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Local Anaesthetics review

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https://www.readbyqxmd.com/read/29313904/peripheral-nerve-injury-arising-in-anaesthesia-practice
#1
REVIEW
D W Hewson, N M Bedforth, J G Hardman
In this article, we will discuss the pathophysiology of peripheral nerve injury in anaesthetic practice, including factors which increase the susceptibility of nerves to damage. We will describe a practical and evidence-based approach to the management of suspected peripheral nerve injury and will go on to discuss major nerve injury patterns relating to intra-operative positioning and to peripheral nerve blockade. We will review the evidence surrounding particular strategies to reduce the incidence of peripheral nerve injury during nerve blockade, including nerve localisation methods, timing of blocks, needle techniques and design, injection pressure-monitoring and local anaesthetic and adjunct choice...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29305377/are-corticosteroid-injections-more-beneficial-than-anaesthetic-injections-alone-in-the-management-of-rotator-cuff-related-shoulder-pain-a-systematic-review
#2
REVIEW
Tim Cook, Catherine Minns Lowe, Mark Maybury, Jeremy S Lewis
OBJECTIVE: To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP). DESIGN: Systematic review with best evidence synthesis. DATA SOURCES: The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Reference lists of included articles were also hand searched. ELIGIBILITY CRITERIA: Two reviewers independently evaluated eligibility...
January 5, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29225780/the-decision-to-delivery-interval-in-emergency-caesarean-sections-impact-of-anaesthetic-technique-and-work-shift
#3
Anette Hein, David Thalen, Ylva Eriksson, Jan G Jakobsson
Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS). A Decision to Delivery Interval (DDI) <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA), spinal anaesthesia (SPA) with opioid supplementation, or "top-up" of labour epidural analgesia (tEDA) with local anaesthesia and fentanyl mixture) and work shift for ECS at Danderyds Hospital, Sweden...
2017: F1000Research
https://www.readbyqxmd.com/read/29182798/pharmacological-interventions-for-pain-relief-during-orthodontic-treatment
#4
REVIEW
Aoife B Monk, Jayne E Harrison, Helen V Worthington, Annabel Teague
BACKGROUND: Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29177072/efficacy-of-platelet-rich-plasma-injections-for-symptomatic-tendinopathy-systematic-review-and-meta-analysis-of-randomised-injection-controlled-trials
#5
Larry E Miller, William R Parrish, Breana Roides, Samir Bhattacharyya
Aim: To determine the efficacy of platelet-rich plasma (PRP) injections for symptomatic tendinopathy. Design: Systematic review of randomised, injection-controlled trials with meta-analysis. Data sources: Systematic searches of MEDLINE and EMBASE, supplemented by manual searches. Eligibility criteria for selecting studies: Randomised controlled trials with 3 months minimum follow-up that evaluated pain reduction with PRP versus control (saline, local anaesthetic, corticosteroid) injections in patients with symptomatic tendinopathy...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/29170283/local-anaesthetics-combined-with-vasoconstrictors-in-patients-with-cardiovascular-disease-undergoing-dental-procedures-systematic-review-and-meta-analysis-protocol
#6
Caio Chaves Guimaraes, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi, Jimmy de Oliveira Araújo, Natalia Karol de Andrade, Mabel Fernandes Figueiró, Juliana Cama Ramacciato, Luciane Cruz Lopes
INTRODUCTION: The use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes. METHOD/DESIGN: Trials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors...
November 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29162621/needle-use-declarations-at-the-olympic-games-rio-2016
#7
Molly Allen, Mark Campbell Stuart, Hannah Gribble, Richard Budgett, Andrew Pipe
AIM: We report on the results of the 'IOC Needle Policy' applied during the course of the Games of the XXXI Summer Olympiad in Rio de Janeiro, Brazil. The policy was intended to empower physicians to ensure appropriate clinical use of needles within team medical environments, enhance the safety of those responsible for housekeeping services and others in the Olympic environment, and permit documentation of such procedures as an adjunct to the doping control programme. Any needle use required the submission of an 'Injection Declaration Form' to IOC medical officials...
November 21, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29161394/managing-anaesthetic-provision-for-global-disasters
#8
R M Craven
The numbers of people affected by large-scale disasters has increased in recent decades. Disasters produce a huge burden of surgical morbidity at a time when the affected country is least able to respond. For this reason an international disaster response is often required. For many years this disaster response was not coordinated. The response consisted of what was available not what was needed and standards of care varied widely producing a healthcare lottery for the affected population. In recent years the World Health organisation has initiated the Emergency Medical Team programme to coordinate the response to disasters and set minimum standards for responding teams...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#9
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29119061/emla-anaesthetic-cream-for-debridement-of-burns-a-study-of-plasma-concentrations-of-lidocaine-and-prilocaine-and-a-review-of-the-literature
#10
Stefan Lillieborg, Leif Aanderud
The lidocaine-prilocaine cream (EMLA(TM)) effectively reduces the pain from debridement of chronic leg ulcers. Studies have demonstrated that when applied to leg ulcers, plasma concentrations of the local anaesthetics are well below the threshold for CNS toxicity. However, there are minimal pharmacokinetic data available from EMLA application to burn wounds. This study evaluated EMLA cream for debridement of burns with regard to plasma concentrations of lidocaine and prilocaine, and reviewed the published literature on safety and efficacy of lidocaine-prilocaine applied epicutaneously to burns...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/29111790/early-adopters-of-perioperative-medicine-who-are-they-and-what-motivates-them
#11
C Groves, A Whiteman, G Kumar, R Stephens, D Walker
Perioperative medicine is an emerging specialty aimed at improving outcomes in the high-risk surgical population. The authors set out to characterize the demographics and determine the motivation of 'early adopters' of this specialty by retrospectively reviewing the application forms of students enrolled on the UCL Perioperative Medicine Masters Programme. A total of 139 applications were reviewed. The median age of applicants was 35 years; 81% were UK based, with the remainder from a worldwide distribution...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29067198/an-extended-release-local-anaesthetic-potential-for-future-use-in-veterinary-surgical-patients
#12
REVIEW
B Duncan X Lascelles, Kristin Kirkby Shaw
One of the most effective means of preventing the transduction and transmission of acute and perioperative pain is through the use of local anaesthetics. However, local anaesthetics currently available have a relatively short duration of action. Although there are several tools available to treat perioperative pain in companion animals, overall, there is an unmet need for products that can be administered in the clinic, and provide pain relief for the crucial first few days following surgery in the home environment...
November 2016: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29054510/safety-and-efficiency-in-a-canadian-outpatient-gynaecological-surgical-centre
#13
Caroline E Lee, Annette Epp
OBJECTIVE: This study sought to describe safety and efficiency outcomes for patients undergoing procedures at the Women's Health Centre, an outpatient gynaecological surgical centre in Saskatoon, SK. METHODS: A retrospective chart review of surgical outpatient health records was conducted for the period of July 2014 to June 2015. Data were abstracted using a standardized data form for patient admissions during the study period. Primary outcomes of interest included procedure time, lead time (registration to discharge), complication rates, readmission rates, and reoperation rates...
October 17, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29034840/non-anaesthetic-effects-of-volatile-anaesthetics-a-short-trip-on-the-sea-of-translational-medicine
#14
Lukasz J Krzych, Anna J Szczepanska
BACKGROUND: Volatile anaesthetics (VA) are commonly used worldwide for induction and/or maintenance of general anaesthesia. They act in the central nervous system to reduce sensation and motor response during surgical and invasive diagnostic procedures. VAs also have some non-anaesthetic properties in the brain when administrated to patients at the extremes of age. Their biological impact on other organs should be taken into account during administration of anaesthesia. OBJECTIVE: In this review we summarize the recent knowledge on the non-anaesthetic effects of inhaled halogenic ethers on cells and tissues...
October 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28992753/pelvic-vein-embolisation-of-gonadal-and-internal-iliac-veins-can-be-performed-safely-and-with-good-technical-results-in-an-ambulatory-vein-clinic-under-local-anaesthetic-alone-results-from-two-years-experience
#15
Mark S Whiteley, Chiyinde Lewis-Shiell, Sophia I Bishop, Eluned L Davis, Tim J Fernandez-Hart, Previn Diwakar, David Beckett
Objectives Pelvic vein embolisation is increasing in venous practice for the treatment of conditions associated with pelvic venous reflux. In July 2014, we introduced a local anaesthetic "walk-in walk-out" pelvic vein embolisation service situated in a vein clinic, remote from a hospital. Methods Prospective audit of all patients undergoing pelvic vein embolisation for pelvic venous reflux. All patients had serum urea and electrolytes tested before procedure. Embolisation coils used were interlock embolisation coils (Boston Scientific, USA) as they can be repositioned after deployment and before release...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28972589/articaine-and-neurotoxicity-a-review
#16
A J G Hopman, J A Baart, H S Brand
The biochemical composition of articaine differs from other amide anaesthetics. The lipophilic part of articaine consists of a thiophene ring, whereas other amide anaesthetics contain a benzene ring. When used correctly, local anaesthetics are remarkably safe. However, all local anaesthetics are potentially neurotoxic. In rare cases a prolonged abnormal perception/sensation may be present after the expected duration of action (paraesthesia). In several countries retrospective studies have been conducted that examined the incidence of persistent paraesthesia after the use of local anaesthetics...
November 2017: British Dental Journal
https://www.readbyqxmd.com/read/28953311/short-title-anaesthetic-mechanisms-in-the-cns-where-and-how-do-anaesthetics-act-mec
#17
Tomohiro Yamamoto, Ehrenfried Schindler
General anaesthesia is a balance of hypnosis, amnesia, analgesia, and immobility, including the inhibition of noxious autonomic reflexes. Local anaesthesia implements the latter two elements in a conscious patient. This review article discusses several important aspects of anaesthesia, beginning with basic concepts such as the minimum alveolar concentration and afterwards developing into a discussion about the mechanisms of action of anaesthetics on a cellular level, introducing electrophysiological investigations in the brain to study hypnosis and amnesia, in the dorsal horn of the spinal cord to study analgesia and the inhibition of noxious reflexes, and in the ventral horn of the spinal cord to study immobility, separately...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28913921/analgesic-efficacy-of-local-infiltration-analgesia-vs-femoral-nerve-block-after-anterior-cruciate-ligament-reconstruction-a-systematic-review-and-meta-analysis
#18
REVIEW
K R Kirkham, S Grape, R Martin, E Albrecht
Many published reports consider blockade of the femoral nerve distribution the best available analgesic treatment after anterior cruciate ligament reconstruction. However, some argue that an alternative approach of infiltrating local anaesthetic into the surgical site has similar efficacy. The objectives of this meta-analysis were to compare the analgesic and functional outcomes of both treatments following anterior ligament reconstruction. The primary outcomes were pain scores at rest (analogue scale, 0-10) in the early (0-2 postoperative hours), intermediate (3-12 hours) and late postoperative periods (13-24 hours)...
December 2017: Anaesthesia
https://www.readbyqxmd.com/read/28911283/australian-and-new-zealand-anaesthetic-allergy-group-perioperative-anaphylaxis-investigation-guidelines
#19
R J Scolaro, H M Crilly, E J Maycock, P T McAleer, K A Nicholls, M A Rose, Rih The
These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28894618/percutaneous-emergency-needle-caecostomy-for-prevention-of-caecal-perforation
#20
Alexandra M Limmer, Zackariah Clement
Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic...
2017: Case Reports in Surgery
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