Articles: nerve-block.
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Anesthesia and analgesia · Jun 1989
Subclavian perivascular block: influence of location of paresthesia.
Subclavian perivascular block of the brachial plexus was used in 156 adult patients undergoing orthopedic hand and forearm surgery. The location of the elicited paresthesia prior to deposition of 30 ml of a solution containing 1% mepivacaine, 0.2% tetracaine and 1.200,000 epinephrine was recorded. Twenty minutes later the quality of the block in the distribution of the superior, middle and inferior trunks of the brachial plexus was evaluated. ⋯ A superior trunk paresthesia was the paresthesia most often elicited. It resulted in a significantly lower incidence of inferior trunk anesthesia than did a middle or inferior trunk paresthesia. Complications included arterial puncture (25.6%), Horner's syndrome (64.1%), and recurrent laryngeal nerve block (1.3%), with no instances of symptomatic phrenic block or symptomatic pneumothorax.
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J Pain Symptom Manage · Jun 1989
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of neurolytic blocks using phenol and cryogenic block in the management of chronic pain.
This study compared the use of phenol and cryogenic blocks for neurolysis in 28 patients. Patients were assigned randomly to receive peripheral nerve blocks with either phenol or cryoanalgesia. Significantly more patients in the phenol group received 20% or greater relief at 2, 12, and 24 wk than patients in the cryogenic group. Only 27% of patients received significant relief, however, indicating that neurolytic blocks were not particularly effective even though local anesthetic blocks produced significant but temporary pain relief.
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Randomized Controlled Trial Clinical Trial
Alkalinisation of bupivacaine for sciatic nerve blockade.
This double-blind study investigates the effect of pH adjustment of bupivacaine 0.5% with adrenaline 1:200,000 on block latency, duration of analgesia and systemic absorption of local anaesthetic after sciatic nerve blockade. Twenty-four adult patients were randomly allocated into one of two groups: Group A (n = 12) received bupivacaine with adrenaline 1:200,000 (pH 3.9) 2 mg/kg, while Group B (n = 12) received alkalinised bupivacaine with adrenaline 1:200,000 (pH 6.4) 2 mg/kg. ⋯ There was no significant difference in plasma bupivacaine levels between the two groups. The results indicate that alkalinisation of bupivacaine reduces time to onset and prolongs the duration of useful analgesia when used for sciatic nerve blockade, without significantly increasing systemic absorption.
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Pharmacokinetics and blood concentrations of bupivacaine were studied after intercostal nerve blocks were performed intraoperatively using 1.5 mg.kg-1 in 11 neonates (age 0-28 days) and 11 infants between age 1 and 6 months. The study aimed to provide pharmacokinetic data that are limited in these age groups, and to identify any adverse effects of intercostal nerve block in infancy. Arterial blood samples were taken at 0, 5, 10, 15, 20, 30, 60, 120, 240, and 360 min. ⋯ Patients were further divided into those with acyanotic and cyanotic disease. Cyanotic infants were significantly heavier than acyanotic infants (P less than 0.05), but no other differences were demonstrated. No adverse effects resulting from the technique were identified.(ABSTRACT TRUNCATED AT 250 WORDS)