Articles: nerve-block.
-
Randomized Controlled Trial Clinical Trial
Retrobulbar block fails to prevent an increase in serum cortisol concentration on emergence from anaesthesia after cataract surgery.
We have studied 30 elderly patients undergoing cataract surgery, allocated randomly to receive general anesthesia, local anaesthesia by retrobulbar block or general anaesthesia combined with retrobulbar block given after induction. Retrobulbar block alone prevented the increases in circulating cortisol and glucose values which occurred in those patients receiving general anaesthesia alone. Retrobulbar block given after induction of general anaesthesia, however, suppressed the cortisol and glucose response during surgery, but did not prevent a marked increase in cortisol concentrations during the immediate postoperative period. The results suggest a hormonal response to emergence from anaesthesia which has hitherto been masked by the stress response to surgery itself.
-
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.
-
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.
-
Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus block. A comparison of the supraclavicular lateral paravascular and axillary approaches.
Anesthesia of the brachial plexus has been associated with injuries to adjacent structures (e.g., pneumothorax, vascular penetration). It is not uncommon to have only partial block of the upper extremity, hindering completion of the surgical procedure. The supraclavicular lateral paravascular approach to brachial plexus anesthesia has been proposed as an effective, safe alternative to the traditional approaches to brachial plexus anesthesia. ⋯ The supraclavicular lateral paravascular approach is as effective as the axillary approach.
-
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.