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alternative local anesthesia

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https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-eras-pathways-for-open-and-laparoscopic-colorectal-surgery
#1
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28721992/comparative-evaluation-of-effectiveness-of-intra-pocket-anesthetic-gel-and-injected-local-anesthesia-during-scaling-and-root-planing-a-split-mouth-clinical-trial
#2
Kalyan Chintala, Sandhya Pavan Kumar, K Raja V Murthy
BACKGROUND AND AIM: Pain control is an important outcome measure for successful periodontal therapy. Injected local anesthesia has been used to secure anesthesia for scaling and root planing (SRP) and continues to be the anesthetic of choice for pain control. Alternatively, intra-pocket anesthetic gel has been used as an anesthetic during SRP. Hence, this clinical trial was done to compare the effectiveness of intra-pocket anesthetic gel and injected local anesthesia during SRP and also to assess the influence of intra-pocket anesthetic gel on treatment outcomes in chronic periodontitis patients...
May 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/28697780/local-infiltration-of-analgesia-and-sciatic-nerve-block-provide-similar-pain-relief-after-total-knee-arthroplasty
#3
Hidenori Tanikawa, Kengo Harato, Ryo Ogawa, Tomoyuki Sato, Shu Kobayashi, So Nomoto, Yasuo Niki, Kazunari Okuma
BACKGROUND: Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). METHODS: Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA...
July 11, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28659769/propofol-sevoflurane-and-ketamine-induce-a-reversible-increase-in-delta-gamma-and-theta-gamma-phase-amplitude-coupling-in-frontal-cortex-of-rat
#4
Dinesh Pal, Brian H Silverstein, Lana Sharba, Duan Li, Viviane S Hambrecht-Wiedbusch, Anthony G Hudetz, George A Mashour
Studies from human and non-human species have demonstrated a breakdown of functional corticocortical connectivity during general anesthesia induced by anesthetics with diverse molecular, neurophysiological, and pharmacological profiles. Recent studies have demonstrated that changes in long-range neural communication, and by corollary, functional connectivity, might be influenced by cross-frequency coupling (CFC) between the phase of slow oscillations and the amplitude of local fast oscillations. Phase-amplitude coupling (PAC) between slow oscillations and alpha rhythm during general anesthesia reveal distinct patterns depending on the anesthetic...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28653424/anesthetic-ointment-only-lidocaine-prilocaine-instead-of-injectable-local-lidocaine-in-trans-radial-catheterization-a-viable-no-needle-alternative
#5
George Latsios, Kostas Toutouzas, Alexios S Antonopoulos, Eleni Melidi, Andreas Synetos, Georgia Vogiatzi, Aggeliki Stasinopoulou, Kostas Tsioufis, Eleftherios Tsiamis, Dimitrios Tousoulis
OBJECTIVE: The aim of the present study was to assess the level of access site pain in patients undergoing transradial coronary catheterization by using topical application of an anesthetic ointment (lidocaine/prilocaine-AO) compared to standard local anesthesia (LA) by means of injectable lidocaine. METHODS: We prospectively studied 444 patients undergoing elective trans-radial coronary angiography. The quality of analgesia was assessed using a visual analogue scale (VAS) immediately after the puncture and 30 min after the removal of the sheath...
June 26, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#6
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#7
Cristina Modesti, Paola Aceto, Lucia Masini, Celestino Pio Lombardi, Rocco Bellantone, Liliana Sollazzi
Thyroid carcinoma is the first cancer found in general population and the second diagnosed during pregnancy following the breast one. Diagnostic and therapeutic approaches to thyroid malignancy in pregnant women pose several and serious issues to the physicians. Even if there is no consensus about the surgical treatment of thyroid carcinomas during pregnancy, a large number of women undergo surgery over the world. The best surgical and anesthesiological treatment should be chosen after reaching a consensus between surgeons, anesthesiologists, obstetrics, and the patients...
June 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28632818/benefits-of-islet-transplantation-as-an-alternative-to-pancreas-transplantation-retrospective-study-of-more-than-10-ten-years-of-experience-in-a-single-center
#8
Barbora Voglová, Martina Zahradnická, Peter Girman, Jan Kríž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lenka Németová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Ivan Leontovyc, Tomáš Neškudla, Jan Peregrin, Jozef Kovác, Kvetoslav Lipár, Matej Kocík, Tomáš Marada, Jirí Svoboda, František Saudek
BACKGROUND: Pancreas transplantation (PTx) represents the method of choice in type 1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. In 2005, the Institute for Clinical and Experimental Medicine (IKEM) launched a program to investigate the safety potential of islet transplantation (ITx) in comparison to PTx. AIM: This study aims to compare the results of PTx and ITx regarding severe hypoglycemia elimination, metabolic control, and complication rate...
2017: Review of Diabetic Studies: RDS
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#9
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28619306/management-of-viral-oral-ulcers-in-children-using-chinese-herbal-medicine-a-report-of-two-cases
#10
Yi-Chiao Lee, Ting-Hao Wang, Shih-Yu Chen, Hsiang-Ling Lin, Ming-Yen Tsai
OBJECTIVE: Viral oral ulcers are common presentations in pediatric clinics. Although self-limiting, painful ulcerative lesions and inflamed mucosa can decrease oral intake and lead to dehydration. Despite the widespread use of Chinese herbal medicine (CHM) for pediatric upper respiratory disease in Taiwan, there is little evidence for its effectiveness as an antipyretic or in aiding ulcer healing for children with viral oral ulcers. We report two cases of children who presented with viral oral ulcers to illustrate the potential efficacy of CHM treatment in recovery from herpangina (HA) and herpetic gingivostomatitis (HGS)...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28611004/an-in-situ-forming-phospholipid-based-phase-transition-gel-prolongs-the-duration-of-local-anesthesia-for-ropivacaine-with-minimal-toxicity
#11
Hanmei Li, Tao Liu, Yuxuan Zhu, Qiang Fu, Wanxia Wu, Jie Deng, Li Lan, Sanjun Shi
An injectable, phospholipid-based phase transition gel (PPTG) has been developed for prolonging the release of ropivacaine (RO) for local anesthesia. PPTG was prepared by mixing phospholipids, medium-chain triglyceride and ethanol. Prior to injection, the PPTG is in a sol state with low viscosity. After subcutaneous injection, the PPTG rapidly forms a gel in situ, which acts as a drug release depot as verified by in vitro release profiles and in vivo pharmacokinetics. Administering RO-PPTG to rats led to a significantly smaller initial burst release than administering RO solution or RO base suspension...
June 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28570661/breakdown-of-local-information-processing-may-underlie-isoflurane-anesthesia-effects
#12
Patricia Wollstadt, Kristin K Sellers, Lucas Rudelt, Viola Priesemann, Axel Hutt, Flavio Fröhlich, Michael Wibral
The disruption of coupling between brain areas has been suggested as the mechanism underlying loss of consciousness in anesthesia. This hypothesis has been tested previously by measuring the information transfer between brain areas, and by taking reduced information transfer as a proxy for decoupling. Yet, information transfer is a function of the amount of information available in the information source-such that transfer decreases even for unchanged coupling when less source information is available. Therefore, we reconsidered past interpretations of reduced information transfer as a sign of decoupling, and asked whether impaired local information processing leads to a loss of information transfer...
June 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28546768/effectiveness-of-various-formulations-of-local-anesthetics-and-additives-for-topical-anesthesia-a-prospective-randomized-double-blind-placebo-controlled-study
#13
Christian Weilbach, Christian Hoppe, Matthias Karst, Michael Winterhalter, Konstantinos Raymondos, Arthur Schultz, Niels Rahe-Meyer
BACKGROUND: Topical anesthesia is used to control pain associated with many procedures in medicine. Today, the product most commonly applied for topical anesthesia in Germany is EMLA(®) (lidocaine/prilocaine). However, since prilocaine is a methemoglobin-inducing agent, there are limitations to its use, especially in neonates and infants. The aim of this study was to evaluate the effect of prilocaine and lidocaine as well as propylene glycol, a penetration enhancer, and trometamol, a buffer substance, in anesthetic creams...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28546120/local-anesthesia-for-endovascular-treatment-of-unruptured-intracranial-aneurysms-feasibility-safety-and-periprocedural-complications
#14
Jihye Song, Na Rae Yang, Cheol-Young Lee
OBJECTIVE: The aim of the study is to report the feasibility, safety, and outcomes associated with endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) under local anesthesia. METHODS: Between March 2011 and December 2016, 184 consecutive patients with 198 UIAs were treated with coil embolization under local anesthesia at the author's center. The data about medical comorbidities according to American Society of Anesthesiologists grade, procedural details, and clinical and radiographic outcomes were reviewed...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#15
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#16
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28514241/phrenic-nerve-palsy-and-regional-anesthesia-for-shoulder-surgery-anatomical-physiologic-and-clinical-considerations
#17
Kariem El-Boghdadly, Ki Jinn Chin, Vincent W S Chan
Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery...
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28509777/ultrasound-guided-percutaneous-cryoneurolysis-for-acute-pain-management-a-case-report
#18
Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld
We report 3 different cases in which ultrasound-guided percutaneous cryoneurolysis was performed to treat acute pain: 1 patient with refractory incisional pain after percutaneous nephrolithotomy; 1 patient with burns to the foot; and 1 patient with pain from iliac crest grafting. Acute pain associated with surgery or injury is a challenge to treat with local anesthetic-based regional anesthesia techniques when the anticipated pain duration exceeds a few days. Cryoneurolysis is an alternative analgesic method that utilizes extremely cold temperatures to reversibly ablate peripheral nerves and is potentially a novel method for acute pain management...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28484650/efficacy-of-keyhole-approach-to-carpal-tunnel-syndrome-under-ambulatory-strategy
#19
Rodrigo Ramos-Zúñiga, César J García-Mercado, Iván Segura-Durán, Luis A Zepeda-Gutiérrez
The carpal tunnel syndrome is one of the most common entrapment neuropathies found in humans. Currently, the gold standard is surgical treatment using different modalities. The minimally invasive strategy with high resolution capacity and less morbidity is still a challenge. Methods. Prospective nonrandomised clinical trial in which a minimally invasive microsurgical approach was used following the keyhole principle in 55 consecutive patients and 65 hands under local anesthesia and ambulatory strategy. They were evaluated with stringent inclusion criteria with the Levine severity and functional status scale and with a 2-year follow-up...
2017: Neurology Research International
https://www.readbyqxmd.com/read/28481763/in-plane-ultrasound-guided-knee-injection-through-a-lateral-suprapatellar-approach-a-safe-technique
#20
Francisco A Chagas-Neto, Atul K Taneja, Everaldo Gregio-Junior, Marcello H Nogueira-Barbosa
PURPOSE: This study aims to describe a technique for in-plane ultrasound-guided knee arthrography through a lateral suprapatellar approach, reporting its accuracy and related complications. METHODS: A retrospective search was performed for computed tomography and magnetic resonance reports from June 2013 through June 2015. Imaging studies, puncture descriptions, and guided-procedure images were reviewed along with clinical and surgical history. A fellowship-trained musculoskeletal radiologist performed all procedures under sterile technique and ultrasound guidance with the probe in oblique position on the lateral suprapatellar recess after local anesthesia with the patient on dorsal decubitus, hip in neutral rotation, and 30 to 45 degrees of knee flexion...
June 2017: Ultrasound Quarterly
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