Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Rectus sheath block for diagnostic laparoscopy.
Sixty adult females of ASA grade 1 or 2 scheduled to undergo diagnostic laparoscopy were allocated randomly to one of two groups. In group A, laparoscopy was performed with a standardised general anaesthetic technique alone. ⋯ Postoperative analgesia was assessed at 1, 6 and 10 hours after operation. Visual analogue pain scores in group B were significantly lower than in group A despite a greater use of intramuscular analgesic injections in group A (p less than 0.005 in each case).
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Comparative Study
Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures.
Twelve thousand regional anaesthetics for cataract extraction and intraocular lens implantation surgery were administered by one anaesthetist over a period of 52 months in a free-standing outpatient surgical facility. The ophthalmologist, who did all the operations, assessed the quality of the blocks using an objective scoring system which is described. The first 3,595 patients had retrobulbar and seventh nerve blocks. ⋯ A final group of 1,061 had a combination of peribulbar and periorbital blocks with added retrobulbar injection if indicated. As the method of blocking evolved, the more closely was the goal of safe, painless and effective regional anaesthesia approached. The requirements for effective anaesthesia of this type are presented, the complications described and the importance of familiarity with the anatomy of the orbit and its contents stressed.
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Anesthesia and analgesia · Nov 1988
Comparative StudyComparative motor-blocking effects of bupivacaine and ropivacaine, a new amino amide local anesthetic, in the rat and dog.
Ropivacaine (S-(-)-1-propyl-2',6'-pipecoloxylidide) is a new local anesthetic that is structurally related to mepivacaine and bupivacaine. The comparative effects of ropivacaine and bupivacaine on motor function were assessed in the laboratory rat and dog. (It was not possible to accurately evaluate sensory blockade in these models.) Several concentrations of both agents were injected in the region of the sciatic nerve of the rat and into the lumbar epidural or subarachoid space in the dog. Epidural blockade was also performed utilizing solutions of ropivacaine and bupivacaine which contained epinephrine (1:200,000). ⋯ In the epidural and spinal studies in the dog, ropivacaine was less potent and had a shorter duration of motor blockade than did bupivacaine at equal drug concentrations. A 1.0% solution of ropivacaine produced epidural motor blockade similar in onset and duration to that achieved with a 0.75% solution of bupivacaine. Epinephrine did not significantly prolong the duration of motor blockade of either agent after epidural administration.