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'Anesthesia Regional Digital Block' (277)


Dec
1969

We conducted a prospective and descriptive study on epidural analgesia (EA) at the Sylvanus Olympio University Hospital Center in Lomé from February to June 2014. After taking consent from pregnant women selected by simple random sampling and in the absence of contraindication for anesthesia (pre-anesthetic assessment performed in their 8th month of pregnancy), women were enrolled. Out of 29 selected women, 20 (69%) underwent EA.

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Jun
2017

Aneurysms of the external carotid artery represent approximately 2% of cervical carotid aneurysms, with the majority being traumatic pseudoaneurysms. Given the paucity of literature available for guidance, the diagnosis, treatment, and follow-up of such lesions are completely individualized.
We report an 83-year-old woman with an 8-week history of headache in the occipital region, transient episode of gait disturbance, and pulsatile tinnitus on the right.

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Dec
1969

Digital ischemia is associated with several rheumatologic disorders and is often difficult to treat. Symptoms and sequelae can include pain, disability, need for amputation, and poor quality of life.
Patients diagnosed with digital ischemia were referred for an ultrasound-guided axillary nerve block using liposomal bupivacaine (Exparel, Pacira Pharmaceuticals).

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Oct
2016

Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings.

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Dec
1969

Digital nerve block.

Can J Rural Med 2016 ;21(3):84
Izak Van Niekerk

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Feb
2016

The present study was to examine the effect of stellate ganglion block (SGB) on bilateral regional cerebral oxygen saturation (rSO2) and postoperative cognitive function. Eighty patients undergoing selective coronary artery bypass graft with cardiopulmonary bypass (CPB) were randomly and equally divided into two groups. The patients in group S were given right SGB with ropivacaine, while the patients in group C were injected with normal saline.

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Jul
2016

Regions considered optimal for performing peripheral nerve blocking have been well documented. However identify and perform regional anesthesia in those regions from ultrasound images remains a challenge.
This study aims to develop a virtual environment for the simulation of ultrasound exploration of the neck nerves and both the upper and lower limbs for regional anesthesia.

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Jun
2016

Use of imaging tools like digital C-arm, tridimensional tomography, and navigational surgery has proven its value to the surgical removal of broken needles. A 32-year-old patient was referred for evaluation of a fractured needle during inferior alveolar nerve block attempt few days before. The patient complained of a pricking sensation at the injured area while moving the neck.

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Dec
1969

Should I Use Lidocaine With Epinephrine in Digital Nerve Blocks?

Ann Emerg Med 2016 12 26;68(6):756-757. Epub 2016 Apr 26.
Julie L Welch, Dylan D Cooper

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Apr
2016

The objective of this present study is to compare pain associated with the double-dorsal versus a single-volar subcutaneous injection in the provision of digital anaesthesia for finger injuries presenting to the ED.
A randomised controlled trial from November 2012 to January 2014 at a single adult tertiary-referral hospital. ED patients with finger injuries requiring digital anaesthesia was randomised to either the double-dorsal or a single-volar subcutaneous injection technique.

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Dec
1969

The occasional digital nerve block.

Can J Rural Med 2016 ;21(2):51-2
Len Kelly

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Dec
1969

Intravascular (IV) injection of local anesthetics is a potential cause of false-negative results after lumbar medial branch nerve blockade (L-MBB) performed to diagnose facetogenic back pain. The aim of the present study was to identify the relationship between the needle type and the incidence of IV injection in patients undergoing L-MBB using fluoroscopy with digital subtraction imaging (DSI).
In this prospective randomized study, we compared the incidence of IV uptake of contrast medium using the Quincke needle and Whitacre needle under real-time DSI during L-MBB.

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Dec
1969

Review of various techniques for digital blocks with local anesthetic, with or without epinephrine.
Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia.
The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.

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Dec
1969

Studies about the anesthesia techniques during transrectal ultrasound guided prostate biopsy (TRUS-Bx) are usually focused on pain relief. Although patients' tolerance is an important issue in TRUS-Bx, cancer detection rate (CDR) must not be ignored. In this study, we compared the impact of intrarectal lidocaine gel anesthesia (IRLA) and periprostatic nerve blockade (PNB) techniques on CDR.

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Jan
2016

This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU).
A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) following an initial right hemicolectomy complicated by an anastomotic leak and peritonitis. The patient's condition was further complicated by an abdominal abscess 22 days later.

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Sep
2015

Radix entomolaris presents with an unusual morphology and is a rare occurrence. It is mainly observed in mandibular first molars. The incidence varies in different populations but it is far from common.

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Dec
1969

Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium.

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Nov
2015

Safety of Epinephrine in Digital Nerve Blocks: A Literature Review.

J Emerg Med 2015 Nov 4;49(5):799-809. Epub 2015 Aug 4.
Jonathan Ilicki
Digital nerve blocks are commonly performed in emergency departments. Health care practitioners are often taught to avoid performing blocks with epinephrine due to a risk of digital necrosis.
To review the literature on the safety of epinephrine 1:100,000-200,000 (5-10 μg/mL) with local anesthetics in digital nerve blocks in healthy patients and in patients with risk for poor peripheral circulation.

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Sep
2016

The effects of handler position and perineural anaesthesia in sound horses need investigation to facilitate interpretation of pressure plate analysis in lame horses.
To evaluate the effect of handler position and perineural anaesthesia on limb loading and particularly hoof balance in sound horses.
Nonrandomised crossover study.

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Dec
2015

To evaluate the use of spinal anesthesia by reducing anesthetic agent dose to provide better analgesia with minimal side effects without sacrificing the outpatient setting for prostate biopsy. In this study, efficacy and tolerability of selective low-dose spinal anesthesia versus intrarectal local anesthesia (IRLA) plus periprostatic nerve blockade (PPNB) were compared.
Between September 2012 and April 2013, 100 patients, aged 40 to 80 years, prostate-specific antigen (PSA) ≥4 ng/mL, abnormal digital rectal examinations, and enrolled for biopsy were included in the present study.

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Dec
1969

To provide anatomical information on the position, morphological variations and incidence of mental foramen (MF) and accessory mental foramen (AMF) as they are important for dental surgeons, anesthetists in nerve block and surgical procedures, to avoid injury to the neurovascular bundle in the mental foramen area.
Our study was conducted on 150 adult dry human mandibles from the osteological collection of the Department of Anatomy of the Faculty of Medicine, University of Sarajevo. The location and shape of the MF and the presence of the AMF were studied by visual examination.

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Dec
1969

Review of various techniques for digital blocks with local anesthetic, with or without epinephrine.
Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia.
The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.

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Jun
2015

Local anesthetic nerve blocks are frequently used for postoperative analgesia and to the best of our knowledge no studies have evaluated the effects of injecting bupivacaine into an area previously injected with lidocaine. Sensation was tested in three groups of subjects receiving local anesthetic digital blocks. Group A received bupivacaine 0.

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Sep
2015

To study whether a temporary block of the tactile afferents from the fingers causes altered activity in the neural network for dexterous manipulation.
Whole-brain functional Magnetic Resonance Imaging (fMRI) was conducted in 18 healthy subjects, while they compressed an unstable spring between the thumb and index finger of the right hand. Two sensory conditions--with and without tactile input from the fingers--were employed.

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Apr
2015

Nail surgery: best way to obtain effective anesthesia.

Dermatol Clin 2015 Apr 29;33(2):265-71. Epub 2015 Jan 29.
Nathaniel J Jellinek, Nicole F Vélez
Nail procedures require an effective and reliable approach to anesthesia of the distal digit. Several techniques have been described in the literature. Herein, the relevant anatomy of the nail unit, pain pathways, anesthetic options, and several injection approaches to achieve complete anesthesia are reviewed.

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Mar
2015

Adrenaline with lidocaine for digital nerve blocks.

Cochrane Database Syst Rev 2015 Mar 19(3):CD010645. Epub 2015 Mar 19.
Hemanshu Prabhakar, Santosh Rath, Mani Kalaivani, Neel Bhanderi
Surgery on fingers is a common procedure in emergency and day care surgery. Adrenaline combined with lidocaine can prolong digital nerve block and provide a bloodless operating field. Extended postoperative pain relief can reduce the need for analgesics and can facilitate hand rehabilitation.

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Aug
2015

Digital nerve blocks are commonly used as effective techniques of anaesthesia to allow a variety of surgical procedures performed on digits. This study was conducted to compare the efficacy of volar subcutaneous single injection block and the traditional dorsal two injections digital block.
This randomized controlled trial was conducted at Plastic and Reconstructive Surgery Department, Hayatabad Medical Complex Peshawar from December.

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Oct
2014

Foot and ankle surgical procedures, ranging from simple procedures, such as bunionectomy and correction of hammer toe, to more complex surgery, such as ankle fusion and ankle replacement, are extremely painful. Moreover, there is increasing interest in performing these procedures in an outpatient setting. Nerve blocks are extensively used in foot and ankle surgery, and commonly used techniques include sciatic nerve block with saphenous nerve augmentation; ankle block; and local, digital, or field block.

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May
2015

Current evidence shows that anaesthetic digital block with epinephrine is safe in surgical selected patients. There are no controlled studies that have examined the efficacy of local anaesthesia with vasoconstrictor in chemical matricectomy without using tourniquet to control bleeding.
A controlled, prospective and randomized study was conducted to examine primarily the rate of recurrence after segmental phenolization matricectomy with anaesthetic digital block with epinephrine vs.

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Jun
2014

When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain associated with injection. Local cutaneous infiltration is the most commonly used anesthetic technique and involves direct injection into the area requiring anesthesia.

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Jul
2015

To describe the nerve stimulator-guided sciatic-femoral nerve block in raptors undergoing surgical treatment of pododermatitis.
Prospective clinical trial.
Five captive raptors (Falco peregrinus) aged 6.

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Nov
2014

To assess the most effective local analgesia during transrectal ultrasound-guided prostate biopsy.
A total of 123 consecutive patients undergoing transrectal ultrasound-guided prostate biopsy for elevated prostate-specific antigen levels and/or a suspicious digital rectal examination were randomized to three groups. Patients received a 60-mg lidocaine suppository (group 1, n = 41), a periprostatic nerve block (10-mL injection of lidocaine hydrochloride; group 2, n = 41) or a combination of both (group 3, n = 41) before a 10-core transrectal ultrasound-guided biopsy.

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Apr
2014

Blood hemoglobin can be monitored continuously and noninvasively with a noninvasive spectrophotometric sensor (Masimo SpHb). The perfusion index (PI) of the finger is directly related to the clinical accuracy of SpHb. We evaluated those variables that influence PI without the influences of surgery and anesthesia.

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Apr
2014

To evaluate the time to onset of anesthesia, duration of anesthesia, and pain on injection of local anesthetics.
A systematic search of the English literature was performed of the Medline, Cochrane Central Register of Controlled Trials, The Allied and Complementary Medicine Database (AMED), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, and 6 articles were complied with the study inclusion criteria.

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Nov
2013

The aim of the present study was to analyze the anatomical and morphometric variation in shape, frequency of occurrence, direction, and position of accessory infraorbital foramen (AIOF) in relation to infraorbital foramen (IOF) in cadaveric dry skulls to minimize clinical complications and aid in surgical maneuvering in the maxillofacial region and implementing the regional block anesthesia. The IOF is an important anatomical landmark in these surgical manipulations. Because there is limited literature available on AIOF, which transmits accessory branch of the infraorbital nerve, the present study was designed.

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Jul
2014

Digital blocks are traditionally performed by physicians, physician assistants, and nurse practitioners. Procedures manuals emphasize that digital blocks are usually performed by a physician or an advanced practice nurse. In our community hospital, emergency nurses have performed digital blocks according to protocol for the past 30 years without known complications or diminished patient satisfaction.

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Sep
2014

A local anaesthetic agent capable of temporarily resolving lameness after being administered perineurally would be helpful because rapid return of lameness would allow for other analgesic techniques to be performed within a short period of time.
To determine if a 3% solution of ketamine hydrochloride (HCl), administered around the palmar nerves at the level of the base of the proximal sesamoid bones, can improve naturally occurring lameness that can be improved or abolished with a basilar sesamoid nerve block performed using lidocaine HCl and to compare the change in gait produced using lidocaine to the change in gait produced using ketamine by using objective lameness assessment.
Experimental trial using research horses with naturally occurring lameness.

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Nov
2013

We recently showed that C-tactile fibres (CTs) in human hairy skin (anterior leg) mediate crossover between innocuous touch and noxious touch, i.e. mechanical allodynia.

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Aug
2013

The diagnosis and management of Morton's neuroma: a literature review.

Foot Ankle Spec 2013 Aug 27;6(4):307-17. Epub 2013 Jun 27.
Sameer Jain, Ken Mannan
Morton's neuroma is a common condition mainly affecting middle aged women, and there are many proposed etiological theories involving chronic repetitive trauma, ischemia, entrapment, and intermetatarsal bursitis. Incorrect terminology suggests that the underlying pathological process is a nerve tumor, although histological examination reveals the presence of inflammatory tissue-that is, perineural fibrosis. The common digital nerve and its branches in the third planter webspace are most commonly affected.

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May
2013

The goals of this study are threefold: (1) to determine what effect epinephrine has on the duration of bupivacaine finger block anesthesia; (2) to see whether the duration of action of bupivacaine on digital pain relief is the same duration as numbness to touch/pressure; and (3) to assess the fingertip temperature changes that result from bupivacaine digital blocks.
The ring fingers of both hands of 44 volunteers were randomized to injection of bupivacaine with or without 1:200,000 epinephrine. The durations of time for digits to return to normal pain, touch, pressure sensation, and fingertip temperature were measured and recorded.

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Apr
2013

Lameness is the most common presenting complaint in equine practice. Performing diagnostic nerve blocks is an integral part of any lameness work-up, and is therefore an essential skill for equine practitioners. However, the opportunities for veterinary students to practice this skill are limited.

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Aug
2013

Ilioinguinal (IL) and iliohypogastric (IH) nerve blocks are used in patients with chronic postherniorrhaphy pain. The present study tested the hypothesis that our method, previously developed in cadavers, blocks the nerves separately and selectively in human volunteers.
We blocked the IL and the IH nerves in 16 volunteers in a single-blinded randomized cross-over setting under direct ultrasound visualization, by injecting two times the ED95 volume of 1% mepivacaine needed to block a peripheral nerve.

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Aug
2013

This report presents the case of a 51-year-old man who had an axillary arteriovenous fistula (AVF) as a complication of an axillary plexus block that was performed for internal fixation for a right forefinger phalanx fracture 4 years previously. While performing the axillary plexus block, a 22-gauge needle was placed inside the axillary sheath by observing the pulsations of the axillary artery. A pulsatile mass was found in the right axilla 1 day after the block was performed.

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Feb
2013

Cervical epidural steroid injections (CESI) are an accepted treatment for neck pain with a radicular component, and may be accomplished by using either transforaminal (CTFESI) or interlaminar (CILESI) approaches. CESIs are routinely performed using real-time fluoroscopic-guidance in conjunction with the injection of water soluble, iodine-based contrast media to enhance visualization of intravascular injections. Digital subtraction angiography (DSA) imaging is an adjuvant to fluoroscopic methods for visualizing blood vessels while performing spinal injections.

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Oct
2012

Surgery of carotid artery stenosis is an evidence-based procedure. In Germany approximately 25 percent of the strokes are caused by arteriosclerotic processes in the extracranial internal carotid artery and are consequently potentially avoidable by an appropriate treatment. The symptoms, the stenosis degree as well as the perioperative risk represent the basis for the indication.

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Jan
2013

Supplementing a local anaesthetic with epinephrine has advantages in hand surgery: faster onset of anaesthesia, extended effect of anaesthetics with prolonged pain reduction, decreased bleeding into the operative field, and abandoned need for tourniquet. We hypothesized that the use of ropivacaine with epinephrine additive in digits allows good skin perfusion rates with prolonged pain reduction.
In this prospective, double-blinded, randomized study with 20 volunteers (80 fingers, without operation) the chronological course of changes in digit blood flow, post injection pain status and complication rates after two-injection dorsal technique anaesthetic block with ropivacaine (group 1: ropivacaine 0.

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