Articles: nerve-block.
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Post-thoracotomy wound pain in 11 patients who underwent thoracic operation was controlled by intercostal nerve block with alcohol and thoracic epidural anesthesia. The intercostal nerve block was performed just before the closure of the thoracotomy wound. ⋯ In late post operative periods after discharge, intercostal nerve block could maintain excellent analgesia in 9 of 11 patients, only 2 patients required analgesic drugs or re-block of the intercostal nerve. Thus, intercostal nerve block with alcohol is an effective and simple option to control recalcitrant post-thoracotomy wound pain in thoracic surgery.
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An assessment of local anaesthetic blockade of the lateral femoral cutaneous nerve using a standard technique was made. The rate of successful blockade was high, but the area of sensory loss was inconsistent between patients and was more anterior and distal than described in textbooks of anatomy.
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Regional anesthesia · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative pain treatment after open knee surgery: continuous lumbar plexus block with bupivacaine versus epidural morphine.
The anesthetic and side effects of a continuous lumbar plexus block ("3-in-1" block) were compared with that of epidurally administered morphine after open knee surgery. Twenty-two patients were randomized into two groups in this prospective, double-blind study. At the end of surgery, catheters were inserted for all the patients into both the femoral nerve sheath and the epidural space. ⋯ The pain scores and supplemental morphine consumption were low in both groups and did not differ significantly. Lumbar plexus block produced a statistically significant a lower incidence of nausea, vomiting, pruritus and urinary retention. Although no significant differences in pain relief were shown between the two methods, we conclude that postoperative lumbar plexus block is preferable for postoperative pain relief because there is a lower frequency of side effects.
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This study included 20 children (average 8.5 years) undergoing surgery of the upper limb under brachial plexus block. A method of blocking the brachial plexus using an infraclavicular approach is described. Eighteen brachial plexus block were performed under general anesthesia. ⋯ Post-operative analgesia was satisfactory in all cases. In 10 cases a nerve stimulator was used. It is not necessary for the realization of a brachial plexus block, but the punction is easier under general anesthesia with this instrument.
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Regional anesthesia · Jan 1991
Randomized Controlled Trial Clinical TrialPostoperative pain relief in children from the parascalene injection technique.
Nineteen pediatric patients aged 6 months to 12 years scheduled for elective upper extremity surgery were randomly assigned to receive either a parascalene block or sham injection. Both groups received a potent inhalational agent for operative anesthesia. ⋯ Patients in the parascalene group had superior postoperative analgesia, as evidenced by significantly less opioid requirement in the first 12 postoperative hours and by significantly lower scores on an objective pain scale. We found the parascalene approach to the brachial plexus a simple and reliable analgesic technique in anesthetized children.