Articles: nerve-block.
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Langenbecks Arch Chir · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[A concept for decreasing postoperative pain after inguinal hernia operation].
In Germany approximately 150,000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. ⋯ An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intercostal nerve block for lumpectomy: superior postoperative pain relief with bupivacaine.
To investigate whether equipotent doses of lidocaine and bupivacaine were equally effective for intercoastal nerve blockade (ICNB) and whether a lower amount of lidocaine would be comparably effective. To see whether plasma levels of lidocaine with and without epinephrine and of plain bupivacaine would reach toxic ranges. Finally, to evaluate the duration of postoperative analgesia following general anesthesia and regional anesthesia with two different local anesthetics. ⋯ ICNB is an alternative to general anesthesia for female breast surgery. Both lidocaine with epinephrine and plain bupivacaine in the doses used did not raise venous plasma concentrations to levels considered potentially toxic. With respect to duration of postoperative pain relief and analgesic drug request, the local anesthetics (in particular, bupivacaine) were found to be superior to general anesthesia.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialSciatic nerve block. A comparison of single versus double injection technique.
Two techniques, single versus double injection, for blocking the sciatic nerve via the classical (Labat) approach were prospectively evaluated for onset and efficacy of block in 50 adult patients undergoing lower extremity surgery. The tibial, common peroneal, and posterior femoral cutaneous nerves were evaluated at 5, 10, 15, 20, 30, and 45 minutes after the initial injection of local anesthetic. Motor function was used to assess the block of the tibial and common peroneal nerves while pinprick response was used to assess block of the posterior femoral cutaneous nerve. ⋯ The double injection technique for sciatic nerve block via the classical approach results in a more rapid onset and increased efficacy of block than that of the single injection technique.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Clinical TrialSensory, motor, and sympathetic block during epidural analgesia with 0.5% and 0.75% ropivacaine with and without epinephrine.
Ropivacaine is a new long-acting local anesthetic, with vasoconstrictive properties. The purpose of this randomized, double-blind study was to evaluate sensory, motor, and sympathetic block following epidural anesthesia, and the influence of the addition of epinephrine. ⋯ Ropivacaine given epidurally provided adequate sensory anesthesia and motor block for transurethral surgery. Addition of epinephrine did not provide any significant prolongation of the sensory or motor block, nor any influence upon the sympathetic block.
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Minerva anestesiologica · Jan 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Post-tetanic count after 50 and 100 Hz tetanic stimulation for monitoring deep neuromuscular blockade with vecuronium].
For monitoring of vecuronium profound neuromuscular blockade post-tetanic count (PTC) following tetanic stimulation at frequency of 50 and 100 Hz was employed in 25 ASA I-II patients submitted to elective surgery, to evaluate the differences between the two patterns of stimulation and the possible clinical utility of the latter pattern of stimulation. The drugs employed for anaesthesia were: diazepam 0.15 mg kg-1 in premedication, thiopental 4-5 mg kg-1 for induction, suxamethonium 1.5 mg kg-1 for tracheal intubation. Anaesthesia was maintained with N2 + O2 (2:1). ⋯ The first dose of vecuronium (0.06 mg kg-1) was administered at recovery from suxamethonium (clinically evaluated) and the other doses (0.06 mg kg-1) when the third response to a train of four appeared. The results show that the PTC following 100 Hz tetanus was greater than the PTC following 50 Hz tetanic stimulation (P < 0.01). The results also show that PTC following 100 Hz tetanus leads to underestimate neuromuscular blockade; yet maybe it has any clinical employment in selected surgical situations such as middle ear and eye surgery, microvascular surgery, neurosurgery.