Articles: nerve-block.
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Anesteziol Reanimatol · May 1993
Case Reports[Total spinal paralysis as complication of brachial plexus block].
Local anesthesia of the brachial plexus by interscalenic approach was a cause of total spinal blockade due to the administration of a local anesthetic into subarachnoid space. To prevent this it is necessary to administer a test dose of a local anesthetic with pre-aspiration of the liquor with a syringe. Intensive care procedures should be aimed at maintenance of adequate hemodynamics and gas exchange and to liquidation of circulating blood volume deficiency.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1993
Randomized Controlled Trial Clinical Trial[Postoperative pain therapy following total endoprosthetic surgery on the hip using a continuous 3-in-1 blockade].
40 patients who had undergone total hip replacement were included in a randomised prospective study. Postoperative pain management was performed with a continuous 3-in-1 block combined with demand-adapted intravenous meperidine titration (3-in-1 catheter group; n = 20) or by demand-adapted intravenous meperidine titration alone (control group; n = 20). The 3-in-1 catheter was placed before the start of anesthesia, and the patients received 30 ml 0.5% bupivacaine via this catheter. ⋯ Placement of the 3-in-1 catheters was without complications. For the management of postoperative pain following total hip replacement a continuous 3-in-1 block alone was often insufficient but postoperative meperidine requirements were significantly reduced (p < 0.05). Toxic bupivacaine plasma concentrations were not measured.
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Rev Esp Anestesiol Reanim · May 1993
Randomized Controlled Trial Clinical Trial[Thoracic paravertebral blockade: postoperative analgesic effectiveness and plasma concentrations of bupivacaine].
To compare the analgesic efficacy of thoracic paravertebral blockade with that of endovenous morphine to measure the plasma levels of bupivacaine and to study the complications derived from both techniques in patients undergoing thoracic or abdominal surgery with unilateral incision. ⋯ Thoracic paravertebral blockade is a very effective postoperative analgesic technique and is superior to that of i.v. morphine in patients undergoing thoracic or unilateral abdominal surgery. Peak plasma levels were much lower than those considered as toxic complications of interest were observed. Therefore, this technique may be considered as an alternative to other blockades such as extradural, interpleural or intercostal.
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Acta Anaesthesiol Scand · May 1993
Is there a cholinergic and an adrenergic phase of the oculocardiac reflex during strabismus surgery?
We investigated the counterregulatory effect of the oculocardiac reflex (OCR) in 25 infants and children during strabismus surgery under three experimental conditions. In group 1, a series of measurements were recorded when the OCR was elicited by traction. The beat-to-beat heart rate reduction ranged from -26 to -64 beats/min (median: -46 beats/min). ⋯ The bradycardia and the counterregulation may be referred to as cholinergic and adrenergic phrases of the OCR. Atropine eliminates the cholinergic phase. Our study indicates that there may be receptors and afferent fibres for both phases, which can be blocked by local anaesthetics.
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To determine the length of needle that should be advanced beyond the distance to the lateral pterygoid plate to reach the mandibular nerve. ⋯ There is no osteologic basis to advance the needle beyond the distance to the lateral pterygoid plate to reach mandibular nerve. However, because the needle may contact the nerve at variable points rather than the shortest distance to the nerve, the needle may be advanced by 0.07 cm on the right and 0.11 cm on the left side in patients. This increase is much less than that indicated in the standard textbooks. Therefore, while performing mandibular nerve block, we suggest caution in advancing the needle beyond the distance to lateral pterygoid plate.