Articles: nerve-block.
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Anesteziol Reanimatol · Jul 1991
[The perineural administration of opiates during regional conduction block of nerve trunks and plexuses].
The effect of perineural administration of narcotic analgesics on the efficacy of nerve trunk and plexus blockade has been studied in 290 patients with traumas and surgical diseases. It has been established that combined administration of a local anesthetic and narcotic analgesic into a brachial fascia and sciatic nerve ensures a more even, adequate and durable analgesia during and after surgery on the upper and lower extremities. Similarly, the results of paravertebral analgesia after abdominal surgery are improved. It is also concluded that thermographic registration of infrared irradiation intensity in a "pain" dermatome zone gives an objective information on the efficacy and duration of postoperative analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative analgesia following femoral-neck surgery--a comparison between 3 in 1 femoral nerve block and lateral cutaneous nerve block.
A prospective controlled randomized trial on patients receiving surgery for fractured neck of femur was carried out, in which post-operative analgesic requirements in three separate groups were compared. Patients in Group 1 acted as controls, whilst those in Groups 2 and 3 received lateral cutaneous nerve blocks and 3 in 1 femoral nerve blocks, respectively. Patients in Group 3 needed significantly less analgesia than the other two groups, and the time to first administration of analgesia was significantly longer. No complications of either of the nerve blocks was noted.
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Surg Gynecol Obstet · Jul 1991
Intrathecal phenol rhizotomy for management of pain in recurrent unresectable carcinoma of the rectum.
The medical records of 11 patients with recurrent unresectable adenocarcinoma of the rectum who had intrathecal phenol block for the management of intractable pain were reviewed. There were seven patients with pelvic and four with combined pelvic and perineal recurrences. Five patients had sacral involvement by tumor. ⋯ Patients with good results had relief for a median of three months. The over-all survival rate after phenol injection was three months. Phenol rhizotomy is indicated for the relief of intractable pain secondary to recurrent unresectable carcinoma of the rectum in carefully selected patients.
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Anesthesia and analgesia · Jul 1991
Randomized Controlled Trial Comparative Study Clinical TrialScalp infiltration with bupivacaine in pediatric brain surgery.
To evaluate whether local anesthetic scalp infiltration blunts hemodynamic responses to craniotomy in anesthetized children (age, 2-18 yr), two concentrations of bupivacaine (0.125% and 0.25%) with vasoconstrictor (epinephrine 1:400,000) were compared with control data when a solution of vasoconstrictor alone was injected. Arterial plasma levels of bupivacaine were measured by high-pressure liquid chromatography. Statistically significant increases in mean arterial pressure and heart rate above baseline measurements occurred in the control group during the period between scalp incision and dural reflection (P less than 0.05). ⋯ These results suggest that bupivacaine infiltration blocks the hemodynamic response to craniotomy. A concentration of 0.125% bupivacaine with 1:400,000 epinephrine is as effective as 0.25% bupivacaine with 1:400,000 epinephrine at reducing the hemodynamic response to craniotomy. Because the lower concentration of bupivacaine produces lower blood levels, we recommend 0.125% bupivacaine with 1:400,000 epinephrine as a useful, safe adjunct to general anesthesia in children undergoing craniotomy.