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Local anesthetics

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https://www.readbyqxmd.com/read/29054121/multisensory-modulation-of-experimentally-evoked-perceptual-distortion-of-the-face
#1
Lilja K Dagsdóttir, Valeria Bellan, Ina Skyt, Lene Vase, Lene Baad-Hansen, Eduardo Castrillon, Peter Svensson
Chronic orofacial pain patients often perceive the painful face area as 'swollen' without clinical signs, i.e., a perceptual distortion (PD). Local anesthetic (LA) injections in healthy participants are also associated with PD OBJECTIVE: The aim was to explore whether PD evoked by LA into the infraorbital region of could be modulated by adding mechanical stimulation (MS) to the affected area METHODS: MS was given with a brush and a 128 mN von Frey filament. First, sixty healthy participants were randomly divided into three groups: 1) LA control, 2) LA with MS, 3) Isotonic solution (ISO) with MS as an additional control condition...
October 20, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29053523/enhanced-informed-consent-in-hand-surgery-techniques-to-improve-the-informed-consent-process
#2
Brent R DeGeorge, Anthony J Archual, Bruce D Gehle, Raymond F Morgan
The informed consent process is central to the practice of surgery. Rather than a single event or required form, informed consent should be an educational discussion between the surgeon and patient covering the proposed benefits, risks, potential complications, and alternatives of a given operation. The rise in medical malpractice claims in recent decades has placed ever greater importance on the informed consent process. Informed consent requires a patient with decision making capacity to comprehend the pertinent details of the proposed intervention...
October 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29053033/hyaluronidase-allergy-mimicking-orbital-cellulitis
#3
Nirav D Raichura, Md Shahid Alam, V V Jaichandran, Saurabh Mistry, Bipasha Mukherjee
PURPOSE: Hyaluronidase enzyme is a common additive with local anesthetic agent to facilitate faster permeation of the anesthetic in periocular tissues during ophthalmic surgery. We report a series of five subjects presenting with clinical features mimicking orbital cellulitis following peribulbar anesthesia and consequently diagnosed with hyaluronidase hypersensitivity. SETTING: The study was conducted at a tertiary eye care center in Southern India. DESIGN: It was a retrospective interventional case series...
October 20, 2017: Orbit
https://www.readbyqxmd.com/read/29049072/effect-of-stellate-ganglion-block-on-the-regional-hemodynamics-of-the-upper-extremity-a-randomized-controlled-trial
#4
Min Kyoung Kim, Myung Sub Yi, Pyung Gul Park, Hyun Kang, Jae Sung Lee, Hwa Yong Shin
BACKGROUND: The success of stellate ganglion block (SGB) is traditionally determined on the basis of findings such as Horner's syndrome, temperature rise in the face, hyperemia of the tympanic membrane, and nasal congestion. However, decreases in vascular resistance and increases in blood flow in the arm may be more meaningful findings. To date, the effect of SGB on the regional hemodynamics of the arm has not been evaluated using pulsed-wave Doppler ultrasound. METHODS: A total of 52 patients who were to undergo orthopedic surgery of the forearm were randomly assigned to either the mepivacaine group (SGB with 5 mL of 0...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#5
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29045055/c2-modified-sparteine-derivatives-are-a-new-class-of-potentially-long-acting-na-channel-blockers
#6
Vaibhavkumar S Gawali, Svilen Simeonov, Martina Drescher, Thomas Knott, Olaf Scheel, John Kudolo, Ulla Hochenegg, Alexander Roller, Hannes Todt, Nuno Maulide
The lupin alkaloid Sparteine is a well-known chiral diamine with a range of applications in asymmetric synthesis, as well as a blocker of voltage-gated Na channels (VGSCs). However, there is only scarce information on the VGSC-blocking activity of Sparteine derivatives where the structure of the parent alkaloid is retained. Herein, building on the recent renewed availability of Sparteine and derivatives we report how modification of Sparteine in position 2 produces irreversible blockers of VGSCs. These compounds could be clinically envisaged as long-lasting local anesthetics...
October 17, 2017: ChemMedChem
https://www.readbyqxmd.com/read/29043507/extraction-of-mandibular-premolars-and-molars-comparison-between-local-infiltration-via-pressure-syringe-and-inferior-alveolar-nerve-block-anesthesia
#7
Daniel G E Thiem, Florian Schnaith, Caroline M E Van Aken, Anne Köntges, Vinay V Kumar, Bilal Al-Nawas, Peer W Kämmerer
OBJECTIVES: The purpose of this study was to evaluate the anesthetic efficiency of local infiltration anesthesia administered with a pressure syringe (P-INF) via a special technique versus direct block anesthesia of the inferior alveolar nerve (IANB) for tooth extraction in the posterior mandible. MATERIALS AND METHODS: In a prospective randomized study, 101 teeth in 101 patients were extracted in the posterior mandible under local anesthesia whereby two different administration techniques were used (P-INF n = 48; IANB n = 53)...
October 17, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29042744/palatal-perforation-a-rare-complication-of-postanesthetic-necrosis
#8
Vidisha Gargi, Ravi Prakash Sasankoti Mohan, Nagaraju Kamarthi, Swati Gupta
The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042718/are-local-anesthesia-vials-similar-to-champagne-do-they-lose-their-potency-once-opened-an-in-vitro-study
#9
P S Gopinath Thilak, Sameep S Shetty, Jagadeesh Chandra, Kavana Gowda
BACKGROUND AND OBJECTIVES: Epinephrine is volatile and unstable on exposure to air. Addition of sodium metabisulfite as an antioxidant has been effective, but there are no clear-cut consensus on its efficiency in retarding the oxidation that sets in once the anesthetic vials are kept open with a needle in situ. There is a paucity of scientific data regarding the risks of reuse of anesthetic vials following the use of cartridges, a common practice in western countries. It is our endeavor to shed light on the constant change in pH, drug deterioration, and instability that sets in an anesthetic vial with a needle in situ...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042063/-pharmacokinetic-and-clinical-effects-of-two-bupivacaine-concentrations-on-axillary-brachial-plexus-block
#10
Leonardo H C Ferraro, Alexandre Takeda, Cleber N Barreto, Bernadete Faria, Nilson A Assunção
INTRODUCTION: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. METHODS: 30 patients were randomized...
October 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29039153/postoperative-analgesia-after-arthroscopic-shoulder-surgery-a-comparison-between-single-shot-interscalene-block-and-single-shot-supraclavicular-block
#11
Ahmet Kemalettin Koltka, Mehmet Büget, Emre Sertaç Bingül, Ali Erşen, Süleyman Küçükay, Ata Can Atalar, Mert Şentürk
OBJECTIVES: In arthroscopic rotator cuff surgery for postoperative analgesia opioids, nonsteroid analgesics, and local anesthetics can be used. This study aimed to compare the effectiveness, additional analgesic requirements, patients satisfaction, and complications of single-shot interscalene and supraclavicular blocks. METHODS: After obtaining the ethics committee's approval and informed consent, 50 ASA I-II patients were randomized to either the interscalene (GISB) or supraclavicular (GSCB) group...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/29037430/total-spinal-block-after-local-anesthetic-administration-through-the-wrong-access-port-of-a-spinal-infusion-pump
#12
Sensar
We present a case reported on the SENSAR database. A patient with a spinal infusion pump was admitted for reservoir refill. On administration of 22ml of 0.75% bupivacaine the patient suffered a total spinal block with widespread loss strength and respiratory arrest. The patient required emergency orotracheal intubation, mechanical ventilation and admission to ICU, where extubation was achieved within two hours without incidences. At a later stage it was stated that the local anaesthetic had been administered via the access port for bolus or contrast administration instead of via the access to the reservoir...
October 13, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29037195/comparison-between-xcelligence-biosensor-technology-and-conventional-cell-culture-system-for-real-time-monitoring-human-tenocytes-proliferation-and-drugs-cytotoxicity-screening
#13
Chih-Hao Chiu, Kin Fong Lei, Wen-Ling Yeh, Poyu Chen, Yi-Sheng Chan, Kuo-Yao Hsu, Alvin Chao-Yu Chen
BACKGROUND: Local injections of anesthetics, NSAIDs, and corticosteroids for tendinopathies are empirically used. They are believed to have some cytotoxicity toward tenocytes. The maximal efficacy dosages of local injections should be determined. A commercial 2D microfluidic xCELLigence system had been developed to detect real-time cellular proliferation and their responses to different stimuli and had been used in several biomedical applications. The purpose of this study is to determine if human tenocytes can successfully proliferate inside xCELLigence system and the result has high correlation with conventional cell culture methods in the same condition...
October 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29036728/a-retrospective-study-evaluating-the-effect-of-low-doses-of-perineural-dexamethasone-on-ropivacaine-brachial-plexus-peripheral-nerve-block-analgesic-duration
#14
Gregory D Schnepper, Benjamin I Kightlinger, Yunyun Jiang, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
Objective: Examination of the effectiveness of perineural dexamethasone administered in very low and low doses on ropivacaine brachial plexus block duration. Design: Retrospective evaluation of brachial plexus block duration in a large cohort of patients receiving peripheral nerve blocks with and without perineural dexamethasone in a prospectively collected quality assurance database. Setting: A single academic medical center. Methods: A total of 1,942 brachial plexus blocks placed over a 16-month period were reviewed...
September 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29035977/long-term-safety-of-using-local-anesthetic-injections-in-professional-rugby-league-for-modified-indications
#15
Safaa Sebak, John W Orchard, Leigh D Golding, Elizabeth Steet, Steph A Brennan, Ameer Ibrahim
OBJECTIVE: To assess and evaluate the long-term safety of local anesthetic injections before or during games in professional rugby league players. DESIGN: Retrospective case series; Level of evidence, 4. SETTING: Professional rugby league team. PARTICIPANTS: Sydney Roosters players over a 6-year period (2008-2013), who had been administered a local anesthetic injection for an injury before or during a match to aid return to play...
October 5, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#16
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29034443/prospective-clinical-study-comparing-intraligamentary-anesthesia-and-inferior-alveolar-nerve-block-for-extraction-of-posterior-mandibular-teeth
#17
P W Kämmerer, A Adubae, I Buttchereit, D G E Thiem, M Daubländer, B Frerich
OBJECTIVES: The aim of the study was to compare the efficacy of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) for extraction of mandibular posterior teeth. MATERIALS AND METHODS: In a prospective clinical trial, a total of 301 mandibular posterior teeth were extracted in 266 patients. Randomization was conducted into those who received ILA (patients n = 98; teeth n = 105) and those who received IANB (patient n = 140; teeth n = 140)...
October 15, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29033727/ultrasound-assessment-of-cranial-spread-during-caudal-blockade-in-children-effect-of-different-volumes-of-local-anesthetic
#18
Chandni Sinha, Amarjeet Kumar, Shalini Sharma, Akhilesh Kumar Singh, Somak Majumdar, Ajeet Kumar, Nishant Sahay, Bindey Kumar, U K Bhadani
BACKGROUND: Ultrasound-guided caudal block injection is a simple, safe, and effective method of anesthesia/analgesia in pediatric patients. The volume of caudal drug required has always been a matter of debate. MATERIALS AND METHODS: This present prospective, randomized, double-blinded study aimed to measure extent of the cranial spread of caudally administered levobupivacaine in Indian children by means of real-time ultrasonography. Ninety American Society of Anesthesiologists I/II children scheduled for urogenital surgeries were enrolled in this trial...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#19
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#20
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
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