Articles: nerve-block.
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Acta Obstet Gynecol Scand · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia and maternal side effects of pudendal block at delivery. A comparison of three local anesthetics.
In a randomized double-blind study, 1048 women received pudendal block (PDB) at vaginal delivery, using three different local anesthetics: mepivacaine 1% plain, mepivacaine 1% with epinephrine, and bupivacaine 0.25% plain. The PDB was given transvaginally in doses of 8 ml X 2. Mepivacaine - epinephrine was found to be more effective than the other local anesthetics. ⋯ Inhibition of labor was slightly more pronounced with mepivacaine - epinephrine. The different durations of the local anesthetics did not affect the analgetic effect in clinical use. It is concluded that as the adverse effects on labor are quite common, PDB should not be given as a routine before delivery, but may be offered liberally when pain in the pudendal area is a main part of the pain of childbirth.
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A technique of regional anaesthesia of the foot for forefoot surgery (ingrowing toe-nail, hallux valgus, amputation, etc.) is described. It consists of a block of the superficial peroneal nerve at the ankle combined with a block of the posterior tibial nerve behind the medial malleolus. ⋯ A pneumatic tourniquet was placed on the upper part of the thigh after the patient had been given an intramuscular premedication. The results of 52 such blocks carried out in 40 patients are discussed.
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Orthopedic surgery on the distal lower extremities can be performed with conduction anesthesia of the sciatic nerve at the popliteal fossa, supplemented by blocking of the femoral nerve with ischemia or partial deprivation of blood supply. The technique of this method of anesthesia is described. It has proved its value in patients with high anesthesia risk as well as in out-patients.
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Acta Anaesthesiol Scand · Dec 1984
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intramuscular analgesia, intercostal block, epidural morphine and on-demand-i.v.-fentanyl in the control of pain after upper abdominal surgery.
Eighty patients undergoing upper abdominal surgery were randomly allocated to four groups according to the postoperative pain treatment. All patients had a standardized balanced anaesthesia and for postoperative analgesia either intramuscular oxycodone and/or metamizol (IM), intercostal block with 0.5% bupivacaine (IC), epidurally 4 mg morphine (EM) or i.v. infusion of fentanyl 0.54-0.99 micrograms min-1 + on-demand boluses of 7.2-13.5 micrograms (ODAC) were given. The pain intensity 2 h postoperatively was similar in all groups, mean score ranging from 3.2-4.3 on a scale from 0-10. ⋯ The amount of fentanyl infused in 24 h to the ODAC patients varied considerably, 814-2233 micrograms, as did the number of on-demand boluses, 3-155. At 24 h, an efficacy rating "good" was distributed as follows: IM 9/20, IC 11/20, EM 11/20 and ODAC 13/20. In the whole patient material 92.5% rated their condition as "good" or "fair".