Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Nerve Block”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2000

Prospective evaluation of deep topical fornix nerve block versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification.

We compared the efficacy of deep topical fornix nerve block anaesthesia (DTFNBA) versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. We studied 120 patients, allocated randomly to two groups. Group 1 (n = 60) received peribulbar block with 5 ml of a 1:1 mixture of 0.5% plain bupivacaine and 2% lidocaine supplemented with hyaluronidase 300 i.u. ml-1. Group 2 received DTFNBA with placement of a sponge soaked with 0.5% bupivacaine deep into the conjunctival fornices for 15 min. No sedation was given to either group. Analgesia was assessed by the reaction to insertion of the superior rectus suture and by questioning during the procedure. A three-point scoring system was used (no pain = 0, discomfort = 1, pain = 2). Scoring was repeated at keratotomy, hydrodissection and hydrodelineation, phacoemulsification, irrigation and aspiration, and at intraocular lens insertion. If the patient's pain score was 0 or 1, no further action was taken. If the pain score at any stage of the operation was 2, intracameral injection of 1% preservative-free lidocaine was given. One patient in Group 2 needed intracameral lidocaine at the stage of phacoemulsification (P > 0.05) and four experienced discomfort at irrigation and aspiration (P = 0.043). We conclude that DTFNBA may be a useful needle-free anaesthetic technique in patients undergoing cataract surgery using phacoemulsification.

Administration, Topical↗
PubMed2000

Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures.

BACKGROUND: Various nerve blocks using local anaesthetic agents have been used in order to reduce pain after hip fracture. OBJECTIVES: To determine the effects of nerve blocks (inserted either pre-operatively, operatively or post-operatively) as part of the treatment for a hip fracture. SEARCH STRATEGY: The Cochrane Musculoskeletal Injuries Group trials register, MEDLINE, and bibliographies of trial reports were searched. Date of the most recent search: April 1998. SELECTION CRITERIA: Randomised and quasi-randomised trials involving the use of nerve blocks as part of the care of a hip fracture patient. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality, by use of an eight item scale, and extracted data. Wherever appropriate, results of outcome measures were pooled. MAIN RESULTS: Six randomised or quasi-randomised trials involving 229 patients were included. One trial related to insertion of a nerve block pre-operatively and the remaining five, to peri-operative insertion. Nerve blocks resulted in a reduction of the quantity of parental or oral analgesia administered to control pain from the fracture/operation or during surgery. It was not possible to demonstrate if this reduction in analgesia use was associated with any clinical benefit. REVIEWER'S CONCLUSIONS: Because of the small number of patients included in this review and the differing type of nerve blocks and timing of insertion, it is not possible to determine if nerve blocks confer any benefit when compared with other analgesic methods as part of the treatment of a hip fracture. Further trials with larger numbers of patients and full reporting of clinical outcomes would be justified.

Hip Fractures↗
PubMedDate not supplied

Postoperative analgesia and functional recovery after total-knee replacement: comparison of a continuous posterior lumbar plexus (psoas compartment) block, a continuous femoral nerve block, and the combination of a continuous femoral and sciatic nerve block.

BACKGROUND AND OBJECTIVES: Continuous femoral nerve block is a well-accepted technique for regional analgesia after total-knee replacement. However, many patients still experience considerable pain at the popliteal space and at the medial aspect of the knee. The goal of this study is to evaluate whether a psoas compartment catheter provides better postoperative analgesia than a femoral nerve catheter does and whether it is as effective as the combination of a femoral and a sciatic nerve catheter and, thus, improves functional outcome. METHODS: Ninety patients who underwent total-knee replacement under standardized general anesthesia participated in this prospective randomized study. Group FEM received a continuous femoral nerve block, group FEM/SCI received a combination of a femoral and a sciatic continuous nerve block, and group PSOAS received a continuous psoas compartment block. Patient-controlled analgesia with piritramide was available for 48 hours. Maximal bending and extending of the knee and walking distance was assessed during the first 7 days. A standardized telephone survey was conducted after 9 to 12 months to evaluate residual pain and functional outcome. RESULTS: Postoperative opioid consumption during 48 hours was significantly less in the FEM/SCI group (median: 18 mg; 25th/75th percentile: 6/40) compared with the FEM group (49 mg; 25/66) and the PSOAS group (44 mg; 30/62) (P =.002). Postoperative pain scores were not different, and no differences occurred with respect to short-term or long-term functional outcome. CONCLUSION: The FEM/SCI catheter is superior to FEM and PSOAS catheter with respect to reduced analgesic requirements after total-knee replacement, but functional outcome does not differ with those 3 continuous regional analgesia techniques.

Aged↗
PubMed1991

Post-operative analgesia following femoral-neck surgery--a comparison between 3 in 1 femoral nerve block and lateral cutaneous nerve block.

A prospective controlled randomized trial on patients receiving surgery for fractured neck of femur was carried out, in which post-operative analgesic requirements in three separate groups were compared. Patients in Group 1 acted as controls, whilst those in Groups 2 and 3 received lateral cutaneous nerve blocks and 3 in 1 femoral nerve blocks, respectively. Patients in Group 3 needed significantly less analgesia than the other two groups, and the time to first administration of analgesia was significantly longer. No complications of either of the nerve blocks was noted.

Aged↗
PubMed1976

Inadvertent abducens nerve block during therapeutic trigeminal nerve block. A case report.

A case is presented where reversible abducens nerve block accompanied second and third division trigeminal block with bupivacaine on two occasions. Intraorbital injection through the inferior orbital fissure most likely took place. Careful poistioning of the needle and limitation of the drug volume is mandatory for therapeutic trigeminal nerve blocks with neurolytic solutions.

Aged↗
PubMed1999

Anesthetic efficacy of the mylohyoid nerve block and combination inferior alveolar nerve block/mylohyoid nerve block.

OBJECTIVE: The purpose of this study was to measure the degree of anesthesia obtained with the mylohyoid nerve block and the combination mylohyoid nerve block/conventional inferior alveolar nerve (IAN) block in mandibular teeth. STUDY DESIGN: With the use of a repeated-measures design, 30 subjects randomly received each of 3 combinations of injections at 3 separate appointments. The combinations were as follows: mylohyoid nerve block (1.8 mL of 2% lidocaine with 1:100,000 epinephrine) + IAN block (3.6 mL of 2% lidocaine with 1:100,000 epinephrine); mock mylohyoid nerve block + IAN block (3.6 mL of 2% lidocaine with 1:100,000 epinephrine); mylohyoid nerve block (1.8 mL of 2% lidocaine with 1:100,000 epinephrine) + mock IAN block. The mylohyoid injections were aided by the use of a peripheral nerve stimulator. Mandibular anterior and posterior teeth were blindly tested with a pulp tester at 4-minute cycles for 60 minutes postinjection. Anesthesia was considered successful when 2 consecutive 80 readings were obtained. RESULTS: One hundred percent of the subjects had lip numbness with the mylohyoid nerve block + IAN block and mock mylohyoid nerve block + IAN block techniques. For these 2 techniques, anesthetic success rates were higher in posterior teeth (73% to 93%) than in anterior teeth (33% to 60%). There were no significant differences (P > .05) between the 2 techniques. The mylohyoid nerve block + mock IAN block technique resulted in a very low success rate (0% to 17%) and was significantly different (P < .05) from the mylohyoid nerve block + IAN block technique. CONCLUSIONS: The results of this study suggest that the mylohyoid nerve block does not by itself predictably provide pulpal anesthesia in mandibular teeth and does not significantly enhance pulpal anesthesia when administered in combination with the IAN block.

Adult↗
PubMed2006

The effect of single-injection femoral nerve block versus continuous femoral nerve block after total knee arthroplasty on hospital length of stay and long-term functional recovery within an established clinical pathway.

Total knee arthroplasty (TKA) may result in severe pain, and single-injection femoral nerve blocks (SFNB) have been demonstrated to have a limited duration of analgesia. Continuous femoral nerve blocks (CFNB) can prolong the analgesic duration of SFNB. We prospectively randomized 36 patients undergoing TKA to CFNB versus SFNB and evaluated the effect on hospital length of stay (LOS) as the primary outcome within a standardized clinical pathway. Secondary outcomes included visual analog scale (VAS) pain scores, opioid consumption, and long-term functional recovery at 12 wk. Mean VAS resting scores were significantly lower among patients who received CFNB versus SFNB: first day (1.7 vs 3.3 [P = 0.002]) and second day (0.9 vs 3.2 [P < 0.0001]) after surgery. Mean maximal VAS scores during physical therapy were significantly lower among patients who received CFNB versus SFNB: first day (4.7 vs 6.3 [P = 0.01]) and second day (3.9 vs 6.1 [P = 0.0005]) after surgery. Mean oxycodone consumption was significantly lower among patients who received CFNB versus SFNB: 15 mg versus 40 mg (P = or < 0.0001) on the first day after surgery; 20 mg versus 43 mg (P = 0.0004) on the second day after surgery. There was no difference in hospital LOS (3.8 vs 3.9 days) or long-term functional recovery (117 degrees versus 113 degrees knee flexion at 12 wk) between the two groups. The lack of effect provided by increased duration of analgesia (from CFNB) after TKA may now have minimal impact on hospital LOS and long-term functional recovery in the contemporary healthcare environment within the United States.

Aged↗
PubMedDate not supplied

Paravertebral somatic nerve block compared with peripheral nerve blocks for outpatient inguinal herniorrhaphy.

BACKGROUND: Inguinal herniorrhaphy (IH) is a common outpatient procedure, yet postoperative pain and anesthetic side effects remain a problem. Paravertebral somatic nerve blocks (PVB) have the potential to offer unilateral abdominal wall anesthesia and long-lasting pain relief with minimal side effects. We compared PVB with peripheral neural blocks for outpatient IH. METHODS: Forty-six patients scheduled for IH were entered into this prospective, single-blind study. All patients underwent a standardized general anesthetic. Patients were randomly assigned to receive a PVB (levels T10-L2) preoperatively (n = 24) or an intraoperative peripheral block (PB) by the surgeon (n = 22), using 0.5% ropivacaine (40 mL). Opioid use, verbal analog pain scores, and side effects were documented for 72 hours. RESULTS: The use of opioids during surgery was less for the PVB group 162 +/- 70 mg than the PB group, 210 +/- 60 (P =.02). Need for opioids in PACU was less for the PVB group (39%) than the PB group (61%) (P =.002). Time until first pain after discharge was not different between groups, 312 +/- 446 minutes (PB) and 425 +/- 384 minutes (PVB) (P =.12). Of the PVB patients, 29% used no opioids at all compared with 18% of PB patients (P =.12). Mean time until first oxycodone use was similar between groups, 303 +/- 469 minutes (PB) and 295 +/- 225 minutes (PVB) (P =.18). Oxycodone use was also similar; 35 +/- 34 mg (PVB) versus 49 +/- 42 mg (PB) (P =.30). More patients in the PB group (50%) required antiemetic treatment in the postanesthesia care unit than the PVB group (21%) (P <.001). Side effects were similar at all other measurements. CONCLUSIONS: This study shows that PVB provides analgesia equivalent to extensive peripheral nerve block for inguinal herniorrhaphy, offering an alternative method of postoperative pain management and perhaps fewer side effects.

Abdominal Wall↗
PubMed2002

Post-operative analgesia following total knee replacement: an evaluation of the addition of an obturator nerve block to combined femoral and sciatic nerve block.

BACKGROUND: Femoral and sciatic nerve block may not provide complete post-operative analgesia following total knee replacement. This study was designed to evaluate whether the addition of an obturator nerve block to combined femoral and sciatic nerve block improves the quality of post-operative analgesia following primary total knee replacement. METHODS: Sixty patients were randomised into one of two groups: combined femoral and sciatic nerve block with 15 ml 0.75% ropivacaine to each nerve or combined femoral and sciatic nerve block with 15 ml 0.75% ropivacaine to each nerve and an obturator nerve block with 5 ml 0.75% ropivacaine. RESULTS: Peripheral nerve blocks were successful in 85% of patients. The group which received the obturator nerve block showed a significant increase in the time until their first request for analgesia (mean 257.0 vs. 433.6 min) and a significant reduction in the total requirements for morphine throughout the study period (mean 83.8 vs. 63.0 mg) (P<0.05). There were no systemic or neurological sequelae in any of the groups. CONCLUSIONS: The addition of an obturator nerve block to femoral and sciatic blockade improved post-operative analgesia following total knee replacement.

Aged↗
PubMed2001

Regional nerve blocks. Part 3--Regional nerve blocks of the hand.

This is the third in our series of regional nerve blocks. This month specific blocks of the hand are reviewed. The anatomy of the region is revised and the indications for using these blocks is discussed and some pitfalls to be aware of are highlighted. Some practical tips are also provided.

Hand↗
PubMed1985

Sciatic nerve block for children. Sciatic nerve block by the anterior approach for postoperative pain relief.

This study aimed to establish whether it was practical to perform sciatic nerve block by the anterior approach in a group of children of different ages and weights. A total of 82 blocks were performed of which 78 (95.2%) were judged to have been successful. The technique of the block differed slightly from that used in adult practice, in that great reliance was placed on the loss of resistance felt as the needle point passed through the thigh muscles into the sciatic neurovascular compartment. There were no immediate or late complications associated with this block in any of the patients. It is concluded that the block is easy to perform and can produce reliable postoperative analgesia for most common operations on the foot and ankle in paediatric practice.

Acetaminophen↗
PubMed2003

Comparing the effects of femoral nerve block versus femoral and sciatic nerve block on pain and opiate consumption after total knee arthroplasty.

The goal of this study was to compare femoral and femoral plus sciatic nerve blocks in the postoperative pain management of patients undergoing total knee arthroplasty (TKA). A total of 97 patients participated in a convenience sample, comparative study. Patients who received femoral nerve block only (n = 30) reported statistically higher pain scores (P <.05) and showed 61% higher opiate consumption than those who received femoral and sciatic nerve blocks (n = 67) in the first 24 hours after surgery. The results suggest that the combined femoral and sciatic nerve block provides superior pain management in the early postoperative period after TKA.

Aged↗