Articles: nerve-block.
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The intercostal nerve block is an effective and relatively safe intervention for postoperative pain control after upper abdominal and thoracic surgery. It may be done in the operating room or in the PACU. Understanding the mechanics of the technique can help to improve care of patients receiving this intervention.
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Ugeskrift for laeger · Sep 1994
Case Reports[Brachial plexus blockade via the interscalene port--for regional anesthesia/analgesia of upper extremities; use, application and risks].
The interscalene technique for brachial plexus anaesthesia is described. The method is suitable for anaesthesia of the upper extremity, especially when anaesthesia of the proximal part of the arm and the shoulder region is desired. The technique is also useful in paediatric cases. Side effects are few, but the risk of paralysing of the diaphragm makes this method inappropriate for patients with severe respiratory disease.
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American family physician · Sep 1994
Anesthesia in the emergency setting: Part II. Head and neck, eye and rib injuries.
Anesthesia for procedures of the head and neck includes ear field blocks, supraorbital and supratrochlear nerve blocks, infraorbital, mental, mandibular and posterosuperior alveolar nerve blocks. Topical ophthalmic anesthesia is useful in treating a variety of ocular injuries, including corneal abrasion and laceration, chemical/thermal burns, and injuries caused by foreign bodies and contact lenses. The intercostal nerve block is used to manage the pain of rib fractures, thus improving patient comfort, tidal volume and ventilation, and pulmonary toilet.
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Randomized Controlled Trial Clinical Trial
Preferential channelling of anaesthetic solution injected within the perivascular axillary sheath.
Preferential channelling of anaesthetic solution injected into the perivascular axillary sheath was investigated in 40 patients undergoing elective orthopaedic upper-limb surgery. Three needles, with different approaches and inclinations, were inserted near the three main terminal branches of the brachial plexus using an axillary approach. ⋯ Back flow was observed, mainly in the needle nearest to the radial nerve during injection of the anaesthetic solution in the superior and inferior aspects of the brachial artery, and in the needle close to the ulnar nerve when the injection was performed posterior to the artery, near the radial nerve. These results could be related to the trapping of anaesthetic solution in unconnected compartments and to the slope of the needle injecting the anaesthetic solution which spreads preferentially along a gradient following the needle shaft direction.
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Journal of anesthesia · Sep 1994
The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane.
The aim of this study was to determine the neuromuscular blocking potency of rocuronium (ORG 9426) in 4-to 14-year old children anesthetized with halothane. After induction of anesthesia, the ulnar nerve was stimulated with electrical impulses of 0.2 ms duration every 12 s and the force of contraction of the thumb (P) was continuously recorded. Doses of 0.12, 0.16, 0.20, and 0.24 mg·kg(-1) rocuronium were administered, in a randomized fashion, to 4 groups of 12 patients each. ⋯ When at termination of anesthesia T4/T1 ratios were lower than 0.75, the residual neuromuscular block could be antagonized with 0.5 mg·kg(-1) edrophonium in 2 min. Rocuronium, 0.3 mg·kg(-1) caused a 13.5% increase of heart rate but had no effect on blood pressure. In conclusion, in 4 to 14-year-old children, rocuronium appears to have a more rapid onset and shorter duration of action than other steroid-type muscle relaxants.