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perineural local anesthetic adjuncts

Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
E Albrecht, C Kern, K R Kirkham
We systematically reviewed the safety and efficacy of perineural dexamethasone as an adjunct for peripheral nerve blockade in 29 controlled trials of 1695 participants. We grouped trials by the duration of local anaesthetic action (short- or medium- vs long-term). Dexamethasone increased the mean (95% CI) duration of analgesia by 233 (172-295) min when injected with short- or medium-term action local anaesthetics and by 488 (419-557) min when injected with long-term action local anaesthetics, p < 0.00001 for both...
January 2015: Anaesthesia
Neil S Bailard, Jaime Ortiz, Roland A Flores
PURPOSE: The therapeutic rationale, clinical effectiveness, and potential adverse effects of medications used in combination with local anesthetics for peripheral nerve block therapy are reviewed. SUMMARY: A wide range of agents have been tested as adjuncts to peripheral nerve blocks, which are commonly performed for regional anesthesia during or after hand or arm surgery, neck or spine surgery, and other procedures. Studies to determine the comparative merits of nerve block adjuncts are complicated by the wide variety of coadministered local anesthetics and sites of administration and by the heterogeneity of primary endpoints...
March 1, 2014: American Journal of Health-system Pharmacy: AJHP
Saule Svediene, Audrius Andrijauskas, Juozas Ivaskevicius, Andrius Saikus
PURPOSE: Optimal postoperative analgesia after anterior cruciate ligament repair remains challenging. The objective of this prospective experimental clinical study was to compare the postoperative analgesic efficacy of two infusion regimens of 0.1 % bupivacaine administered via perineural femoral catheter. METHODS: Forty adult ASA I and II patients undergoing anterior cruciate ligament reconstruction were enrolled. Surgery was performed under spinal anesthesia combined with femoral nerve block...
March 2013: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kalliopi Petroheilou, Stavros Livanios, Nikolaos Zavras, John Hager, Argyro Fassoulaki
BACKGROUND: The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. Most of the studies in adults have demonstrated the positive effects of clonidine on intra- and postoperative analgesia when used as an adjunctive agent or in some cases as a single to regional techniques. In the pediatric population, there are only few trials involving clonidine as an adjunct to regional anesthesia, and the analgesic benefits are not definite in this group of patients...
2012: BMC Anesthesiology
De Q H Tran, Loreto Muñoz, Gianluca Russo, Roderick J Finlayson
PURPOSE: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) offering blinded assessment and sample size justification, in order to determine the benefits associated with adjunctive ultrasonography (US) and stimulating perineural catheters for nerve blocks. SOURCE: The literature search for this review was conducted during the second week of December 2007 using the MEDLINE (January 1950 to November 2007) and EMBASE (January 1980 to November 2007) databases...
July 2008: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Leigh A Lamont, Kip A Lemke
OBJECTIVE: To compare the sensory and motor effects of adding medetomidine to mepivicaine, administered either perineurally or systemically, for radial nerve block in dogs. STUDY DESIGN: Prospective randomized cross-over study. ANIMALS: Six healthy Beagles, aged 18.7 +/- 6.3 months and weighing 10.4 +/- 1.3 kg. METHODS: Dogs were anesthetized briefly with sevoflurane on three separate occasions and received each treatment administered in random order: mepivacaine 5 mg kg(-1) perineurally around the radial nerve with saline 0...
January 2008: Veterinary Anaesthesia and Analgesia
S Mannion, S O'Callaghan, D B Murphy, G D Shorten
BACKGROUND: Tramadol has been administered peripherally to prolong analgesia after brachial plexus and neuraxial blocks. Our aim was to evaluate the systemic and perineural effects of tramadol as an analgesic adjunct to psoas compartment block (PCB) with levobupivacaine. METHODS: In a randomized, prospective, double-blinded trial, 60 patients (ASA I-III), aged 49-88 yr, undergoing primary total hip or knee arthroplasty underwent PCB and subsequent bupivacaine spinal anaesthesia...
March 2005: British Journal of Anaesthesia
J M Gracies, E Elovic, J McGuire, D M Simpson
Spasticity is a velocity-dependent increase in stretch reflex activity. It is one of the forms of muscle overactivity that may affect patients with damage to the central nervous system. Spasticity monitoring is relevant to function because the degree of spasticity may reflect the intensity of other disabling types of muscle overactivity, such as unwanted antagonistic co-contractions, permanent muscle activity in the absence of any stretch or volitional command (spastic dystonia), or inappropriate responses to cutaneous or vegetative inputs...
1997: Muscle & Nerve. Supplement
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