Articles: nerve-block.
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J. Oral Maxillofac. Surg. · Aug 1984
A modified auriculotemporal nerve block for regional anesthesia of the temporomandibular joint.
A technique for producing regional auriculotemporal nerve analgesia is described. Undesirable side effects have been minimized by avoiding facial nerve branches and blood vessels, and injection at the site of the nerve trunk.
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The management of a broken short 30-gauge hypodermic needle after an inferior alveolar dental nerve block in a 3-year-old child is discussed. Because of the possibility of the needle migrating toward vital structures, and because of the psychologic and medicolegal implications that could arise, we believed that the needle should be immediately removed with surgical procedures.
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Anesthesia and analgesia · Jul 1984
Continuous axillary brachial plexus block--a clinical and anatomical study.
In order to decrease both the failure rate and inadvertent arterial puncture rate that may be associated with continuous axillary brachial plexus block, a new technique of insertion of the catheter in the axilla was studied in 52 patients and in 12 fresh cadavers. With the arm abducted, externally rotated, and flexed at the elbow, an 80-mm long catheter was inserted under the skin at a site located 40-mm below the axilla and medial to the biceps muscle. Injection of lidocaine and bupivacaine produced sensory and motor blockades of the median, radial, ulnar, and musculocutaneous nerves in 98% of the patients. ⋯ In the anatomical study, injection of dye and molding solutions showed that the tip of the catheter lay not in the perivascular sheath, but in a virtual cavity that was very superficial, under the skin, and surrounding the perivascular space. The technique used was safe and had a high success rate. It is particularly useful in patients undergoing long operations and in patients in whom pain would otherwise prevent postoperative physiotherapy of the upper arm.
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Anesthesia progress · Jul 1984
Comparative StudyComparison of the effectiveness of etidocaine and lidocaine as local anesthetic agents during oral surgery.
In a double-blind study conducted in 112 patients undergoing removal of four impacted third molar teeth, etidocaine hydrochloride 1.5% solution with epinephrine 1:200,000 and lidocaine hydrochloride 2.0% solution with epinephrine 1:100,000 were used, one on each side of the face, to produce inferior alveolar nerve block, infiltration anesthesia of the maxillary tooth and hemostasis of the mucoperiosteum around each tooth. Surgically adequate anesthesia was rapidly produced by both agents but the duration of action of etidocaine was longer than that of lidocaine as reflected in more prolonged numbness of the lip and delayed onset of pain. Moreover, after etidocaine treatment fewer patients reported severe pain as the local anesthesia receded. No adverse local or systemic effects were observed in, or reported by, any of the patients.
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Regional-Anaesthesie · Jul 1984
[Electrical nerve localization and catheter technic. A safe method for brachial plexus anesthesia].
A technique for sub-axillary blockade of the brachial plexus by means of a special catheter set is presented. A plastic self-retaining cannula is placed within the vasomotor nerve sheath, using the advantages of electric nerve stimulation. In our opinion the decisive advantages of this procedure lie in the fact that the user is not dependent on the cooperation of the patient and anatomical orientation takes place on the basis of clear and objective criteria through the muscle contractions induced in this way. ⋯ This method makes subsequent injections into the vasomotor nerve sheath through repeated puncture unnecessary. The catheter technique makes it possible to operate on the upper extremity using regional anaesthesia, whose effects can be prolonged beyond those of long-acting anaesthetics. The possibility of incomplete blockade resulting from individual variations in the amounts of local anaesthetics needed, is excluded and the anaesthetist can, if necessary, carry out pre- and post-operative pain therapy.