Articles: nerve-block.
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Klin Monbl Augenheilkd · Feb 1994
Review Comparative Study[Peribulbar anesthesia versus retrobulbar anesthesia with facial nerve block. Techniques, local anesthetics and additives, akinesia and sensory block, complications].
Retrobulbar anesthesia (RETRO), combined with a facial block, is the most frequently employed method of anesthesia in cataract surgery. There is, however, an increasing tendency to use peribulbar anesthesia (PERI), which is claimed to provide the same degree of anesthesia and akinesia as RETRO while reducing many of the complications. ⋯ In randomized order, 160 cataract patients received PERI (technique with 2 injections) with 6, 8 or 10 ml of a bupivacaine-lidocaine-hyaluronidase mixture (without facial block) or RETRO (Unsöld technique) with 5 ml of the above mixture, combined with a Nadbath/Rehman facial nerve block (5 ml etidocaine-lidocaine mixture). Measured 20 min after injection (intervening period of oculopression), the smallest ocular motility (Kestenbaum limbus test) was left after RETRO. After administration of PERI - even with a volume of 10 ml - the range of residual ocular motility was always higher, i.e., there was a less reliable globe akinesia than after RETRO. The lid closure force (Straub technique) averaged zero after all methods of anesthesia; however, the smallest spread (highest reliability) was observed after PERI. Complete corneal anesthesia (Draeger esthesiometer) was found in nearly all cases, i.e., RETRO and PERI are comparably effective concerning sensory blockade...
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Lumbar plexus block is indicated in anesthesia and analgesia of the proximal part of the lower limb. Several techniques, two via the anterior approach and at least three via a posterior paravertebral approach have been described. All these techniques are not equivalent in terms of technical facilities or difficulties, efficacy, success or failure rates and postoperative analgesia. The best choice must be done keeping in mind all advantages or disadvantages of each technic.
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Anaesthesiol Reanim · Jan 1994
Clinical Trial Controlled Clinical Trial[Mixtures of different local anesthetics for subaxillary plexus anesthesia].
In a prospective clinical study, 76 patients were scheduled for subaxillary plexus block in order to investigate onset time, duration of action and quality of motor and sensitive blockade of various mixtures of local anaesthetics. Sixty-one patients were allocated to four groups. Each of them received 15 ml of bupivacaine 0.5% with either 15 ml of lidocaine 1% (n = 14), of mepivacaine 1% (n = 16), of prilocaine 1% (n = 15) or of etidocaine 1% (n = 15). ⋯ But regarding the quality of motor block, the mixture of bupivacaine and lidocaine was less effective than the other combinations, of which the mixture of bupivacaine and prilocaine showed the best motor block. The combination of the two long-acting local anaesthetics bupivacaine and etidocaine had the longest effect and, therefore, this mixture is a real alternative to subaxillary block via catheter technique. Specific electric stimulation of the radial nerve leads to higher success rate of subaxillary plexus block.