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Xavier Sala-Blanch

Publications and source records attributed to Xavier Sala-Blanch.

7 recordsLinked to original sources
PubMed2005

Nerve stimulation in regional anesthesia: theory and practice.

There is now an accumulation of extensive and varied experience with the use of electrical stimulation for verifying the close approximation of needle and nerve, and for increasing the corresponding success rate. The application of this experience has been of proven benefit in the teaching of regional anesthetic techniques, in the performing of difficult nerve blocks, and in the use of novel accesses, resulting in decreased morbidity and a reduced requirement for local anesthetic. Nerve stimulation can also be used in uncooperative patients and in anesthetized individuals or patients under the effects of CNS depressors, although the risk of intraneural injection of local anesthetic is not eliminated in such cases. Putting the accummulated knowledge into practice is not simply a question of using electrical stimulation to elicite an artificial muscle contraction. Sound knowledge of the anatomy of the area to be blocked, the muscle territory subsidiary to the nerve in question, the applied neurophysiology, and the pharmacology of the local anesthetic used are needed. This chapter reviews the most important aspects, from nerve anatomy and physiology, to electrical features of the needle, and devices used for the updated clinical application of nerve stimulation in the practice of plexus regional anesthesia.

Anesthesia, Conduction↗
PubMed2005

Analgesic effects of epidurally administered levogyral ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs undergoing ovariohysterectomy.

OBJECTIVE: To evaluate the analgesic and adverse effects of epidurally administered levogyral (S[+]) ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs undergoing ovariohysterectomy. ANIMALS: 30 dogs scheduled for ovariohysterectomy. PROCEDURE: Dogs were randomly allocated to 1 of 3 groups. Dogs in group 1 received S(+) ketamine (1 mg/kg), dogs in group 2 received S(+) ketamine (0.5 mg/kg) and morphine (0.05 mg/kg), and dogs in group 3 received S(+) ketamine (1 mg/kg) and morphine (0.025 mg/kg). The skin was incised 15 minutes after epidural administration of analgesics. Heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), oxygen saturation as measured by pulse oximetry, and arterial blood gases were obtained before anesthesia, 15 minutes after epidural administration of analgesics, 15 and 30 minutes after initiation of surgery, and at the end of surgery. During the intraoperative period, an increase of > or =20% in baseline values for HR, RR, and SBP was considered a sign of intraoperative pain. Signs of pain and adverse effects were assessed at 2, 4, and 8 hours postoperatively. RESULTS: There were no significant differences in intraoperative or postoperative measurements among the 3 groups. No dogs had intraoperative signs of pain. Mean postoperative pain assessment scores were <3.5 in all 3 groups. Salivation was the most frequent adverse effect in dogs in groups 1 and 3, and sedation occurred more frequently in dogs in groups 2 and 3. CONCLUSIONS AND CLINICAL RELEVANCE: All 3 analgesic regimens provided good respiratory and cardiovascular stability intraoperatively and adequate postoperative analgesia with minimal adverse effects.

Analgesia, Epidural↗
PubMed2004

Image-guided techniques for peripheral nerve blocks.

PURPOSE OF REVIEW: Success of plexus nerve block is most dependent upon the correct positioning of the local anaesthetic solution within proximity to the corresponding nerve trunk. With the aim of verifying the close approximation of needle and nerve, and increasing the corresponding success rate, in the course of the history of regional anaesthesia, and in addition to the classical methods like seeking of paraesthesia, different mechanical aids have been used for nerve detection. In the last two decades, important medical diagnostic and therapeutic advances in imaging technology have been presented. In this review we will analyse the role such imaging diagnostic procedures will play in regional anaesthesia practice. RECENT FINDINGS: Last developments in the field have produced increased interest in the application of imaging techniques in regional anaesthesia. Of special interest are ultrasound and low radiation x-ray techniques for location of the needle in relation with neural structures. SUMMARY: In this paper we will analyse which imaging techniques are of relevance to anaesthesia in terms of clinical outcome, research and teaching of regional anaesthetic techniques, and the clinical impact of such imaging techniques upon anaesthesia practice.

Journal Article↗