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Local Anaesthetics review

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https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#1
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#2
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29764889/autologous-stem-cells-in-achilles-tendinopathy-ascat-protocol-for-a-phase-iia-single-centre-proof-of-concept-study
#3
Andrew J Goldberg, Razi Zaidi, Deirdre Brooking, Louise Kim, Michelle Korda, Lorenzo Masci, Ruth Green, Paul O'Donnell, Roger Smith
INTRODUCTION: Achilles tendinopathy (AT) is a cause of pain and disability affecting both athletes and sedentary individuals. More than 150 000 people in the UK every year suffer from AT.While there is much preclinical work on the use of stem cells in tendon pathology, there is a scarcity of clinical data looking at the use of mesenchymal stem cells to treat tendon disease and there does not appear to be any studies of the use of autologous cultured mesenchymal stem cells (MSCs) for AT...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29753606/immunizations-under-sedation-at-a-paediatric-hospital-in-melbourne-australia-from-2012-2016
#4
Daryl R Cheng, Sonja Elia, Kirsten P Perrett
BACKGROUND: Sedation for immunizations is of particular importance in a subset of paediatric patients with anxiety disorders, needle phobia, developmental or behavioural disorders. The Royal Children's Hospital (RCH) Melbourne offers a unique immunization under sedation service for these patients. We aimed to evaluate the number and types of patients using inpatient sedation for immunizations, distraction and sedation techniques used, and outcomes of these procedures. METHODS: A medical record review was conducted on all patients who had immunization under sedation between January 2012 to December 2016 in the RCH Day Medical Unit (DMU)...
May 9, 2018: Vaccine
https://www.readbyqxmd.com/read/29753178/the-management-of-dorsal-peroneal-nerve-compression-in-the-midfoot
#5
Baljinder Singh Dhinsa, Laila Hussain, Sam Singh
The foot and ankle specialist will frequently encounter patients with dorsal midfoot pain in clinic. In the presence of midfoot pain and/or paraesthesia, nerve entrapment must be considered. The authors report the outcome of a case series of patients who underwent surgical release of the DPN. Between 2011-2017, a single surgeon operated on seven patients with a diagnosis of DPN entrapment. A retrospective review of the patient's clinical notes was performed, including the operative findings. The average age at presentation was 47 years (range, 31-70 years), and the left foot was affected in four cases...
December 28, 2017: Foot
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#6
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29707356/the-role-of-local-anaesthetic-techniques-in-eras-protocols-for-thoracic-surgery
#7
REVIEW
Seamus Crumley, Stefan Schraag
The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29706016/role-of-local-anaesthetic-nerve-block-in-endoscopic-sinus-surgery-a-systematic-review-and-meta-analysis
#8
E Shamil, M J Rouhani, S Basetti, F Bast, C Hopkins, P Surda
OBJECTIVE: The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS). DESIGN: The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946-2017). RESULTS: Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta-analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared to the control group (MD -0...
April 29, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29694674/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#9
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29666908/intravenous-local-anaesthetic-compared-with-intraperitoneal-local-anaesthetic-in-abdominal-surgery-a-systematic-review
#10
REVIEW
Wiremu S MacFater, Weisi Xia, Ahmed Barazanchi, Bruce Su'a, Darren Svirskis, Andrew G Hill
INTRODUCTION: Modern perioperative care strategies aim to optimise perioperative care by reducing the body's stress response to surgery. A major facet of optimising an abdominal surgery analgesia programme is using a multimodal opioid sparing approach. Local anaesthetics have shown promise and there has been considerable research into the most effective route for their administration. This review aims to determine if there is a difference in analgesic efficacy between intraperitoneal local anaesthetic (IPLA) and intravenous local anaesthetic (IVLA)...
April 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#11
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#12
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29498413/use-of-hyaluronidase-as-an-adjunct-to-local-anaesthetic-eye-blocks-to-reduce-intraoperative-pain-in-adults
#13
REVIEW
Heinrich RĂ¼schen, Kavitha Aravinth, Catey Bunce, Desta Bokre
BACKGROUND: Hyaluronidase has been used over many decades as an adjunct to local anaesthetic solution to improve the speed of onset of eye blocks and to provide better akinesia and analgesia. With the evolution of modern eye surgery techniques, fast onset and akinesia are not essential requirements anymore. The assumption that the addition of hyaluronidase to local anaesthetic injections confers better analgesia for the patient needs to be examined. There has been no recent systematic review to provide evidence that hyaluronidase actually improves analgesia...
March 2, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29491513/advances-in-regional-anaesthesia-a-review-of-current-practice-newer-techniques-and-outcomes
#14
REVIEW
Christopher Wahal, Amanda Kumar, Srinivas Pyati
Advances in ultrasound guided regional anaesthesia and introduction of newer long acting local anaesthetics have given clinicians an opportunity to apply novel approaches to block peripheral nerves with ease. Consequently, improvements in outcomes such as quality of analgesia, early rehabilitation and patient satisfaction have been observed. In this article we will review some of the newer regional anaesthetic techniques, long acting local anaesthetics and adjuvants, and discuss evidence for key outcomes such as cancer recurrence and safety with ultrasound guidance...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29479931/dexmedetomidine-as-an-adjunct-for-caudal-anaesthesia-and-analgesia-in-children-a-review
#15
Mehdi Trifa, Dmitry Tumin, Joseph D Tobias
BACKGROUND: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anaesthetic agents (LAA) for caudal blockade anaesthesia and analgesia in children. METHODS: A literature search was performed of the Medline, Embase, and CINAHL databases using the keywords "dexmedetomidine" and "caudal". We included all studies that used caudal dexmedetomidine as an adjuvant to a LAA in children, excluding case reports, reviews, expert opinions, and animal studies...
February 22, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29437732/fatal-air-embolism-following-local-anaesthetisation-does-needle-size-matter
#16
Faiza Khalid, Sofiya Rehman, Rania AbdulRahman, Shikha Gupta
A 76--year--old male cigarette smoker presented with a 2-week history of cough and haemoptysis. Chest CT on admission revealed multiple new lung nodules concerning for malignancy. CT--guided biopsy of the nodule in left lower lobe was attempted in prone oblique position for tissue diagnosis. Local anaesthetic (lidocaine) was administered using a 25--gauge (1.5-inch) needle to anaesthetise the skin and subcutaneous tissue. This was followed by insertion of a 25-gauge (3.5-inch) Whitacre needle to anaesthetise deeper tissues and parietal pleura...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29424493/is-it-safe-to-inject-local-anaesthetic-with-adrenaline-into-the-pinna-and-external-nose
#17
Emma Millar, Arthur Henderson, Angus Waddell
Adrenaline containing lidocaine preparations such as lignospan are routinely used in ear, nose and throat (ENT) care. Despite this, textbooks and internet resources warn against their use in peripheries, including the nose and ear. As a result, they are commonly avoided by other specialties, such as emergency medicine. This article reports on the findings of a review undertaken to assess the evidence of harm associated with using lignospan in the pinna and external nose. A literature search was carried out, and retrospective data were collected on all elective facial skin lesion surgery in the ENT department at the Great Western Hospital in Swindon between 2005 and 2015...
February 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29416155/erector-spinae-plane-block-as-an-alternative-to-epidural-analgesia-for-post-operative-analgesia-following-video-assisted-thoracoscopic-surgery-a-case-study-and-a-literature-review-on-the-spread-of-local-anaesthetic-in-the-erector-spinae-plane
#18
Sanjib Das Adhikary, Ashlee Pruett, Mauricio Forero, Venkatesan Thiruvenkatarajan
Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406172/the-impact-of-neuraxial-clonidine-on-postoperative-analgesia-and-perioperative-adverse-effects-in-women-having-elective-caesarean-section-a-systematic-review-and-meta-analysis
#19
REVIEW
T K Allen, B M Mishriky, R Y Klinger, A S Habib
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29377171/the-effect-of-adjusting-the-ph-of-local-anaesthetics-in-dentistry-a-systematic-review-and-meta-analysis
#20
REVIEW
P V Aulestia-Viera, M M Braga, M A Borsatti
The acidic nature of commercial local anaesthetics (LAs) can cause pain during infiltration and delay the onset of anaesthesia. It is suggested that adjusting the pH of anaesthetic agents could minimize these effects. This systematic review aimed to evaluate the efficacy of buffered LAs in reducing infiltration pain and onset time during dental procedures. MEDLINE, Embase, Scopus and Scielo databases were searched up to April 2017. Randomized controlled trials comparing buffered and unbuffered LAs for intraoral injections were included...
January 29, 2018: International Endodontic Journal
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