Articles: nerve-block.
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Clinical Trial
Air-flow meter assessment of the effect of intercostal nerve blockade on respiratory function in rib fractures.
The respiratory effect of intercostal nerve block for pain from fractured ribs was evaluated in a prospective study of ten hospitalized patients. The respiratory function, evaluated with a Glaxo AirFloMeter, showed significant improvement one hour after induction of blockade, but after six hours the effect had subsided.
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To evaluate the effectiveness of the dorsal penile nerve block in reducing the stress of circumcision upon newborns, physiologic measurements in 30 healthy full-term infants (including transcutaneous oxygen levels, crying time, heart rate, and respiratory rate) were monitored continuously before, during, and after the operation. Infants receiving the dorsal penile nerve block with lidocaine (1% Xylocaine) (N = 20) experienced significantly less stress, as evidenced by smaller decreases in transcutaneous oxygen pressure levels, less time spent crying, and smaller increases in heart rate, than infants circumcised in an identical manner without anesthetic (N = 10). No complications resulted from injection of the local anesthetic or from the circumcision procedure itself. Inasmuch as dorsal penile nerve block has a low complication rate, is simple to learn, and adds little time or expense to the overall procedure, and if it proves to be as effective clinically as the physiologic data indicate, the dorsal penile nerve block should be considered for every infant undergoing circumcision.
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Anesthesia and analgesia · Jan 1983
Comparative StudyThe extent of blockade following various techniques of brachial plexus block.
The extent of sensory and motor blockades was examined in 195 patients 5 and 20 min after four different techniques of brachial plexus block using 50 ml of 0.5% bupivacaine. The interscalene technique of Winnie (N = 50) resulted in a preferential blockade of the caudad portions of the cervical plexus and the cephalad portions of the brachial plexus. The supraclavicular approach of Kulenkampff (N = 55) and the subclavian perivascular approach of Winnie (N = 56) each resulted in a homogeneous blockade of the nerves of the brachial plexus. ⋯ With all four techniques, motor blockade developed faster than sensory blockade. The difference in results suggests that the approach to be used should depend primarily upon the site of the operation. The perineural space enclosing the brachial plexus greatly facilitates the spread of a local anesthetic when injected; however, it is usually not filled completely or evenly.
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A prolonged brachial plexus block with bupivacaine hydrochloride is described. Anaesthesia was induced with 40 ml of a solution made of equal parts of 0.50% bupivacaine hydrochloride and distilled water. Reversal of the motor block began 24 h later. ⋯ Whether this low osmolality caused nerve lesions was unknown. Postoperative exploration revealed a bilateral slowing down of conduction in the brachial plexus of this 73 year old patient. The importance of this finding could not be assessed.