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Local anaesthetics

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https://www.readbyqxmd.com/read/29456391/the-use-of-thromboelastography-to-measure-the-influence-inclusion-of-a-local-anesthetic-agent-has-on-the-mechanical-and-kinetic-properties-of-fibrin
#1
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
Context: Delivery of slow-release local anesthesia has considerable potential for postoperative analgesia. Fibrin gel has shown huge potential for drug delivery, but has not been fully investigated for the delivery of local anesthetics nor has whether incorporation of anesthetic drugs into fibrin alters its mechanical properties. Aims: This study aimed to evaluate the effects of bupivacaine inclusion on the mechanical and kinetic properties of fibrin as measured by thromboelastography (TEG)...
January 2018: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#2
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29446060/effect-of-adding-midazolam-to-bupivacaine-during-rectus-sheath-block-a-randomised-controlled-trial
#3
A Ammar, K Mahmoud, Z Kasemy
BACKGROUND: Various adjuvants have been tried to improve quality and increase duration of local anaesthetics during various nerve blocks. We aimed to evaluate the effect of adding midazolam to bupivacaine on rectus sheath (RS) block in patients undergoing umbilical or epigastric hernia repair. METHODS: In all, 60 adult patients were divided into two equal groups, each group included 30 patients. Group I received 20 ml of bupivacaine hydrochloride 0.25% + midazolam 50 μg/kg in 2 ml saline 0...
February 14, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29442191/measurement-and-implications-of-the-distance-between-the-sphenopalatine-ganglion-and-nasal-mucosa-a-neuroimaging-study
#4
Joan Crespi, Daniel Bratbak, David Dodick, Manjit Matharu, Kent Are Jamtøy, Irina Aschehoug, Erling Tronvik
BACKGROUND: Historical reports describe the sphenopalatine ganglion (SPG) as positioned directly under the nasal mucosa. This is the basis for the topical intranasal administration of local anaesthetic (LA) towards the sphenopalatine foramen (SPF) which is hypothesized to diffuse a distance as short as 1 mm. Nonetheless, the SPG is located in the sphenopalatine fossa, encapsulated in connective tissue, surrounded by fat tissue and separated from the nasal cavity by a bony wall. The sphenopalatine fossa communicates with the nasal cavity through the SPF, which contains neurovascular structures packed with connective tissue and is covered by mucosa in the nasal cavity...
February 13, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29442160/peri-articular-injection-of-an-analgesic-mixture-in-primary-total-hip-arthroplasty-an-effective-strategy-for-pain-control-during-the-first-post-operative-day
#5
Maria Bautista, Meilyn Muskus, Adolfo Llinás, Guillermo Bonilla, Carlos Guerrero, Jairo Moyano
BACKGROUND: Previous studies of soft tissue infiltration in hip arthroplasty present variable results. The purpose of this study is to identify whether injection of an analgesic mixture improves pain management during the immediate post-operative period. MATERIALS AND METHODS: This cohort study compared 129 patients that received peri-articular soft tissue injection with 20 ml of 0.25% bupivacaine and 2 ml of ketorolac (30 mg/1 ml) in 28 ml of saline solution, with 71 patients who did not received injections...
February 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29441574/intrathecal-pramoxine-causes-long-lasting-spinal-sensory-and-motor-block-in-rats
#6
An-Kuo Chou, Chong-Chi Chiu, Ming-Ming Han, Yu-Wen Chen, Jhi-Joung Wang, Ching-Hsia Hung
OBJECTIVES: The objective of this experiment was to investigate spinal anaesthetic effects of pramoxine and its comparison with bupivacaine, a long-lasting local anaesthetic. METHODS: After intrathecal injection, three neurobehavioural assessments, which consisted of nociceptive, proprioceptive and motor block, were constructed in rats. The effects of bupivacaine and pramoxine (four doses of each drug) in a dose-related manner were conducted to obtain the ED 50 (50% effective dose)...
February 13, 2018: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/29437732/fatal-air-embolism-following-local-anaesthetisation-does-needle-size-matter
#7
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
#8
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/29422576/neighbourhood-incidence-rate-of-paediatric-dental-extractions-under-general-anaesthetic-in-south-west-england
#9
P J Lucas, D Patsios, K Walls, P Neville, P Harwood, J G Williams, J Sandy
Introduction Extraction of decayed teeth is the most common reason for UK children aged 5-9 years to receive a general anaesthetic. Inequalities in oral health are well recognised, but is under-explored in dental general anaesthesia (DGA).Methods Secondary analysis of routinely collected data from three local authorities in South West England was used to assess: 1) dental activities recorded for children <18 years attending NHS general dental practitioners (GDP); 2) the incidence rate of DGA and disease severity among <16-year-olds; and 3) individual and neighbourhood factors associated with higher rates of child DGA, and greater severity of disease...
February 9, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29421432/dc-evoked-modulation-of-excitability-of-myelinated-nerve-fibres-and-their-terminal-branches-differences-in-sustained-effects-of-dc
#10
Dominik Kaczmarek, Elzbieta Jankowska
Direct current (DC) evokes long-lasting changes in neuronal networks both presynaptically and postsynaptically and different mechanisms were proposed to be involved in them. Different mechanisms were also suggested to account for the different dynamics of presynaptic DC actions on myelinated nerve fibres stimulated before they entered the spinal grey matter and on their terminal branches. The aim of the present study was to examine whether these different dynamics might be related to differences in the involvement of K+ channels...
February 5, 2018: Neuroscience
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
#11
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/29415859/effects-of-transdermal-lidocaine-or-lidocaine-with-prilocaine-or-tetracaine-on-mechanical-superficial-sensation-and-nociceptive-thermal-thresholds-in-horses
#12
Franz J Söbbeler, Sabine Br Kästner
OBJECTIVE: To evaluate the transdermal local anaesthetic effect of lidocaine or lidocaine combined with prilocaine or tetracaine in horses. STUDY DESIGN: Experimental, randomized study. ANIMALS: A total of five healthy adult warmblood horses. METHODS: Horses were clipped bilaterally at the withers, cranial saddle area and caudal saddle area. Baseline measurements for mechanical superficial sensation via von Frey filaments and nociceptive thermal thresholds were performed...
December 2, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29406181/local-anaesthetic-dosage-of-peripheral-nerve-blocks-in-children-analysis-of-40%C3%A2-121-blocks-from-the-pediatric-regional-anesthesia-network-database
#13
S Suresh, G S De Oliveira
BACKGROUND: The knowledge regarding appropriate dosage of local anaesthetics for peripheral nerve blocks in children is very scarce. The main objective of the current investigation was to evaluate dosing patterns of local anaesthetics in children receiving peripheral nerve blocks across multiple paediatric hospitals in the USA. We also sought to estimate the incidence of local anaesthetic systemic toxicity. METHODS: This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406174/high-dose-versus-low-dose-local-anaesthetic-for-transversus-abdominis-plane-block-post-caesarean-delivery-analgesia-a-meta-analysis
#14
REVIEW
S C Ng, A S Habib, S Sodha, B Carvalho, P Sultan
BACKGROUND: The optimal local-anaesthetic (LA) dose for transversus-abdominis-plane (TAP) block is unclear. In this meta-analysis, we aimed to determine whether TAP blocks for Caesarean delivery (CD) with low-dose (LD) LA demonstrated non-inferiority in terms of analgesic efficacy, compared with high-dose (HD) LA. METHODS: A literature search was performed for randomised controlled trials examining the analgesic efficacy of TAP blocks vs control after CD. The different dosing used in these studies was classified as HD or LD (bupivacaine equivalents >50 or ≤50 mg per block side, respectively)...
February 2018: British 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
#15
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/29405670/low-concentration-distal-nerve-blocks-with-0-125-levobupivacaine-versus-systemic-analgesia-for-ambulatory-trapeziectomy-performed-under-axillary-block-a-randomized-controlled-trial
#16
Mireia Rodríguez, FJavier González, Sergi Sabaté, Mercedes García, Claudia Lamas, Adrià Font, Marisa Moreno, Ignasi Proubasta, M Àngels Gil, M Victoria Moral, Rolf Hoffmann
BACKGROUND: Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anaesthetic versus conventional systemic analgesia. METHODS: Fifty-two patients undergoing trapeziectomy were randomized to receive levobupivacaine 0.125% 5ml on radial and median nerves at the elbow (dNB group), or not to receive these blocks (control group)...
February 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29397793/loco-regional-versus-general-anaesthesia-for-elective-endovascular-aneurysm-repair-results-of-a-cohort-study-and-a-meta-analysis
#17
Shahin Hajibandeh, Shahab Hajibandeh, Kelvin Adasonla, Stavros A Antoniou, Janet Barrie, Manmohan Madan, George A Antoniou
BACKGROUND: The aim of this study was to investigate whether patients undergoing elective endovascular aneurysm repair (EVAR) with loco-regional anaesthetic techniques have better outcomes than those treated with general anaesthesia (GA). PATIENTS AND METHODS: We retrospectively evaluated outcomes of EVAR performed with regional anaesthesia (RA) or GA over a five-year period. Furthermore, we searched electronic bibliographic sources (MEDLINE, EMBASE, CINAHL, and CENTRAL) to identify studies comparing different anaesthetic methods in EVAR...
February 5, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29377171/the-effect-of-adjusting-the-ph-of-local-anaesthetics-in-dentistry-a-systematic-review-and-meta-analysis
#18
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 in 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
https://www.readbyqxmd.com/read/29373333/adding-sufentanil-to-ropivacaine-in-continuous-thoracic-paravertebral-block-fails-to-improve-analgesia-after-video-assisted-thoracic-surgery-a-randomised-controlled-trial
#19
Christian Bauer, Isabelle Pavlakovic, Catherine Mercier, Jean-Michel Maury, Catherine Koffel, Pascal Roy, Jean-Luc Fellahi
BACKGROUND: The benefit of adding opioid to a local anaesthetic for continuous thoracic paravertebral analgesia after video-assisted thoracic surgery (VATS) is unclear. OBJECTIVES: To analyse the analgesic efficacy of ropivacaine and sufentanil in combination compared with ropivacaine alone after VATS. DESIGN: A randomised, double-blinded, single-centre clinical trial. SETTING: A tertiary university hospital between March 2010 and April 2014...
January 25, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29364797/anaesthesia-in-dental-medicine-with-local-infiltrative-anaesthetic-technique-versus-diploe-anaesthesia-delivery-systems-efficacy-and-behaviour-an-experimental-study
#20
Manuel Marques-Ferreira, Eunice Carrilho, Siri Paulo, Teresa Carrilho, José Pedro Figueiredo, Ricardo Macedo
INTRODUCTION: This study aimed to compare the analgesic efficacy and the influence of local infiltrative anesthesia techniques, with diploe anesthesia, on the cardiac rhythmMaterial and Methods: We selected 32 healthy volunteers who were given both anaesthetic techniques on tooth 1.4 (0.45 mL of lidocaine with adrenaline, 1:80 000). In the first phase, the volunteers underwent periapical infiltrative anaesthesia. In the second phase, diploe anaesthesia was performed with a QuickSleeper® device...
December 29, 2017: Acta Médica Portuguesa
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