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tumescent anaesthesia

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https://www.readbyqxmd.com/read/30227790/a-practical-approach-to-tumescent-local-anaesthesia-in-ambulatory-endovenous-thermal-ablation
#1
Isaac K Nyamekye
Background Thermal ablation, usually performed with tumescent local anaesthesia (TLA), is the preferred method for varicose veins treatment. Tumescent local anaesthesia is always cited; however, little detail of the procedure is presented in publications. This retrospective audit of clinical tumescent local anaesthesia practice aims to provide detailed information on an important aspect of endovenous practice. Methods Patients who underwent three types of endothermal treatment (Venefit, Radiofrequency Induce Thermal Therapy and Endovenous Laser Ablation) to a single saphenous trunk using tumescent local anaesthesia were assessed...
September 18, 2018: Phlebology
https://www.readbyqxmd.com/read/30022718/staged-ultrasound-guided-liposuction-for-hidden-arteriovenous-fistulas-in-obese-patients
#2
Gabor Cs Nagy, Reiner Verwiebe, Matthias Wunsch
BACKGROUND: In obese patients with end stage renal disease, puncturing matured arteriovenous fistulas (AVF) that run deep under the skin surface may prove difficult. To achieve reliable puncturability, there are several surgical solutions. Superficialization with mobilization is common. With some newer options (lipectomy and liposuction) subcutaneous adipose tissue is surgically reduced. There are only a few authors who have published their experience with liposuction and we want to add our own results...
August 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29928084/autologous-emulsified-fat-injection-for-rejuvenation-of-scars-a-prospective-observational-study
#3
Lekshmi S Bhooshan, M Geetha Devi, R Aniraj, P Binod, M Lekshmi
Background: The skin rejuvenation potential of the autologous emulsified nanofat was studied by Tonnard et al . in 2013. This property is due to the viable adipose-derived stem cells present in the nanofat; although, there are no viable adipocytes. The aim of this study was to determine the aesthetic outcome of autologous emulsified nanofat injection in scars using a standardised and validated Patient Observer Scar Assessment Scale (POSAS) and photographs. Materials and Methods: A total of 34 patients with scars of varied aetiologies were included in the study as per inclusion criteria...
January 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29644283/plating-of-an-isolated-fracture-of-shaft-of-ulna-under-local-anaesthesia-and-periosteal-nerve-block
#4
Amir Adham Ahmad, Mohammad Arshad Ikram
Isolated fractures of shaft of ulna are common. Plate fixation with anatomic reduction is thought to produce the best functional results in closed or open fractures. Surgery can be done under general and various types of regional anaesthesia. We report a case of fracture shaft of ulna treated by plating under a combination of WALANT (wide awake, local anaesthesia, no tourniquet) using tumescent anaesthesia and periosteal nerve block as a day care procedure.
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29620000/lymph-node-dissection-for-melanoma-using-tumescence-local-anaesthesia-an-observational-study
#5
Lukas Kofler, Helmut Breuninger, Hans-Martin Häfner, Katrin Schweinzer, Saskia M Schnabl, Thomas K Eigentler, Ulrike Leiter
The possibility that tumescence local anaesthesia (TLA) may lead to dissemination of tumour cells in lymph nodes is presently unclear. To evaluate whether infiltration by TLA influences metastatic spread and survival probability, compared to general anaesthesia (GA), based on lymph node dissection in melanoma patients. In total, 281 patients (GA: 162; TLA: 119) with cutaneous melanoma and clinically or histologically-confirmed metastases in regional lymph nodes were included. All patients underwent complete lymph node dissection...
April 1, 2018: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/29240057/-experience-with-using-cyanoacrylate-glue-in-endovascular-treatment-of-varicose-veins
#6
E V Shaĭdakov, A Zh Mel'tsova, O Ia Porembskaia, E A Kudinova, D É Korzhevskiĭ, O V Kirik, E G Sukhorukova
The method of cyanoacrylate-mediated obliteration of subcutaneous veins is known to be an alternative to thermal endovascular obliteration and eliminates the need for tumescent anaesthesia. This technique is based on glue-induced damage to the venous intima, followed by immune response according to the delayed-type hypersensitivity principle. The authors report herein their first experience with using cyanoacrylate-mediated embolization in treatment of patients presenting with varicose veins. The operation was carried out using the VenaSeal closure system (Medtronic)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29205140/autologous-fat-transplantation-for-secondary-breast-reconstruction-our-experience
#7
F Simonacci, M P Grieco, N Bertozzi, E Raposio
BACKGROUND: Autologous fat transplantation is used after breast reconstruction to improve the breast profile. There are a variety of different methods used for fat harvesting, preparation, and reinjection. This study describes the specific techniques we used in this series of autologous fat transplantations in breast reconstruction patients and reports their outcomes compared with other studies in the literature. PATIENTS AND METHODS: At the University Hospital of Parma between May 2012 and December 2016, we performed 53 autologous fat transplantations for secondary breast reconstruction patients with an average age of 49 years (range: 34-65 y)...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28681498/tumescent-local-anaesthesia-for-early-dermatosurgery-in-infants
#8
M Heister, H M Häfner, H Breuninger, C Schulz, K Meier, L Kofler, C Spott, M Röcken, S M Schnabl, F C Eberle
BACKGROUND: Early paediatric dermatosurgery reveals excellent cosmetic results due to high skin elasticity and pronounced capacity to recover from trauma. Furthermore, the size of skin lesions increases during life proportionally to skin growth and therefore early removal is of major importance. Selected local anaesthetics like prilocaine can cause methaemoglobinemia. However, in contrast to general anaesthesia, many other local anaesthetics do not bare any major risks for infants. OBJECTIVE: In this retrospective study, we analysed infants aged less than 7 months receiving tumescent local anaesthesia (TLA) followed by dermatosurgery at our department between 2005 and 2015...
December 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28669458/mid-term-results-of-catheter-directed-foam-sclerotherapy-combined-with-tumescent-local-anaesthesia-for-treatment-of-great-saphenous-vein-incompetence
#9
H Ali, A Elbadawy, M Saleh, O Mahmoud
OBJECTIVES: The purpose of this prospective study was to evaluate the occlusion rate, clinical severity, disease specific health related quality of life (HRQoL), and safety in patients with great saphenous vein (GSV) reflux 3 years after a single treatment session of catheter directed foam sclerotherapy (CDFS) combined with peri-saphenous infiltration of tumescent local anaesthesia (TLA). METHODS: A total of 249 patients with symptomatic unilateral GSV incompetence underwent CDFS combined with TLA and were followed up for 3 years...
September 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28524054/surgical-treatment-of-rhinophyma-experience-from-a-german-cohort-of-70-patients
#10
Katrin Schweinzer, Lukas Kofler, Corinna Spott, Markus Krug, Claudia Schulz, Saskia M Schnabl, Helmut Breuninger, Hans-Martin Häfner, Franziska Carola Eberle
Rhinophyma is a deforming soft tissue hyperplasia of the nose and surgical removal represents the treatment of choice. Comprehensive data on surgical therapy and the impact of rhinophyma on patient quality of life are lacking. Patients who received surgery for rhinophyma between 2006 and 2015 were retrospectively evaluated for postoperative complications, clinical outcome, recurrence of rhinophyma, and the impact of rhinophyma on daily life. A total of 143 patients were treated with superficial tumour decortication by scalpel under tumescent anaesthesia...
June 1, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28509770/tumescent-anaesthesia-its-applications-and-well-tolerated-use-in-the-out-of-operating-room-setting
#11
REVIEW
Natalie F Holt
PURPOSE OF REVIEW: Tumescent anaesthesia is a method of administering dilute local anaesthetic into the subcutaneous tissue. Many anaesthesiologists are unfamiliar with the technique, its applications and potential risks. RECENT FINDINGS: The maximum safe dose of lidocaine with epinephrine in tumescent anaesthesia for liposuction is probably between 35 and 55 mg/kg. Without liposuction, the maximum dose of lidocaine with epinephrine should be no more than 28 mg/kg...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27981883/varicose-vein-therapy-and-nerve-lesions
#12
Tobias Hirsch
Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Non-thermal methods that can be applied without tumescent anaesthesia have been introduced to the market...
March 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27688037/hydrodisplacement-of-sural-nerve-for-safety-and-efficacy-of-endovenous-thermal-ablation-for-small-saphenous-vein-incompetence
#13
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
https://www.readbyqxmd.com/read/27552990/endovenous-laser-ablation-versus-mechanochemical-ablation-with-clarivein-%C3%A2-in-the-management-of-superficial-venous-insufficiency-lama-trial-study-protocol-for-a-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Clement C M Leung, Daniel Carradice, Tom Wallace, Ian C Chetter
BACKGROUND: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. MOCA combines physical damage to endothelium using a rotating wire, with the infusion of a liquid sclerosant...
August 24, 2016: Trials
https://www.readbyqxmd.com/read/27454649/technical-tip-for-proximal-release-during-open-carpal-tunnel-release-using-a-subcutaneous-pocket
#15
Dariush Nikkhah, Amir H Sadr, Mohammed Ali Akhavani
Technical steps to avoid incomplete proximal release of the carpal tunnel are described. Local anaesthesia is infiltrated as a subcutaneous bleb over the distal wrist crease and extending 2-3 cm over the forearm fascia. Tumescence of local anaesthesia into the subcutaneous plane helps create a pocket between the forearm fascia and subcutaneous tissues. Intraoperatively a subcutaneous pocket is made above the transverse carpal ligament and antebrachial fascia with blunt dissection. A retractor is placed under the pocket, which facilitates optimal visualization to allow reliable complete proximal release of compression...
June 2016: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/27306991/defining-the-optimum-tumescent-anaesthesia-solution-in-endovenous-laser-ablation
#16
Tom Wallace, Clement Leung, Sandip Nandhra, Nehemiah Samuel, Daniel Carradice, Ian Chetter
Objectives To produce a tumescent anaesthesia solution with physiological pH for endovenous thermal ablation and evaluate its influence on peri- and postoperative pain, clinical and quality of life outcomes, and technical success. Methods Tumescent anaesthetic solution (0.1% lidocaine with 1:2,000,000 epinephrine) was titrated to physiological pH by buffering with 2 ml incremental aliquots of 8.4% sodium bicarbonate. Patients undergoing great saphenous vein endovenous laser ablation and ambulatory phlebectomy were studied before and after introduction of buffered tumescent anaesthetic...
June 2017: Phlebology
https://www.readbyqxmd.com/read/27099242/efficacy-of-topical-local-anaesthesia-to-reduce-perioperative-pain-for-endovenous-laser-ablation-of-varicose-veins-a-double-blind-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Sunita Saha, Alok Tiwari, Charlotte Hunns, Jonathan Refson, Ahmed Abidia
OBJECTIVES: Tumescent local anaesthesia via multiple injections in the perivenous space leads to intraoperative and postoperative pain during endovenous laser ablation (EVLA). We considered whether the application of topical local anaesthesia reduces pain caused by these injections. METHODS: Eligible patients undergoing local anaesthetic EVLA were recruited and randomized to either application of topical local anaesthesia or water-based gel (placebo) to the inner thigh over the marked great saphenous vein...
August 2016: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/26556699/glue-steam-and-clarivein-best-practice-techniques-and-evidence
#18
REVIEW
Mark S Whiteley
In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins...
November 2015: Phlebology
https://www.readbyqxmd.com/read/26519807/penile-incerceration-a-tight-affair
#19
Faraj O Alkizim, Daniel Kanyata, Joseph Githaiga, Joseph Oliech
A patient presents with penile ring incarceration after using it for penile enlargement and prolonging tumescence. We present a case study of removal of the penile ring under local anaesthesia in a setting where cutting tools were inadequate.
2015: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26515225/nitrous-oxide-oxygen-inhalation-provides-effective-analgesia-during-the-administration-of-tumescent-local-anaesthesia-for-endovenous-laser-ablation
#20
Thomas Oleg Meier, Vincenzo Jacomella, Robert Karl Josef Clemens, Beatrice Amann-Vesti
BACKGROUND: Tumescent anaesthesia (TA) is an important but sometimes very painful step during endovenous thermal ablation of incompetent veins. The aim of this study was to examine whether the use of fixed 50% nitrous oxide/oxygen mixture (N2O/O2), also called equimolar mixture of oxygen and nitrous oxide, reduces pain during the application of TA. PATIENTS AND METHODS: Patients undergoing endovenous laser ablation (EVLA) of incompetent saphenous veins were included...
November 2015: VASA. Zeitschrift Für Gefässkrankheiten
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