In spite of the great strides made by general anesthesia to date, conduction anesthesia has gained increasing importance in temporary relief of pain itself as well as in enabling surgeons to carry out some minor procedures that must be done immediately or are performed more easily this way (e. g., in cases of dislocated shoulder). If blocking a nerve is accompanied by positive effects on other organs, thereby improving the condition of a patient (e. g., spreading of solution to stellate ganglion in brachial plexus block and thereby possibly improving an existing hypoxic cardiac state), it is preferred to a general anesthetic. If metabolic disorders are present (such as diabetes), routine intubation anesthesia carries a certain risk. Such risks may not exist if the (simple) required procedure is carried out under a nerve block. It should, however, be recalled that nerve blocking should not be performed in children under about 10 to 12 years of age. Also neurasthenics, neurotics, and depressive patients (these latter presenting possible symptoms of organic diseases as signs of their psychic disorder) do not allow one to expect good results from therapeutic blocks. The majority of pathologic states that may be ameliorated by nerve blocking are presented together with the respective blocking procedure. Some indications are not generally accepted but are included because of the experience of the author. One basic principle is imperative and generally accepted: Only the smallest amount of anesthetic in a solution of the lowest possible concentration of which a certain effect is to be expected should be used.
KeywordsLocal Anesthetic Nerve Block Brachial Plexus Block Muscular Relaxation Percent Solution
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