Articles: nerve-block.
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Clin. Orthop. Relat. Res. · Oct 1983
Evaluation of acute knee injuries with sciatic/femoral nerve blocks.
A preliminary study of the applicability of sciatic and femoral regional nerve blocks in the evaluation of acute knee injuries was conducted. During the period from January 1980 to March 1981, 12 patients with acute knee injuries in whom clinical examination under local anesthesia was considered totally unreliable secondary to patient uncooperation or severe pain were examined at Grady Memorial Hospital. Each of these patients received regional anesthesia by sciatic/femoral nerve block. ⋯ A full range of motion was present in each patient after the block. No complications were encountered. A satisfactory block was obtained in one attempt in 96% of the patients. (One patient had a failed femoral nerve block, but a repeated block was successful).
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Comparative Study
Penile block for circumcision? A comparison with caudal blockade.
A prospective blind trial was conducted comparing the analgesia and adverse effects produced by caudal extradural blockade (caudal block) with blockade of the dorsal nerves of the penis (penile block) in 38 boys undergoing elective circumcision. Analgesia was assessed by senior nurses using a linear analogue scale and by the response to direct questioning over the first 7 hours after surgery. ⋯ One technical failure occurred in the penile block group. It is concluded that a penile block is a satisfactory alternative to caudal blockade with regard to postoperative analgesia and offers several specific advantages.
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The differential susceptibility of large and small axons to lidocaine was studied on units in the rabbit vagus nerve. The results classified the units into three groups: 1) myelinated, conduction velocity 37.5-5 m/s, which were blocked by lidocaine 0.4-0.8 mM; 2) slow, unmyelinated axons, conduction velocity 1.2-0.5 m/s, and these axons were not blocked by 0.2, 0.4, or 0.6 mM lidocaine but usually were blocked by 0.8 mM lidocaine; and 3) Axons of intermediate conduction velocity, between 1.2 and 4 m/s. The last group of axons was the most sensitive: some were blocked by as little as 0.2 mM lidocaine. No size-related trend was detected within the groups.
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The rationale, anatomy and technique of transsacral phenol injection are described and the author's results in the treatment of nine patients with intractable perineal pain presented. The technique is recommended as a safe, simple and useful alternative to intrathecal neurolysis in this condition.
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A simplified, predictable method of peripheral nerve block at the ankle and foot with a long acting anesthetic agent bupivacaine (Marcaine) 0.5% is presented. Combined with the use of a pneumatic tourniquet it allows the performance of mid and forefoot surgery on an inpatient or outpatient basis. It alleviates the risks of general or spinal anesthesia and avoids the use of analgesics for a period of 10 to 25 hours. ⋯ The sural nerve is blocked subcutaneously at one fingerbreadth distal to the tip of the lateral malleolus. The results have been excellent to good. No adverse reactions occurred affecting the central nervous system of the myocardium.