Articles: nerve-block.
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Anesthesia and analgesia · Jul 1993
Randomized Controlled Trial Clinical TrialNerve stimulator polarity and brachial plexus block.
To determine whether needle polarity significantly affects nerve stimulation during peripheral nerve block, we performed a randomized double-blinded study of 10 patients undergoing axillary block for upper extremity surgery. Using an insulated needle, we determined the minimum current necessary to elicit muscle contraction with positive and negative needle polarity at two needle placements: (A) where stimulation was first observed and (B) where stimulation was maximal. At Position A, stimulation required significantly more current when the needle was positive (2.32 +/- 0.45 mA, mean +/- SEM) than when it was negative (1.05 +/- 0.23 mA, P < 0.001). ⋯ The mean ratio of positive to negative threshold stimulation current at Position B (3.11 +/- 0.20) was significantly greater than that at Position A (2.37 +/- 0.19, P < 0.05). Our results emphasize the importance of attaching the negative terminal of the nerve stimulator to the stimulating electrode. Use of the positive terminal could lead to abandoning a block if stimulation were not obtained at a low enough current; alternatively, motor contraction might not be observed before neural contact or vascular puncture.
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J Vasc Interv Radiol · Jul 1993
Randomized Controlled Trial Clinical TrialRandomized double-blind clinical trial of celiac plexus block for percutaneous biliary drainage.
This study was undertaken to determine the efficacy of celiac plexus block (CPB) as a method of providing analgesia for percutaneous biliary drainage (PBD). ⋯ This study indicates that CPB is not an effective means of providing additional visceral pain relief over and above that which can be accomplished with self-administered intravenous medication for patients who undergo PBD.
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Case Reports Comparative Study
Vecuronium block in the myasthenic patient. Influence of anticholinesterase therapy.
The neuromuscular block of vecuronium was investigated in two myasthenic patients undergoing thymectomy. The first patient had no pre-operative anticholinesterase therapy, the second patient was given pyridostigmine 60 mg 4 hourly, continued until the morning of surgery. In the two patients, neuromuscular block of vecuronium was monitored by electromyography. The results suggest that the neuromuscular block of vecuronium may be decreased by pre-operative preparation of the myasthenic patient by pyridostigmine.
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Regional anesthesia · Jul 1993
Case Reports Comparative StudyRectus block for postoperative pain relief.
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Randomized Controlled Trial Clinical Trial
False-positive rates of cervical zygapophysial joint blocks.
To determine the false-positive rate of anesthetic blocks of the medial branches of the cervical dorsal rami in the diagnosis of cervical zygapophysial joint pain. ⋯ Uncontrolled diagnostic blocks are compromised by a significant false-positive rate that seriously detracts from the specificity of the test.