Articles: nerve-block.
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Ann Chir Main Memb Super · Jan 1992
[Techniques of continuous nerve block at the level of the wrist].
Functional treatment without pain is a condition for good results after operations at gliding structures (tendons) or periarticular structures. Good analgesia of the arm and hand is obtained with continuous axillary nerve blocks. Often there is concomitant paralysis and active motion is not possible. ⋯ We use a prefabricated catheter set to introduce the polyethylene catheter and to place it near the nerve as in single shot wrist block. This technique for continuous analgesia of the hand can be used for functional treatment after tenolyses, arthrolyses and stable osteosyntheses of fingers. Median, radial and ulnar nerves can be blocked all at the same time or alone.
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Intensive care medicine · Jan 1992
Review Case ReportsRare procedures during delivery room resuscitation--cardioversion of ventricular tachycardia in an asphyctic neonate.
Successful cardioversion of ventricular tachycardia in a full-term male infant, born severely depressed by emergency Cesarean section 9 min after the mother was given bilateral paracervical bupivacaine blocks for pain relief during normal labor, is described. The apparently stillborn baby was resuscitated by conventional means until electronic heart monitoring revealed transition from asystole to rapid ventricular tachycardia 14 min after birth. ⋯ The child recovered rapidly and neurological status at 12 months was normal. Obviously, active search and aggressive management of rapid ventricular arrhythmias are indicated during neonatal resuscitation, if potentially arrhythmogenic drugs are used in perinatal care.
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Acta Anaesthesiol Scand · Jan 1992
Effect of continuous interscalene brachial plexus block on diaphragm motion and on ventilatory function.
Interscalene block may cause phrenic nerve block and decreased diaphragmatic motion. We evaluated the effect of continuous interscalene block on ventilatory function and diaphragmatic motion. We studied ten patients scheduled for surgery or manipulation of the shoulder. ⋯ In the other five patients, the amplitude of diaphragmatic motility on the side of the block was only 4-37% of the values before the block. All patients had a clear reduction in forced vital capacity (FVC), forced expiratory volume in 1s (FEV1) and peak expiratory flow (PEF) 3 and 8 h after the block without signs of dyspnoea. In conclusion, in all our patients interscalene block caused an ipsilateral hemidiaphragm paresis, which in five of ten patients persisted until the end of the continuous block.
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Scand J Thorac Cardiovasc Surg · Jan 1992
Randomized Controlled Trial Clinical TrialContinuous extrapleural intercostal nerve block and post-thoracotomy pulmonary complications.
To evaluate the effects of continuous extrapleural intercostal nerve block on post-thoracotomy pain and pulmonary complications, a randomized, double-blind, placebo-controlled study was conducted on 80 patients undergoing elective thoracotomy for pulmonary (n = 47) or oesophageal (n = 33) procedures. In patients who received continuous bupivacaine infusion, the requirement for intramuscular opiate and rectal diclofenac was less, the score on a visual linear analogue pain scale lower and recovery of pulmonary function more rapid than in saline-infused controls. ⋯ Among the patients without COAD there was no significant intergroup difference in such complications. We conclude that continuous extrapleural intercostal nerve block is effective for post-thoracotomy analgesia and reduces pulmonary complications of thoracotomy in patients with COAD.
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Randomized Controlled Trial Clinical Trial
Perioperative analgesia by 3-in-one block in total hip arthroplasty. Prospective randomized blind study.
In a prospective randomized blind study of 182 patients undergoing total hip arthroplasty, the patients per- and postoperative need for analgesics was assessed in two groups, one receiving general anesthesia and a 3-in-one block, the other group only general anesthesia. Although we found a significant reduction in analgesics per- and postoperatively in the 3-in-one block group, the difference in analgesics was small and has no clinical relevance in the patient with a healthy cardiovascular status. We conclude that 3-in-one block in combination with light general anesthesia is not the anesthetic of choice in total hip arthroplasty using the posterior approach.