Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Continuous extrapleural intercostal nerve block after pleurectomy.
A randomised, double blind trial was carried out in 16 patients undergoing pleurectomy to assess the effect of continuous extrapleural intercostal block on postoperative pain and pulmonary function. Subjective pain relief was assessed on a linear visual analogue scale. Pulmonary function was measured on the day before operation and daily for five days after surgery. ⋯ The speed of recovery of pulmonary function was superior in the bupivacaine group. There were no complications related to the infusion. Continuous extrapleural intercostal nerve blockade with bupivacaine provides safe and effective postoperative analgesia and improves respiratory mechanics after pleurectomy.
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Regional anesthesia · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialIntercostal nerve block for minor breast surgery.
Two anesthetic procedures, intercostal nerve block (ICNB) and general anesthesia, were evaluated in 45 female patients scheduled for minor breast surgery. The study was designed to compare ICNB with general anesthesia for breast surgery with respect to efficacy, surgical stress and postoperative analgesia and to evaluate epinephrine and ornipressin as vasoconstrictors in the local anesthetic solution. Thirty patients received ICNB of T3-T7 unilaterally using 2% lidocaine plus epinephrine (15 patients, Group A) and 2% lidocaine plus ornipressin (15 patients, Group B). ⋯ Before and during surgery, epinephrine and norepinephrine plasma levels were highest in the epinephrine group, whereas, postoperatively, the plasma levels of both catecholamines were highest in the patients receiving general anesthesia. The latter patients experienced significantly more nausea and vomiting than the regional anesthesia groups. Patients with regional anesthesia required significantly less analgesics postoperatively than the patients receiving general anesthesia.
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Cahiers d'anesthésiologie · Jan 1991
Review[Mechanism of action and clinical use of opioids administered by the peripheral perineural route].
Experimental studies have shown that opioids could produce two types of effect on neuronal excitability. The first one, aspecific, is a local anesthetic action on the nerve fiber with a diminution of sodium and potassium conductance. ⋯ Clinical studies have proved that opioid injection in peripheral nervous trunks and specially in the brachial plexus produce a prolonged analgesia status in the post operative period but also and mostly in the chronic pain. The more liposoluble opioids like fentanyl and buprenorphine are the more effective.
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A number of chronic pain syndromes in the perineal area can be related to pudental nerves suffering. The constancy of symptoms among various patients, and in duration for a particular one, alterations revealed by electrophysiologic studies, pain relief by diagnostic blocks, data from anatomic studies, preliminary results of medical and surgical applied therapies, give consistent arguments for possible organic lesions of pudental nerves.
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Ann Chir Main Memb Super · Jan 1991
Review[Local and regional anesthesia of the upper limb in emergency hand surgery].
The very conditions of the emergency led the authors to define the indications for the various modalities of local and regional anaesthesia: intravenous regional anaesthesia, nerve trunk blocks, plexus blocks, interdigital block and local infiltration. The parallel development of anaesthetic drugs with variable systemic toxicity and a duration of action inversely proportional to the toxicity now allows precise adaptation of the anaesthesia to the type of lesion, the patient's general condition, the practical conditions of the emergency and the surgical technique selected, provided the anaesthetist is fully aware of the traps to be avoided, which can only be based on a long practice of local and regional anaesthesia in elective surgery.