Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
[Intubation conditions and circulatory effects 90 seconds after a divided mivacurium dose with three different TIVA induction methods].
The aim of this study was to compare the intubating conditions of a mivacurium-induced neuromuscular block 90 s after a divided administration with three different methods of induction of anaesthesia. ⋯ A dose of mivacurium 3.57 times the ED95 does not produce any haemodynamic instability, if it is divided into two parts to induce a TIVA. After this dose, all patients could be safely intubated within 90 s. A prolongation of the neuromuscular block after higher mivacurium doses could not be seen, and this dose did not produce a more rapid onset of the maximal block in any group. The time for recovery from a mivacurium infusion did not differ among the groups. Etomidate, due to its short half-life, seems not ideal for induction of a TIVA together with mivacurium in the dosage used. Mivacurium meets the demands of good controllability as required for a TIVA and can be recommended for a 90-s injection-intubation interval as well as for maintenance of the neuromuscular block.
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Infraorbital nerve block in neonates is not well described although it has been suggested that bilateral infraorbital nerve block is the local analgesic technique of choice for early repair of cleft lip. The purpose of this study was to determine the location of the infraorbital nerve in neonatal cadavers and to identify clinically useful landmarks. Thirty infraorbital nerves were identified in 15 neonatal cadavers with a mean weight of 2.85 (SD 0.32) kg (range 2.45-3.5 kg) via an upper buccal sulcus incision. ⋯ A line drawn from the angle of the mouth to the midpoint of the palpebral fissure measured 30.6 (1.9) mm (left) and 30.7 (1.8) mm (right). The nerve was situated approximately halfway along this line at a point 15.5 (1.5) mm (left) and 15.2 (1.4) mm (right) from the angle of the mouth. These measurements were used to perform bilateral infraorbital nerve blocks in four neonates undergoing cleft lip surgery under general anaesthesia, thereby providing analgesia with minimal risk of respiratory depression.
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Anaesth Intensive Care · Apr 1995
Inguinal field block for adult inguinal hernia repair using a short-bevel needle. Description and clinical experience in Solomon Islands and an Australian teaching hospital.
One of the limitations of an inguinal field block is that it does not reliably produce complete anaesthesia. The purpose of this study was to describe a modified short-bevel needle technique, facilitating correct needle placement, for inguinal hernia repair. Anaesthetists from two different institutions performed the described infiltration blocks. ⋯ Results of the modified inguinal field block showed a 97% ability to achieve a "fair" block or better. Intraoperative and postoperative data showed high surgeon and patient satisfaction for the block. The described block using a short-bevel needle is recommended as a suitable method for adult patients undergoing inguinal hernia repair.
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J Neurosurg Anesthesiol · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of anesthetic techniques for awake intubation in neurosurgical patients.
Two different methods of achieving upper airway anesthesia for awake fiberoptic intubation were prospectively compared in patients undergoing surgery for cervical spine instability. Forty patients were randomized to either topical anesthesia or nerve block groups. Topical anesthesia patients were administered nebulized 4% lidocaine (approximately 20 ml) via the oropharynx plus a transtracheal injection of 4% lidocaine (3 ml). ⋯ Ten minutes later there was no difference for plasma lidocaine concentration between groups. No patients had evidence of seizures or neurologic change during the procedure. There was no difference in patient perception of discomfort during the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)