Articles: nerve-block.
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Acta Anaesthesiol Scand · Jul 1994
Comparative StudyOn the relative potency of amino-amide local anaesthetics in vivo.
With the aim of comparing the analgesic effectiveness of lidocaine, prilocaine, bupivacaine and etidocaine in vivo, a study of the relationships between dose and duration of infraorbital nerve block (IONB) of various intensities (IONB degrees 3-10) was performed in the rat. With increasing doses longer durations of action were obtained. Further analyses were performed using multiple regression analysis. ⋯ The difference between these agents with respect to their duration of action at all dose levels amounted to 11 +/- 3 minutes (M +/- s.e.m.) for etidocaine vs. lidocaine (IONB degree 10), 27 +/- 4 min for prilocaine vs. lidocaine and 54 +/- 5 min for bupivacaine vs. etidocaine (IONB degree 3). For all other comparisons the log (dose)-duration lines deviated from parallelism, i.e. differences between agents with respect to their duration of action were found to be dose-dependent. The slopes of the log (dose)-duration lines were found to correlate closely to the log (partition coefficient) and log (protein binding) of the investigated agents.
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Ugeskrift for laeger · Jun 1994
Randomized Controlled Trial Clinical Trial[Inguinal funicular block in vasectomy].
The analgesic efficacy of inguinal funicular block with 10 ml carbocaine 1% as a supplement to local infiltration analgesia of the vas deferens was investigated in patients undergoing vasectomy. Pain/discomfort during vasectomy and on the first and third day postoperatively were investigated using a questionnaire. ⋯ There was significantly less intraoperative pain on the side of the active inguinal funicular block (p < 0.0001), but no significant differences were found at the first and third postoperative day (p = 1.16-1.19). Inguinal funicular block can be recommended as a supplement to the usual use of local infiltration analgesia of the vas deferens.
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Randomized Controlled Trial Clinical Trial
Phentolamine sympathetic block in painful polyneuropathies. II. Further questioning of the concept of 'sympathetically maintained pain'.
To test for the presence of "sympathetically maintained pain" (SMP), we administered placebo-controlled phentolamine sympathetic blocks to 14 patients with painful polyneuropathies. Six received i.v. infusion of saline for 30 minutes, followed by phentolamine (35 mg). In eight patients, the saline phase was followed by double-blind infusion of phentolamine or phenylephrine (500 micrograms), a second saline phase, and then the other active drug. ⋯ Five patients reported significant diminution of pain (> 50%), all in response to placebo. Neither phentolamine nor phenylephrine provided relief, although all patients had signs of physiologic abnormalities reputed to be determinants or predictors of SMP. These results complement previous studies demonstrating the nonexistence of SMP among "reflex sympathetic dystrophy" patients and further question the concept of SMP.