Articles: nerve-block.
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Continuous regional anesthesia through a catheter placed in the axillary sheath has been an effective method of brachial plexus neural blockade. This article confirms this observation and demonstrates that continuous axillary block is useful in replantation surgery to provide anesthesia and analgesia in addition to sympathetic blockade for up to 7 days after operation. This anesthetic technique may allow extensive revascularization or replantation procedures to be performed for patients who could not safely tolerate prolonged application of general anesthesia.
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Anesthesia and analgesia · Oct 1984
Comparative StudyComparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator.
This study was designed to compare the use of insulated and uninsulated needles with a peripheral nerve stimulator for locating a peripheral nerve in an anesthetized cat. The needles were mounted on a one-dimensional manipulator and both the saphenous and sciatic nerves were located. The tip of the insulated needle was consistently placed on the sciatic nerve. ⋯ Using an insulated needle, the minimum current required to stimulate the nerve occurred when the tip of the needle touched the saphenous nerve. Using an uninsulated needle, the minimum current occurred when the tip was 0.1-0.8 cm past the nerve. The conclusion is that insulated needles more precisely locate the peripheral nerve than uninsulated needles.
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The behavior of full-term neonates undergoing circumcision with and without local anesthesia was examined using the Brazelton Neonatal Assessment Scale (BNAS). Evaluations were done blindly pre-and postcircumcision and on the day following the procedure. Infants receiving lidocaine in a dorsal penile nerve block (DPNB) remained more attentive to animate and inanimate stimuli following circumcision and demonstrated a greater ability to quiet themselves when disturbed. ⋯ This report adds to the growing body of data that indicate that circumcision is a painful procedure that disrupts the course of behavioral recovery following birth. These disruptions can be lessened by the use of local anesthesia to relieve pain and stress during the procedure without any additional morbidity. These data support the use of DPNB during anesthesia for routine neonatal circumcisions still requested by the majority of parents in the country.
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Anesthesia and analgesia · Oct 1984
Comparative StudyElectrical nerve location: numerical and electrophoretic comparison of insulated vs uninsulated needles.
We compared the electrical characteristics of insulated and uninsulated needles in two models that simulate use of a stimulator for nerve localization. With a digital computer, we solved for and graphed the contours of constant electric field strength, defining regions of simulated tissue in which a nerve would become depolarized for a particular stimulation current. ⋯ We also found that the necessary stimulator current is much more dependent on the depth of needle insertion with uninsulated needles than with insulated needles. We conclude that the electrical characteristics of insulated needles are more favorable for successful nerve block.