Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Efficacy of a nerve stimulator in regional analgesia; experience in a resident training programme.
Forty interscalene brachial plexus regional blocks and twenty sciatic-femoral lower limb blocks were performed by 1st and 2nd year anaesthesia residents. Nerve trunk location was equally but randomly divided between use of a peripheral nerve stimulator and reliance on paraesthesiae. ⋯ It is concluded that the stimulator is not a useful adjunct for nerve location, except in those patients who are unable to co-operate in eliciting paraesthesia. In such patients the stimulator permits a comparable success rate.
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Anesthesia and analgesia · Jul 1976
Comparative StudyPost-thoracotomy intercostal block: comparison of its effects on pulmonary function with those of intramuscular meperidine.
Study of 34 patients who had undergone thoracotomy revealed that the group given intercostal nerve block analgesia had a significantly smaller decline in vital capacity after operation than did the group given narcotic analgesia only. The postoperative increase in arterial CO2 tension of the nerve block group also was significantly smaller than that of the narcotic group. The study suggests that intercostal nerve block for post-thoracotomy analgesia offers some advantage in preserving effort-dependent pulmonary function when compared with postoperative narcotic analgesia.
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Anesthesia and analgesia · May 1976
Case ReportsProlonged neuromuscular blockade with pancuronium in the presence of acute renal failure: a case report.
Prolongation of neuromuscular block following pancuronium administration to anephric patients has been reported. A patient is described whose postoperative course after resection of gangrenous bowel was complicated by acute renal failure and prolonged neuromuscular blockade. A large intraoperative dose of pancuronium was administered without monitoring neuromuscular transmission with a peripheral nerve stimulator. ⋯ The absence of renal excretion considerably increases the duration of action of curare when given in high doses. It has been suggested that doses of pancuronium greater than 3.6 mg/sq m or multiple doses would result in prolonged neuromuscular block in patients without renal function. The case reported illustrates the importance of monitoring neuromuscular transmission during administration of pancuronium in the presence of renal insufficiency to avoid this complication.