Articles: nerve-block.
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Two cases with rib injuries are reported where intercostal nerve block without rib palpation was safely and successfully performed on six separate occasions using a Doppler blood-flow detector ultrasound stethoscope. A third case studied by a radiologist using a pulsed Doppler flowmeter, determined the source of the Doppler signals as originating from the intercostal artery. The significance of these findings is discussed.
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Arch Orthop Trauma Surg · Jan 1988
Reduction of shoulder dislocations under interscalene brachial blockade.
Even under short sedation, reduction of shoulder dislocations is often difficult, because of the reflectory contraction of the muscles around the humeroglenoidal joint in response to pain. Administration of interscalene brachial blockade produces analgesia and complete relaxation of the muscles of the shoulder joint. We report on ten consecutive shoulder dislocations which were reduced while the patients were under interscalene brachial blockade. In all cases, reduction was easy and free from complications.
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Lumbar nerve root anesthesia using a local anesthetic was performed in 100 cases of sciatica. The neurological state before and after nerve block was recorded and also the degree of pain alleviation caused by the block. Three indications for the block were used in the study: unilateral sciatic pain and normal findings on myelography and/or CT or MR (n = 51), minor myelographic findings that possibly but not necessarily explained the patient's symptom (n = 40), and multiple pathological findings on myelography (n = 9). ⋯ No side effects of the procedure were noted. Patients with pain alleviation after anesthesia were offered an operative nerve root decompression and short-term results of this decompression seem to be comparable to conventional disc surgery. Anesthetizing the lumbar nerve root outside the intervertebral foramen may be considered in the preoperative evaluation of patients with sciatic pain and minor or no radiographic findings.
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Regional-Anaesthesie · Jan 1988
[Axillary blockade of the brachial plexus. A prospective evaluation of 1133 cases of plexus catheter anesthesia].
The results of 1133 axillary catheter brachial blocks are reported. Effectiveness and side-effects were monitored in a prospective manner over a period of 1 year. ⋯ Surgery was completed in 72% of patients; 24% required some form of supplementation including 17.2% of patients who received a "top-up" after 20 min (Table 1). In 3.8% of cases the technique was considered to be a complete failure, meaning that patients needed some type of general anesthesia including the use of i.v. ketamine.(ABSTRACT TRUNCATED AT 250 WORDS)
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Regional-Anaesthesie · Jan 1988
[Combined sciatic nerve/3-in-1 block. I. Dose determination for CO2-lidocaine 1.1%].
The goal of this open-labeled clinical study on 30 patients was to find out which dosage of CO2-lidocaine 1.1% (= lidocaine HCl 1%) would provide clinically acceptable analgesia for surgical procedures on the lower extremities under combined sciatic-femoral block. A first group of 5 patients was given a dose of 330 mg = 30 ml (15 ml to block the sciatic nerve and 15 ml for the 3-in-1 block), the maximum dose allowed by the manufacturer. This dosage did not result in any degree of satisfactory block and all patients had to be operated upon under general anaesthesia (GA). ⋯ Only in the third group of 10 patients, who were given 550 mg = 50 ml (sciatic nerve: 20 ml; 3-in-1 block: 30 ml) was a clinically acceptable success rate achieved; there was only 1 patient who needed light GA for supplementation. In group I (330 mg) only partial sensory blockade was achieved (after approx. 5 min); the femoral and lateral femoral cutaneous nerves could not be blocked in any patient, and motor blockade was present in only 1 patient. In group 2 (440 mg) the onset of sensory block began after 5 min, was complete by 11 min, and in 6 of 15 patients (= 40%) motor blockade was achieved.(ABSTRACT TRUNCATED AT 250 WORDS)