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Digital Block

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2881. Nitrous oxide vs periprostatic nerve block with 1% lidocaine during transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, controlled trial. (PubMed)

Nitrous oxide vs periprostatic nerve block with 1% lidocaine during transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, controlled trial. We compared the efficacy of Entonox (BOC Gases, Manchester, United Kingdom), a mixture of 50% nitrous oxide and oxygen, with periprostatic infiltration of 1% lidocaine to provide analgesia during transrectal ultrasound (TRUS) guided biopsy of the prostate.The study included 235 consecutive men undergoing TRUS guided biopsy (...) of the prostate for elevated prostate specific antigen or abnormal digital rectal examination. Patients were randomized to 3 groups, including group 1-84 controls who did not receive any form of analgesia prior to the procedure, group 2-75 who received periprostatic infiltration with 10 ml 1% lidocaine with biopsies performed 5 minutes after infiltration and group 3-76 who received Entonox for 2 minutes through a breath activated device prior to the procedure and thereafter according to patient preference

2003 The Journal of urology Controlled trial quality: uncertain

2882. Single-injection paravertebral block before general anesthesia enhances analgesia after breast cancer surgery with and without associated lymph node biopsy. (PubMed)

Single-injection paravertebral block before general anesthesia enhances analgesia after breast cancer surgery with and without associated lymph node biopsy. Paravertebral block (PVB) seems to decrease postoperative pain and postoperative nausea and vomiting (PONV) after breast surgery, but the studies have not been placebo controlled. We studied 60 patients scheduled for breast cancer surgery randomly given single-injection PVB at T3 with bupivacaine 5 mg/mL (1.5 mg/kg) or saline before general (...) anesthesia. The patient and attending investigators were blinded; the PVB or the sham block was performed behind a curtain by an anesthesiologist not involved in the study. The patients given PVB with bupivacaine needed 40% less IV opioid medication (primary outcome variable) in the postanesthesia care unit, had a longer latency to the first opioid dose, and had less pain at rest after 24 h than the control patients (P < 0.01). They also had less PONV in the postanesthesia care unit (P < 0.05), were less

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2004 Anesthesia and analgesia Controlled trial quality: uncertain

2883. The effects of continuous axillary brachial plexus block with ropivacaine infusion on skin temperature and survival of crushed fingers after microsurgical replantation. (PubMed)

there was a trend of increased skin temperature on the reconstructive digits in patients receiving continuous axillary brachial plexus block (Group A) as compared to those without receiving the block (Group B). Also, the difference in skin temperature (dT) differed slightly at 0, 9 and 21 hours postoperatively in Group A in comparison with Group B (0.75 +/- 0.65 vs. -2.33 +/- 1.24, 0.53 +/- 0.34 vs. -3.02 +/- 1.27, -0.125 +/- 0.55 vs. -2.33 +/- 0.91, p < 0.05). However, no patients in both groups received (...) a second operation or amputation of the graft.The result of this study demonstrated that axillary brachial plexus block with continuous infusion of 0.75% ropivacaine can increase the skin temperature, an index of tissue perfusion, of the reconstructive digits for 24 h after microvascular surgery of the crushed fingers. However, graft survival was good in both groups.

2005 Chang Gung medical journal Controlled trial quality: uncertain

2884. A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials

A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials Yin (...) Z G, Zhang J B, Kan S L, Wang P CRD summary This review evaluated digital block techniques for treating finger injuries. The authors concluded that traditional digital blocks and single subcutaneous palmar injection blocks produce similar injection pain, and are less painful than the transthecal digital block. Palmar techniques are associated with incomplete anaesthesia. Given the small number of variable and poor-quality studies, the reliability of the authors' conclusions is unclear. Authors

2006 DARE.

2885. Septic arthritis of the distal interphalangeal joint in cattle: comparison of digital amputation and joint resection by solar approach. (PubMed)

Septic arthritis of the distal interphalangeal joint in cattle: comparison of digital amputation and joint resection by solar approach. To determine in cattle with septic arthritis of the distal interphalangeal joint (SADIJ) the efficacy of resection of the distal interphalangeal joint (JRES) as a digit salvage technique compared with digital amputation (DAMP).Prospective, randomized clinical study.German Holstein-Friesian dairy cattle with SADIJ of 1 hind limb (n=52).SADIJ diagnosis was based (...) on clinical examination and radiography. Cows were randomly assigned with owner consent to DAMP (n=26) or JRES (n=26). After JRES, a wooden block was fixed to the partner claw in combination with a tipping claw prophylaxis.After surgery, degree of lameness improved significantly faster after DAMP than after JRES. New claw diseases in the opposite limb occurred more frequently after JRES (n=6) than after DAMP (n=1). New claw defects developed in the partner claw on the operated limb in 6 cows after DAMP

2007 Veterinary surgery : VS Controlled trial quality: uncertain

2886. Significant variations in nuclear structure occur between and within Gleason grading patterns 3, 4, and 5 determined by digital image analysis. (PubMed)

Significant variations in nuclear structure occur between and within Gleason grading patterns 3, 4, and 5 determined by digital image analysis. Alterations in nuclei structure and DNA content captured from Gleason grading patterns 3, 4 and 5 of radical prostatectomy (RP) cases were determined by a computer-assisted microscope. Quantitative Nuclear Morphometry (QNM) profiles were created to evaluate variability in nuclear structure within each of these grades.A tissue microarray (TMA (...) ) was constructed using RP cases and the prostate cancer (PCa) TMA cores prepared from 20 GG-3, 9 GG-4, 10 GG-5 patterns, and 20 benign cancer-adjacent cases from RP archival paraffin blocks. Feulgen-stained nuclei were captured from 0.6 mm spots using the AutoCyte system. Pools of 1100 nuclei captured from each test group were used to calculate Multivariate Logistic Regression (MLR) models that generated predictive indices and predictive probabilities (PP) to make comparisons between and within each set

2007 Prostate

2887. Digital anesthesia with epinephrine: an old myth revisited. (PubMed)

Digital anesthesia with epinephrine: an old myth revisited. The prohibition against the use epinephrine with local anesthetics for digital blocks or infiltrative anesthesia is an established dogma in dermatologic surgery. Major textbooks reinforce this teaching suggesting that there is substantial risk of digital gangrene caused by local anesthesia containing epinephrine.To provide a comprehensive literature review of the cases of digital necrosis associated with the use of local anesthesia (...) to provide evidence to support the dogma that block or infiltrative anesthesia with lidocaine and epinephrine produces digital necrosis. Proper injection technique and adequate selection of patients (absence of thrombotic, vasospastic conditions, or uncontrolled hypertension) are mandatory to minimize complications. The addition of epinephrine, in fact, reduces the need for the use of tourniquets and large volumes of anesthetic and provides better and longer pain control during digital procedures.

2004 Journal of American Academy of Dermatology

2888. Comparison of 2 endothelin-receptor antagonists on in vitro responses of equine palmar digital arterial and venous rings to endothelin-1 (PubMed)

Comparison of 2 endothelin-receptor antagonists on in vitro responses of equine palmar digital arterial and venous rings to endothelin-1 The goals of this study were to determine the concentration-response (C-R) relationship of endothelin-1 (ET-1), compare 2 ET-receptor antagonists and determine the antagonist concentrations that block the vasomotor effects of ET-1, and compare the effectiveness of ET-1 and previously studied vasoconstrictors in equine palmar digital arterial and venous rings (...) with norepinephrine and histamine (10(-10) to 10(-6) M) and comparison of contractile responses of medial and lateral vessel rings. In study I, ET-1 administration caused pronounced and sustained concentration-dependent contraction of vessel rings; these contractile responses were decreased by 10(-5) M PD142893 and were completely blocked by 10(-5) M PD145065. Venous rings had greater apparent maximum contraction in response to ET-1 than arterial rings. In study II, the relative sensitivity of norepinephrine

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2006 Canadian Journal of Veterinary Research

2889. Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training. (PubMed)

Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training. To determine whether recombinant equine growth hormone (rEGH) would alter the in vitro biomechanical properties of the forelimb superficial digital flexor tendon (SDFT) in exercising young Standardbred horses.Randomized complete block design.Twelve Standardbred yearlings.Horses were trained for 12 weeks on a high-speed treadmill (10

2005 Veterinary surgery : VS Controlled trial quality: uncertain

2890. Side-effects of beta-adrenoceptor blocking drugs assessed by visual analogue scales. (PubMed)

Side-effects of beta-adrenoceptor blocking drugs assessed by visual analogue scales. A series of visual analogue scales (VAS) was used to examine the prevalence of side-effects among hypertensive patients taking beta-adrenoceptor blocking drugs. When compared to untreated non-hypertensive control subjects, patients taking beta-adrenoceptor blockers had a greater prevalence of tired legs (P less than 0.001), cold digits (P less than 0.01), insomnia (P less than 0.01) and loss of overall

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1985 British journal of clinical pharmacology

2891. Effects of beta-adrenoreceptor-blocking drugs in patients with Raynaud's phenomenon. (PubMed)

Effects of beta-adrenoreceptor-blocking drugs in patients with Raynaud's phenomenon. Digital vasospastic phenomena have been reported to result from use of nonselective and cardioselective beta-adrenoreceptor-blocking drugs. The effects of 80 mg/day propranolol and 100 mg/day metoprolol on finger hemodynamics and clinical responses were compared with those of placebo in 16 patients with Raynaud's phenomenon. A double-blind, 2 week crossover study design was used with a 2 week washout placebo (...) the placebo period. A decrease in pulse rate occurred with both drugs and there was a decrease in blood pressure with metoprolol. There were no significant changes in the number of vasospastic attacks or in the patients' overall evaluation of their conditions while they were receiving the drugs. It is concluded that the presence of Raynaud's phenomenon is not a contraindication to the use of beta-adrenoreceptor-blocking drugs in the normotensive population.

1985 Circulation

2892. Hemodynamic properties of bucindolol, a beta-adrenoreceptor blocking drug with vasodilator activity. (PubMed)

Hemodynamic properties of bucindolol, a beta-adrenoreceptor blocking drug with vasodilator activity. Bucindolol is a new nonselective beta-adrenergic blocking agent with direct vasodilator, partial agonist and alpha-adrenergic blocking properties. Its hemodynamic effects were evaluated in 13 healthy young men. In an open study, the effects of increasing single oral doses (50 to 200 mg) were examined. Two hours after each dose there was little effect at rest, but the responses of heart rate (...) and systolic blood pressure to cycle exercise (50 to 150 W) were significantly reduced. There was no greater effect with larger doses. The second phase was a 3-way double-blind study comparing the effects of placebo with 50 and 200 mg of bucindolol. Left ventricular (LV) ejection phase indexes derived from digitized M-mode echocardiograms (% fractional shortening, mean and peak velocity of circumferential fiber shortening, stroke volume) increased more than 10% 2 and 4 hours after bucindolol

1986 The American journal of cardiology

2893. The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation. (PubMed)

The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation. Topical beta-blockers are the most common treatment for ocular hypertension in glaucoma, but their ocular hemodynamic effects are not well known. We investigated the acute effects of betaxolol (beta-1 selective antagonist), levobunolol (non-selective antagonist with active polar metabolite), and timolol (non-selective antagonist) on retinal and superficial optic nerve head (...) circulation.Intraocular pressure (IOP), heart rate, blood pressure, and retinal circulation were evaluated in 12 healthy subjects (6F/6M; mean age=24+/-2 years) before and two hours after instillation of each drug on separate occasions at least two weeks apart. Macular capillary blood velocity (MCBV), epipapillary blood velocities (EBV), arteriovenous passage (AVP) times, and arterial and venous diameters were measured by digital image analysis of scanning laser fluorescein angiograms.All drugs significantly (p<0.05

1998 Acta ophthalmologica Scandinavica Controlled trial quality: uncertain

2894. Anesthesia blocks of the lower extremity. Comparing the Biojector with needle and syringe. (PubMed)

, and digital anesthetic blocks. The results indicate that needle-free injection with the Biojector is equal to needle and syringe for some anesthesia blocks. More research in this area is needed to determine if technique with the Biojector has an impact on time of anesthesia onset or on level of discomfort and ecchymosis. (...) Anesthesia blocks of the lower extremity. Comparing the Biojector with needle and syringe. Podiatric surgical procedures frequently involve administration of preoperative local anesthesia, and because of the nature of these blocks, it is believed that needle-free injection could greatly enhance this aspect of clinical practice. The object of the study was to determine if needle-free injections with the Biojector were equivalent to needle and syringe injections for ankle, Mayo, neuroma, hallux

1996 Journal of the American Podiatric Medical Association Controlled trial quality: uncertain

2895. [Peri-prostatic nerve block at the level of the apex versus intrarectal lidocaine gel]. (PubMed)

), or 10 cc of 1% lidocaine solution injected into the apex to induce bilateral periprostatic nerve block (group 2). Pain was evaluated by a 10-point linear visual analogue pain scale (VAS), and a 5-point digital visual scale (DVS).96 patients were included in the study: 43 in group 1 and 53 in group 2. The mean pain score on the VAS was 2.76 +/- 1.69 and 1.73 +/- 1.26 for groups 1 and 2, respectively (p = 0.001). The DVS score was 2.26 +/- 0.82 and 1.62 +/- 0.56 for groups 1 and 2, respectively (p (...) [Peri-prostatic nerve block at the level of the apex versus intrarectal lidocaine gel]. After a review of the contradictory results of studies concerning periprostatic nerve block, the authors decided to prospectively evaluate the efficacy of periprostatic nerve block in the apex compared to the use of endorectal lidocaine gel.From January 2001 to January 2002, 110 patients underwent prostatic biopsies. Patients were randomized to receive 10 cc of 2% lidocaine gel in the endorectal (group 1

2002 Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie Controlled trial quality: uncertain

2896. Periprostatic nerve block gives better analgesia for prostatic biopsy. (PubMed)

Periprostatic nerve block gives better analgesia for prostatic biopsy. To prospectively compare two local anaesthetic techniques for prostatic biopsies, which are usually taken with no anaesthesia; because multiple biopsy techniques are becoming more common and there is an increasing need for analgesia/anaesthesia during the procedure.The study group comprised 86 consecutive men (median age 67.7 years) undergoing prostatic biopsy because of either an abnormality of prostate specific antigen (...) level or digital rectal examination. They were randomized into four groups; men in group 1 received 10 mL of 1% lignocaine infiltrated into the periprostatic nerve plexus bilaterally; men in group 2 received 11 mL of 2% lignocaine gel rectally; men in groups 3 and 4 were recruited as controls, and given either plain gel rectally or an injection with saline into the periprostatic nerve plexus. Sextant prostate biopsies were taken in all cases using a standardized protocol. Immediately after

2002 BJU international Controlled trial quality: uncertain

2897. Intravenous regional anesthesia (Bier block) in a dog. (PubMed)

Intravenous regional anesthesia (Bier block) in a dog. Intravenous regional anesthesia was used in an adult dog as part of a balanced approach to general anesthesia for amputation of the 4th digit of its right hind limb. It allowed the concentration of isoflurane to be reduced to 0.5%.

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1999 The Canadian Veterinary Journal

2898. Evaluation and treatment of chronic digital ischemia. (PubMed)

Evaluation and treatment of chronic digital ischemia. Forty-two patients were evaluated and treated during the past five years at the Union Memorial Hospital Hand Center with the diagnosis of chronic digital ischemia. These patients with this syndrome, manifested by pain, severe cold intolerance and occasional tip ulceration, all were failures of conventional conservative treatment of vasodilators, tobacco abstinence and beta blocking agents. The evaluation consisted of first ruling out large (...) vessel disease by noninvasive techniques of angiography. The patients underwent a variety of noninvasive diagnostic tests including Doppler examination, pulse volume recordings with cold stress, radioisotope scanning of the digital circulation and peripheral sympathetic block of the digital nerves. Treatment included direct microvascular reconstruction of the distal ulnar or radial artery and palmar arch, in ten patients, thermal biofeedback, in 22 patients and a new surgical procedure-digital

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1981 Annals of Surgery

2899. Digital blood flow and 5-hydroxytryptamine receptor blockade after ketanserin in patients with Raynaud's phenomenon. (PubMed)

in digital pulse volume; platelet aggregation by changes in light transmission after challenge with 10(-5) M 5-HT. 4. Ketanserin induced a rise in digital blood flow and blocked the platelet response to 5-HT; the two events were not correlated and were independent of subjective improvement. 5. These data do not support the suggestion that 5-HT2-receptor blockade is of major importance in the dilatory effect of ketanserin in Raynaud's phenomenon. (...) Digital blood flow and 5-hydroxytryptamine receptor blockade after ketanserin in patients with Raynaud's phenomenon. 1. The effect of ketanserin on digital blood flow and 5-hydroxytryptamine (5-HT)-induced platelet aggregation was studied in 18 patients with Raynaud's phenomenon. 2. Measurements were made before and after a single dose of 20 mg ketanserin and again after 1 month of continuous treatment with 20 mg ketanserin three times a day. 3. Digital blood flow was assessed by changes

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1990 British journal of clinical pharmacology

2900. Differing calcium sensitivities of human cerebral and digital arteries, human metatarsal veins, and rat aorta. (PubMed)

Differing calcium sensitivities of human cerebral and digital arteries, human metatarsal veins, and rat aorta. 1. The effects of the voltage dependent calcium channel blocking agent nifedipine, and of a calcium free bathing medium, on the responses of human blood vessels obtained postmortem to various agonists have been compared with those of the rat aorta. The human vessels studied were digital arteries, basilar arteries and metatarsal veins. 2. Responses to potassium chloride (5-80 mM (...) ), noradrenaline (10(-9)-10(-4) M), 5-hydroxytryptamine (10(-8)-10(-4) M) and U46619 (10(-11)-10(-6) M), in the presence and absence of nifedipine (1, 10, and 100 nM) or in a calcium-free bathing medium, were assessed using an area-under-curve analysis. 3. In general, the order of sensitivity of the vessels to inhibition of agonist induced contractures by nifedipine was basilar arteries greater than metatarsal veins = digital arteries = rat aorta. 4. For all the vessels, the order of sensitivity for antagonism

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1991 British journal of clinical pharmacology

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