Regional nerve blocks are useful far anesthetizing the hand and fingers, the foot and toes, and the face and mouth. These simple procedures may be performed prior to wound repair or surgery of the affected area. The a...
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Regional nerve blocks are useful far anesthetizing the hand and fingers, the foot and toes, and the face and mouth. These simple procedures may be performed prior to wound repair or surgery of the affected area. The authors discuss the indications, techniques, dosages, and potential complications of regional anesthesia.
Circumcision of male newborns is one of the most common procedures performed in the United States. Use of local anesthesia reduces the pain and distress associated with neonatal circumcision. Dr Mattson describes two ...
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Circumcision of male newborns is one of the most common procedures performed in the United States. Use of local anesthesia reduces the pain and distress associated with neonatal circumcision. Dr Mattson describes two techniques that provide effective anesthesia with minimal risks for newborns undergoing circumcision.
An attempt was made to illustrate radiologically the absorption of the anesthetic preparation after injection for paracervical block (PCB). 20 women were studied who were admitted for legal abortion in the 14th to 19t...
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An attempt was made to illustrate radiologically the absorption of the anesthetic preparation after injection for paracervical block (PCB). 20 women were studied who were admitted for legal abortion in the 14th to 19th wk of pregnancy. The mixture of contrast medium and anesthetic was injected at various sites and at various depths in order to study the absorption from the paracervical space during pregnancy. The experiences gained were used as a basis for an improved injection technique. The importance of the injection depth of no more than 3 mm was particularly emphasized. This means that the anesthetic preparation should always be deposited paracervically just below the epithelium. From here, a slow diffusion of the anesthetic preparation into the loose intravascular connective tissue occurs instead of, with deeper injections, being deposited directly into the venous plexus of the paracervical tissue, where the risk of intravascular injection is extremely great. At the same time, when the correct technique is used, the risk of depositing the anesthetic preparation in the lower uterine segment, the fetal presenting part, or the nervous plexus of the pelvic wall is avoided. Some other practical aspects are discussed. The improved injection technique was also used for a personal series of consecutive deliveries, over a 6 mth period including 134 patients who were given a total of 204 paracervical blocks. The anesthetic solution bupivacaine chloride (Marcaine) was used in a 0.25% solution with the addition of adrenaline 1 : 400,000 in a dose of 10 ml distributed at 4 injection sites in the lateral fornices. Apart from a considerably better analgesic effect than previously reported, maternal side effects were also completely lacking. Any PCB induced fetal effect was also extremely slight and is subjected to a detailed analysis in the work. With meticulous application of technique and dosage, paracervical block appears to be free from risk; but with the reservation tha
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