia as needed. ⋯ Continuous suprascapular nerve block is safe and simple and has proven to be useful in avoiding extra doses of opioids.
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Ann Acad Med Singap · Jul 1995
Postoperative continuous interscalene brachial plexus blockade for hand surgery.
Interscalene brachial plexus blockade is a well-established means of providing analgesia and anesthesia for upper extremity surgery. Extension into the postoperative period with continuous infusions of 0.25% bupivacaine provides several added advantages. Our survey over two years covered 126 patients undergoing surgery by the Department of Hand Surgery of our hospital. ⋯ The insertion complication rate was 11.1%; all these cases were attributed to the bolus dose given and resolved over the next few hours. Eighteen (14.3%) of the patients developed complications while on continuous infusion, the most frequent being catheter dislodgement and pain at the insertion site. In all we found this method of providing postoperative analgesia to be effective, inexpensive and easy to implement in our large hospital setting.
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Dermatomyositis (DM) is a rare disease of unknown aetiology involving weakness of proximal muscles, myalgia and impairment of the integument. Due to its low incidence, only few reports exist on the anaesthesiologic management of neuromuscular blockade in patients with DM considered for surgical therapy. In this setting, special attention should be given to the administration of muscle relaxants since an increased sensitivity to these drugs in neuromuscular diseases may be expected. ⋯ To date, few experiences of neuromuscular blockade with atracurium in DM have been presented, hence this report. In addition, no standard recommendations are given regarding the application of nondepolarizing muscle relaxants in this context. In our case, atracurium could be implemented as a safe drug under neuromuscular monitoring.
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Anesthesia and analgesia · Jun 1995
Activation of the Bezold-Jarisch reflex in the sitting position for shoulder arthroscopy using interscalene block.
A retrospective analysis of 116 patients who underwent shoulder arthroscopy in the sitting position with interscalene block (ISB) revealed 20 patients who experienced potentially dangerous vasovagal events characterized by sudden severe hypotension and bradycardia (Group 1). The event occurred 61 +/- 18 min after the block placement. Ninety-six patients (Group 2) did not experience a vasovagal event. ⋯ All patients received epinephrine in their local anesthetic for ISB, incision sites, and articular irrigating solution. Total and weight-corrected epinephrine doses differed significantly between groups (lowest in Group 2A, P < 0.01). Activation of the Bezold-Jarisch reflex, induced by increased circulating epinephrine levels and the sitting position, is the postulated mechanism.