Articles: nerve-block.
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Continuous paravertebral block has not previously been described for use in children. This study reports the use of this technique in five patients (aged 7 months to 8 years) scheduled for renal surgery or cholecystectomy. The block was not difficult to perform and provided good intra- and postoperative analgesia. Continuous paravertebral block appears to be a promising technique for pain management in children and might prove a valuable addition in the field of paediatric regional anaesthesia.
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Unilateral phrenic nerve block is common after supraclavicular brachial plexus block techniques, although it is rarely symptomatic in patients without respiratory disease. A 24-weeks-pregnant woman was scheduled for a carpal tunnel release because of intractable pain. ⋯ Respiratory changes produced by pregnancy might compromise ventilatory reserve. Thus, we suggest avoiding supraclavicular approaches to brachial plexus block in pregnant women, since they may be as prone to developing respiratory embarrassment, secondary to phrenic block, as patients with pulmonary pathology.
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Minerva anestesiologica · Jul 1992
Case Reports[Anesthesia of the brain stem after a retrobulbar block. Description of 2 cases].
The Authors report two cases of central nervous system complications after retrobulbar block. These complications have a 0.044% incidence in 4500 subsequent cases of retrobulbar blockade studied from 1981 to 1990. The Authors attribute the respiratory arrest and coma to direct access of the anesthetic to the central nervous system along the subdural space in the optic nerve sheath.
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Randomized Controlled Trial Comparative Study Clinical Trial
Facet joint injection and facet nerve block: a randomised comparison in 86 patients with chronic low back pain.
Eighty-six patients with refractory chronic low back pain were randomly assigned to receive either facet joint injection or facet nerve block, using local anaesthetic and steroid. There was no significant difference in the immediate response. ⋯ Patients who had complained of pain for more than 7 years were more likely to report good or excellent pain relief than those with a shorter history (P less than 0.005), but no other clinical feature was of value in predicting the response to infiltration. Facet joint injections and facet nerve blocks may be of equal value as diagnostic tests, but neither is a satisfactory treatment for chronic back pain.
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Case Reports
Cervicogenic headache: anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/C3).
In a series of 14 patients with cervicogenic headache, cervical nerve blockades (C2-C5 and facet joint C2/C3) have been carried out in order to elucidate possible underlying mechanisms and to evaluate the diagnostic potential of these procedures. Blockade of the C2 nerve resulted in freedom from pain in 5 of 10 patients and seemed to be the most informative procedure. ⋯ C4 and C5 nerve blockades are probably of little value in the work-up of such patients. When evaluating the C2/C3 facet joint injection, one has to take possible leakage of anesthetic agent from the joint into consideration, since the third occipital nerve which runs close to the facet joint may be anesthetized through the leakage.