Articles: nerve-block.
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Regional anesthesia · Nov 1993
Comparative StudyComparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block.
This study compared the efficacy of three perivascular techniques of axillary block. ⋯ There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.
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Randomized Controlled Trial Clinical Trial
Orbicular muscle akinesia in regional ophthalmic anaesthesia with pH-adjusted bupivacaine: effects of hyaluronidase and epinephrine.
The success rate and duration of lid akinesia after adding hyaluronidase and/or epinephrine to pH-adjusted bupivacaine was examined in a double-blind fashion in patients undergoing cataract surgery under local anaesthesia. A two-injection-site technique was used. For globe akinesia all patients (n = 120) received an inferolateral intraconal injection (3 ml) of pH-adjusted bupivacaine 0.75% and hyaluronidase. ⋯ No differences in the success rate or duration of the block among the other groups were seen. The duration of the block was longer in the epinephrine groups than in the two other groups (P < 0.01) and longer in the epinephrine and hyaluronidase group than in the group receiving only hyaluronidase (P < 0.05). We conclude that the best initial results and longest duration of blocks were shown in the groups receiving epinephrine or epinephrine and hyaluronidase.
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Comparative Study
The efficacy and acceptability of using a jet injector in performing digital blocks.
This prospective, nonblinded study, comparing jet injection with needle-syringe injection of lidocaine in performing digital blocks, tested the hypothesis that jet injection can be used effectively as a less painful way to perform digital blocks. Twenty-four adult patients with injuries of the middle or distal phalanges of the fingers received digital blocks using a jet injector on one side of the finger and a needle-syringe on the other side; pain was assessed at 0, 1, 3, 6, 12, and 24 hours using visual analog scales. Differences in pain scores for the two procedures (jet injector vs needle) were tested at each time period using nonparametric statistical procedures for paired or matched data (paired Wilcoxon). ⋯ Comparisons made at the other points were statistically nonsignificant at .05. The anesthesia achieved using the jet injector was considered adequate in 23 of 24 patients. We conclude that the jet injector can be used effectively in performing digital blocks and is less painful than standard needle-syringe methods.