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Local Anaesthetics review

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https://www.readbyqxmd.com/read/29161394/managing-anaesthetic-provision-for-global-disasters
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
September 27, 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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#14
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/28869700/efficacy-of-amc-dcba-lozenges-for-sore-throat-a-systematic-review-and-meta-analysis
#15
Gesine Weckmann, Anke Hauptmann-Voß, Sebastian E Baumeister, Christine Klötzer, Jean-François Chenot
BACKGROUND: Lozenges containing Amylmetacresol and 2,4-Dichlorobenzylalcohol (AMC/DCBA, eg Strepsils(®) ) are marketed as a remedy for acute sore throat. This over-the-counter formulation has antiseptic and local anaesthetic qualities. OBJECTIVES: The objective of this systematic review and meta-analysis is to evaluate the efficacy and safety of AMC/DCBA for the relief of pain associated with acute uncomplicated sore throat. METHODS: A systematic review of Literature was conducted using databases Medline, Embase and Cochrane to identify randomised controlled trials comparing AMC/DCBA against placebo or alternative local treatment options for acute uncomplicated sore throat...
September 4, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28854551/efficacy-of-perineural-vs-systemic-dexamethasone-to-prolong-analgesia-after-peripheral-nerve-block-a-systematic-review-and-meta-analysis
#16
M Baeriswyl, K R Kirkham, A Jacot-Guillarmod, E Albrecht
Perineural dexamethasone has gained popularity in regional anaesthesia to prolong the duration of analgesia, but its advantage over systemic administration is disputed. The objective of this meta-analysis was to compare the analgesic efficacy of both routes of administration during peripheral nerve block. The methodology followed the PRISMA statement guidelines. The primary outcome was the duration of analgesia analysed according to the type of local anaesthetic administered (bupivacaine or ropivacaine). Secondary outcomes included cumulative opioid consumption in morphine i...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28844590/surgical-approaches-anaesthetic-management-and-outcome-in-pediatric-superior-mediastinal-tumors
#17
Gehad Ahmed, Mohammed M Hegazy, Tarek Raafat, Hanafy Hafez, Sayed Fadel, Maged Elshafiey
BACKGROUND: Pediatric superior mediastinal tumors are a heterogeneous group of tumors with marked variation in pathology and extension. We reviewed our experience with different surgical approaches to tumors originating from or extending to superior mediastinum in pediatrics. PATIENTS AND METHODS: The medical records of all patients who had undergone resection for superior mediastinal tumors in Children's Cancer Hospital - Egypt, between January 2008 to December 2015, were reviewed for demographic data, clinico-pathological features, radiologic findings, operative techniques and outcome...
August 22, 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/28794532/local-anaesthetic-systemic-toxicity-following-oral-ingestion-in-a-child-revisiting-dibucaine
#18
Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28776593/relationship-between-the-phenylephrine-test-and-eyelid-droop-after-aponeurotic-repair-with-the-use-of-an-epinephrine-containing-local-anaesthetic
#19
H Matsuda, T Shiba, Y Takahashi, H Tsuneoka
PurposeTo analyse the relationship between the results of the phenylephrine test and postoperative eyelid droop in transcutaneous aponeurotic repair using epinephrine-containing local anaesthetic for aponeurotic blepharoptosis.Patients and methodsWe retrospectively reviewed the medical records of 66 eyelids from 40 patients who underwent transcutaneous aponeurotic repair. A positive phenylephrine test result was defined as an increase in margin reflex distance-1 (MRD-1) ≥0.5 mm after application of phenylephrine eye drops...
August 4, 2017: Eye
https://www.readbyqxmd.com/read/28763315/efficacy-and-safety-of-buprenorphine-in-peripheral-nerve-blocks-a-meta-analysis-of-randomised-controlled-trials
#20
Alexander Schnabel, Sylvia U Reichl, Peter K Zahn, Esther M Pogatzki-Zahn, Christine H Meyer-Frießem
BACKGROUND: The duration of analgesia provided by nerve blocks is limited if local anaesthetics are administered alone. Therefore, a variety of additives to local anaesthetics have been investigated to prolong postoperative analgesia following single-shot nerve blocks. OBJECTIVE(S): The aims of the current meta-analysis were to assess the efficacy and safety of the addition of perineural buprenorphine to local anaesthetic compared with local anaesthetic alone, or combined with systemic administration of buprenorphine, or other perineural opioids for peripheral nerve blocks...
September 2017: European Journal of Anaesthesiology
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