Articles: nerve-block.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Clinical TrialAlkalinization of mepivacaine improves the quality of motor block associated with interscalene brachial plexus anesthesia for shoulder surgery.
Interscalene block has produced appropriate anesthesia for shoulder surgery. Success is partly determined by the quality of motor block achieved. This study was designed to evaluate the influence of alkalinization of mepivacaine on the quality of motor block achieved with interscalene brachial plexus anesthesia. ⋯ Alkalinization of mepivacaine improves the quality of motor block after interscalene brachial plexus block for shoulder surgery.
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Regional anesthesia · Mar 1995
Clinical TrialCompartment block for foot surgery. A new approach to tibial nerve and common peroneal nerve block.
The concept of single injections of local anesthetics into fascial compartments was pioneered by Winnie in reports on paravascular techniques. Winnie described an axillary approach for brachial plexus block and the inguinal route for lumbar plexus block. The compartmental principle can, with advantage, be extended to more peripheral anesthesia of the tibial and common peroneal nerves by the use of osteofascial compartments in the leg. ⋯ Further studies of compartmental anesthesia for other nerve trunks and plexuses may be of value.
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The use of unsheathed non-insulated needles and a nerve stimulator as an aid to peripheral nerve blockade in children has received little attention in the literature. In order to assess the value of such a technique, a study was performed in children presenting for lower limb surgery with no contraindication to femoral and/or sciatic nerve block. Four hundred and eleven children, mean age 4.25 (SD 3.8) years and mean weight 16.8 (SD 9.4) kg, received a total of 883 peripheral nerve blocks: 419 femoral nerve blocks and 464 sciatic nerve blocks. ⋯ The current required to stimulate the more superficial femoral nerve ranged from 0.5-1.0 mA whilst for the deeper sciatic nerve ranged from 1.2-2.0 mA. Staff in training, with little or no experience of the technique, successfully performed 223 nerve blocks in 114 patients under the author's guidance. The overall success rate was 98%, the failures occurring early in the series.