Articles: nerve-block.
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A new technique of sciatic nerve block in the popliteal fossa was evaluated in 120 patients using an 18 s.w.g. cannula. Precise placement of the cannula was facilitated with the aid of a nerve stimulator. In addition to an initial dose of 1% prilocaine with adrenaline 1: 200,000 (5 mg kg-1), 5 mL 0.5% bupivacaine was used for blockade of the saphenous nerve distal to the medial tibial condyle. ⋯ Satisfactory anaesthesia was achieved in 117 patients (97.5%); two patients required general anaesthesia, since repositioning of the cannula after initial application of local anaesthetic was strictly avoided. No post-operative complications relating to the nerve block were observed. This technique of sciatic nerve block in the popliteal fossa provides effective and safe anaesthesia of the lower leg.
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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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Randomized Controlled Trial Clinical Trial
Post-tetanic burst: a new monitoring method for intense neuromuscular block.
A new stimulation pattern for evaluation of intense neuromuscular block (post-tetanic burst (PTB)) was compared with post-tetanic twitch (PTT) during spontaneous recovery from vecuronium-induced neuromuscular block. Thirty adult patients were allocated to two equal groups and we measured times from administration of vecuronium 0.1 mg kg-1 to return of PTB and PTT responses, and evoked responses to PTB and PTT stimuli. For PTB stimulation, a 50-Hz tetanus was applied at 50 mA for 5 s, and after a pause of 3 s, a 50-Hz burst stimulation was applied, consisting of three impulses at 50 mA. ⋯ Similarly, PTT consisted of a tetanus, a 3-s pause and one single twitch stimulation repeated every 5 min. Time to return of the PTB response was significantly shorter than that of PTT (mean 23.7 (SD 7.9) compared with 30.7 (7.0) min) (P = 0.0160), although evoked responses to PTB did not differ significantly from those of PTT throughout recovery from vecuronium-induced neuromuscular block. This study suggested that PTB was more sensitive in evaluating intense neuromuscular block than PTT.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Clinical TrialLateral femoral cutaneous nerve block revisited. A nerve stimulator technique.
Regional block of the lateral femoral cutaneous nerve (LFCN) often has disappointing success rates despite the large volumes of local anesthetic used. This study was undertaken to investigate the utility of using a nerve stimulator (NS) to localize and block the LFCN. ⋯ A NS can be used to localize a purely sensory nerve; such as the LFCN, and improve success rates in regional anesthesia.