Articles: nerve-block.
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Wrist and digital nerve blocks are useful for the management of many common problems of the hands and fingers, including fractures, lacerations, and infections requiring drainage. The principal nerves in the wrist (radial, median, and ulnar), and the digital nerves in the hand or fingers are anatomically superficial. They can be easily located and are accessible for percutaneous injection of anesthetic agents such as lidocaine (Xylocaine), bupivacaine (Marcaine), and mepivacaine (Carbocaine). Careful selection of the anesthetic agent and type of nerve block can provides safe and effective anesthesia for many surgical procedures of the hands and fingers.
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The effects of precurarisation, with small doses of pancuronium, curare or gallamine, on the neuromuscular blockade following suxamethonium, 1 mg/kg, were studied using train-of-four stimulation. The duration of the block was reduced by pretreatment with d-tubocurarine and gallamine but increased with pancuronium. The degree of competitive neuromuscular blockade, both after administration of the precurarising dose and at full recovery from suxamethonium was mild and was insufficient to be a cause of postoperative muscle weakness.
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Comparative Study
Postoperative analgesia for day-case herniorrhaphy patients. A comparison of cryoanalgesia, paravertebral blockade and oral analgesia.
Patients were admitted as day-cases for inguinal herniorrhaphy under epidural anaesthesia and chlormethiazole sedation. The patients were given oral analgesia, and in addition, some were given either a paravertebral block with a dextran/bupivacaine mixture or cryoanalgesia of the ilio-inguinal nerve for postoperative pain relief. These anaesthetic and analgesic techniques are discussed in relation to day-case herniorrhaphy.