Articles: nerve-block.
-
A case is reported in which chemical meningism occurred after lumbar facet joint block with methylprednisolone acetate and bupivacaine. This complication was probably due to inadvertent dural puncture. The use of steroids in facet joint injections is questioned.
-
Anesthesia for cutaneous surgery on the foot is often achieved by local infiltration. However, procedures that involve large surface areas are anesthetized more effectively with peripheral nerve blocks. This discussion of peripheral nerve blocks for the feet includes an overview of the relevant sensory innervation, a brief discussion of local anesthetics, a description of the techniques, and representative cases.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Antagonism of atracurium with neostigmine. Effect of dose on speed of recovery.
In 36 patients in whom anaesthesia was maintained with nitrous oxide and 0.5% isoflurane an atracurium-induced neuromuscular block was either allowed to recover spontaneously or antagonised with one of four doses of neostigmine (15 micrograms/kg, 35 micrograms/kg, 55 micrograms/kg or 75 micrograms/kg). The recovery times to a train-of-four ratio of 0.5, 0.75 and 0.9 were recorded. In patients given neostigmine, antagonism was at an average T1 of between 8.8% and 14.9%. ⋯ Recovery after neostigmine 15 micrograms/kg was significantly slower than after the higher doses. One patient given neostigmine 75 micrograms/kg showed an unusual bimodal pattern of recovery. There appears to be no benefit in giving a larger dose than 35 micrograms/kg of neostogmine as a single bolus.
-
One-hundred and ninety-two obese patients presented for upper abdominal surgery, of which 110 received general anesthesia with opioid analgesia and 82 patients received general anesthesia with opioid analgesia plus a single-shot intercostal nerve block of 0.5% bupivacaine in 1: 200,000 adrenaline. A significant increase in the time to first post-operative opioid dose and a significant reduction in the number of doses over the first 12 and 24 h periods were noted in the patients receiving intercostal nerve block.
-
Anesthesia and analgesia · Jun 1991
Randomized Controlled Trial Clinical TrialEvaluation of the effect of perineuronal morphine on the quality of postoperative analgesia after axillary plexus block: a randomized double-blind study.
A randomized, double-blind study was performed on 50 patients scheduled for elective hand and forearm surgery under axillary plexus block to evaluate the effect of perineuronal morphine on the quality of postoperative analgesia. Patients were divided into two groups. ⋯ In group B (n = 25), 1.0 mL of 0.9% saline was added to the local anesthetic solution and patients received an intramuscular injection of 5 mg of preservative-free morphine in 1.0 mL of 0.9% saline in the thigh. The addition of morphine to the local anesthetic solution for the axillary block did not shorten the onset time of the block, improve the quality of postoperative pain relief, or provide longer lasting analgesia than that obtained with intramuscular morphine.