Articles: nerve-block.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Pain from the lumbar zygapophysial joints: a test of two models.
One hundred seventy-six consecutive patients with chronic low-back pain and no history of previous lumbar surgery were studied to test the clinical criteria of Fairbank et al. and Helbig and Lee for zygapophysial joint pain. All patients underwent a history, examination, and a series of zygapophysial joint injections or blocks of the medial branches of the dorsal ramus with lignocaine. ⋯ None of the clinical features tested was found to be associated with response to the confirmatory block. The Fairbank et al. and Helbig and Lee criteria were shown to be unreliable in distinguishing pain of zygapophysial joint origin from pain of other origins.
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Cholinesterase inhibitors antagonize neuromuscular block produced by mivacurium, but some may also decrease its metabolism by inhibiting pseudocholinesterase. These opposing interactions were examined in rats anaesthetized with pentobarbitone. After spontaneous recovery from an initial bolus dose of 0.03 mg kg-1, mivacurium was infused to produce 80-90% block of gastrocnemius muscle twitch. ⋯ Edrophonium, pyridostigmine and neostigmine reduced the subsequent maximum block, compared with the change in saline control, by 3%, 19% and 35%, respectively. Correspondingly, the time to recovery of T1 to 50% was decreased by 20%, 58% and 62%. In rats, acetylcholinesterase-mediated antagonism of neuromuscular block predominated over decreased pseudocholinesterase-mediated metabolism, such that prior administration of a cholinesterase inhibitor did not prolong the neuromuscular blocking effects of mivacurium.
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J Pharmacol Toxicol Methods · Aug 1994
A surgically implantable nerve irrigation system for intermittent delivery of dissolved drugs: evaluation of long-term performance and histocompatibility in rats.
A surgically implantable system designed to facilitate intermittent delivery of solutions of local anesthetic or other pharmacologically active substances to a segment of peripheral nerve was developed and its long-term performance and histocompatibility were tested in rats. Twenty-two systems, each comprising a subcutaneous injection port, a silicone conduit, and a membranous perineural sheath, were implanted in 20 animals. Of the systems, 12 could be used to perform repeated local anesthetic nerve blocks for periods lasting from several weeks to as long as 13 months. The system is suitable for use in studies of peripheral nerve pharmacology and, with improvements, could find clinical use in the management of peripheral neuralgia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lateral popliteal sciatic nerve block compared with subcutaneous infiltration for analgesia following foot surgery.
A new lateral approach to blocking the sciatic nerve in the popliteal fossa is described. In a prospective study, 40 patients scheduled for foot surgery involving osteotomies were allocated randomly into one of two groups following induction of general anaesthesia: group PS (n = 21) received a lateral popliteal sciatic nerve block and group SC (n = 19) received subcutaneous infiltration of the wound. ⋯ Postoperative analgesia in groups PS lasted a median of 18.0 hr and in group SC lasted 6.3 hr (P < 0.05). The lateral popliteal sciatic nerve block provided effective analgesia following foot surgery and had a high level of patient satisfaction.