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Pain on arterial cannulation

Dirk Rüsch, Tilo Koch, Florian Seel, Leopold Eberhart
OBJECTIVES: Local infiltration with lidocaine is a frequently used measure to prevent pain during arterial cannulation. Its administration is associated with pain. Vapocoolants like ethyl chloride or alkanes also affect rapid-onset anesthesia. However, their administration causes less discomfort compared with administration of lidocaine. The effectiveness of vapocoolants in mitigating discomfort associated with arterial cannulation never has been studied. The authors therefore compared vapocoolant with lidocaine for reducing discomfort caused by arterial cannulation...
June 8, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Kenji Yoshida, Eri Tanaka, Hiroyoshi Kawaai, Shinya Yamazaki
To obtain effective infiltration anesthesia in the jawbone, high concentrations of local anesthetic are needed. However, to reduce pain experienced by patients during local anesthetic administration, low-pressure injection is recommended for subperiosteal infiltration anesthesia. Currently, there are no studies regarding the effect of injection pressure on infiltration anesthesia, and a standard injection pressure has not been clearly determined. Hence, the effect of injection pressure of subperiosteal infiltration anesthesia on local anesthetic infiltration to the jawbone was considered by directly measuring lidocaine concentration in the jawbone...
2016: Anesthesia Progress
Peter K Sculco, Lionel E Lazaro, Edwin P Su, Craig E Klinger, Jonathan P Dyke, David L Helfet, Dean G Lorich
BACKGROUND: Surgical hip dislocation allows circumferential access to the femoral head and acetabulum and is utilized in the treatment of intra-articular hip disorders. Surgical hip dislocation is currently performed with a trochanteric osteotomy that reliably preserves the femoral head arterial supply; however, trochanteric nonunion or painful hardware requiring removal may occur. In a cadaveric model, using gadolinium-enhanced magnetic resonance imaging (MRI) and gross dissection, we evaluated whether modifications to the posterior approach preserve the femoral head arterial supply after a posterior surgical hip dislocation...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
Ayumi Shirota, Tetsuya Nomura, Hiroshi Kubota, Shunta Taminishi, Ryota Urata, Takeshi Sugimoto, Yusuke Higuchi, Taku Kato, Natsuya Keira, Tetsuya Tatsumi
INTRODUCTION: Because of the unusual anatomy of an anomalous origin of the right coronary artery from the left sinus of Valsalva, selective cannulation of the guiding catheter in percutaneous coronary intervention for these cases is always challenging. CASE PRESENTATION: A 58-year-old Japanese man was admitted to our hospital complaining of worsening exertional chest pain. He was suspected of having unstable angina pectoris and underwent cardiac catheterization...
2015: Journal of Medical Case Reports
Claudio Morselli, Paolo Chiari, Tiziana Aliberti, Guglielmo Celli, Silvia Catalani, Ignazia Miale, Vanessa Melandri, Lorenza Bianchi
BACKGROUND: Current protocols recommend the use of a blunt needle to access the arteriovenous fistula via a buttonhole. This study aims to demonstrate whether a sharp needle can be used at the same buttonhole site without causing complications. GOAL: To measure and compare fistula cannulation failures between the use of blunt and sharp needles. PLAN: Open-crossover randomised controlled trial. PARTICIPANTS: Adult out-patients who had provided consent and were on dialysis with a mature arteriovenous fistula and buttonhole cannulation...
December 2015: Journal of Renal Care
Koray Akkan, Emetullah Cindil, Koray Kilic, Erhan Ilgit, Baran Onal, Gonca Erbas
PURPOSE: We report on the endovascular management of hemorrhage with stent-graft due to a misplaced central venous catheter in the vertebral artery (VA) during percutaneous internal jugular vein catheterization in a child. METHODS: A 16-year-old female was presented with the diagnosis of familial Mediterranean fever related chronic renal insufficiency. An attempt was made to place a central venous catheter via the right internal jugular vein without image guidance and the patient experienced dyspnea and pain at the catheter insertion site...
September 2014: Journal of Vascular Access
Raghunath Prabhu, Rajgopal Shenoy, Nitin Thinda, Anisha Patel, Sakshi Sadhu
Obtaining an intravenous (IV) access is a simple procedure which can be done in almost any hospital setting. One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra-arterially, which can potentially lead to life altering consequences. In the hope that these types of events can be prevented, we are presenting a case of a 57-year-old male who underwent bougie dilatation for an oesophageal stricture and was accidentally given medication for pain management intra-arterially through an improperly placed IV line, which resulted in ischaemia, gangrene and subsequent loss of the hand...
March 2014: Journal of Clinical and Diagnostic Research: JCDR
Tomasz Gołębiowski, Mariusz Kusztal, Ewa Wątorek, Jerzy Garcarek, Krzysztof Letachowicz, Wacław Weyde, Marian Klinger
We describe a 65-year-old woman with diabetes on hemodialysis maintenance, with a number of complications associated with high-flow arteriovenous fistula (AVF, anastomosis between brachial artery and medial vein of the forearm) requiring an extended diagnostic and individual approach. The patient was admitted to our hospital because of pain, edema of the limb, hand ischemia, and infection caused by steal syndrome. To reduce fistula flow, banding of the proximal cephalic vein was performed. Simultaneously because of necrosis, amputation of the fifth finger was necessary...
July 2014: Annals of Vascular Surgery
O Akdas, G Basaranoglu, H Ozdemir, M Comlekci, K Erkalp, L Saidoglu
BACKGROUND: Venipuncture is one of the most painful events for children in hospitals. Valsalva maneuver (VM) decreases the incidence and severity of pain on venipuncture pain in adults. This study was designed to evaluate VM as compared with Eutectic Mixture of Local Anesthetic (EMLA(®)) cream for venipuncture pain in children. METHOD: In this study, we evaluated the effect of VM on venipuncture pain in children. 60 patients scheduled for elective surgery were randomly divided into three groups...
December 2014: Irish Journal of Medical Science
G Redaelli, A Annoni, R Caruso, F Formica, V Meroni, L Avalli
A 60-year-old man with history of hypertension and unspecified left ventricular dysfunction had chest pain at home at 9 am. At 1 pm he was transported to a peripheal hospital and treated for acute myocardial infarction. At 4.30 pm, despite pharmacological and intra aortic balloon pump support , the extreme hemodynamic instability and the echocardiographic signs forced the doctors in charge to contact the "extracorporeal membrane oxygenation team" of our Intensive Care Unit. The team, that in our hospital is composed of an intensivist, a cardiac surgeon, a perfusionist and a nurse, reached the hospital at 5...
2010: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
D Michael McMullan
A healthy 14-year-old presented to an emergency department in Alaska, complaining of shortness of breath, chest pain, and 72 hours of malaise and headache. On admission, her blood pressure was 80/50 mm Hg, and she had cool extremities. Electrocardiography revealed wide-complex ventricular tachycardia. She underwent synchronized electrical cardioversion. Although she initially converted to sinus rhythm, she subsequently became pulseless, with electrocardiographic evidence of ventricular tachycardia. Despite cardiopulmonary resuscitation, she failed to achieve a perfusing rhythm...
March 2013: Pediatrics
Sanjith Saseedharan, Sunil Bhargava
UNLABELLED: A 56-year-old female, recently (3 months) diagnosed with chronic kidney disease (CKD), on maintenance dialysis through jugular hemodialysis lines with a preexisting nonfunctional mature AV fistula made at diagnosis of CKD, presented to the hospital for a peritoneal dialysis line. The recently inserted indwelling dialysis catheter in left internal jugular vein had no flow on hemodialysis as was the right-sided catheter which was removed a day before insertion of the left-sided line...
January 2012: International Journal of Critical Illness and Injury Science
Nuntarat Sukthinthai, Aporn Sittipraneet, Banluesak Tummanittayangkoon, Somkiat Vasuvattakul, Thawee Chanchairujira
BACKGROUND: The buttonhole (constant site) arteriovenous fistulae cannulation technique, in which the inserted needle utilizes exactly the same site and the same angle every dialysis session, offers the advantage of an easier cannulation procedure, less pain associated with cannulation, and fewer complications when compared with the traditional method. OBJECTIVE: To compare buttonhole arteriovenous fistula (AVF) cannulation technique with area puncture method on the effect of hemostasis after needle withdrawal and pain during needle puncture...
February 2012: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
J Lindholm, K Palmér, B Frenckner
A previously healthy 60-year-old male presented with fever, general pain and a C-reactive protein (CRP) of 160 mg/L. He was prescribed doxycycline. In the emergency room three days later, he was intubated and had a saturation of 70% on 100% oxygen. The chest X-ray showed bilateral lobar pneumonia. Streptococcus pneumonia was later verified. As a Jehovah's Witness, he had refused blood transfusions, but accepted albumin. Two days after admission, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was started and the patient was then transported on ECMO to Stockholm...
July 2012: Perfusion
Murtaza Y Dawood, Eric J Lehr, Andreas de Biasi, Reyaz Haque, Alina Grigore, Bartley P Griffith, Johannes O Bonatti
Robotic assistance has enabled coronary artery bypass surgery to be performed safely in a completely endoscopic fashion, but diffusely diseased target vessels may pose a technical challenge. We present a case in which coronary endarterectomy was performed on the left anterior descending coronary artery during a two-vessel totally endoscopic coronary artery bypass procedure. A 52-year-old woman presented with intermittent substernal pain. Preoperative studies showed diffuse disease in the left coronary artery system...
November 2011: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
K M Aló, M J Yland, C Feler, J Oakley
Objective. Since 1996 we have placed temporary catheters at the cervical nerve roots in chronic pain patients for the treatment of radiculopathy and complex regional pain syndrome. We investigated the possibility of placing electrodes both at the cervical spinal nerve and dorsal root ganglion for the purpose of neuromodulation. Methods. Anatomic and technical feasibility studies were performed on 4 human cadavers to examine the placement of electrodes at the cervical nerve roots. We proposed a novel trans-spinal approach to the cervical and upper thoracic nerve roots...
July 1999: Neuromodulation: Journal of the International Neuromodulation Society
C H Santuzzi, H A Futuro Neto, J G P Pires, W L S Gonçalves, R V Tiradentes, S A Gouvea, G R Abreu
The objective of the present study was to determine the antihyperalgesic effect of sertraline, measured indirectly by the changes of sciatic afferent nerve activity, and its effects on cardiorespiratory parameters, using the model of formalin-induced inflammatory nociception in anesthetized rats. Serum serotonin (5-HT) levels were measured in order to test their correlation with the analgesic effect. Male Wistar rats (250-300 g) were divided into 4 groups (N = 8/per group): sertraline-treated group (Sert + Saline (Sal) and Sert + Formalin (Form); 3 mg·kg-1·day-1, ip, for 7 days) and saline-treated group (Sal + Sal and Sal + Form)...
January 2012: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Taku Sakurada, Hisayoshi Osawa, Jun Sasaki, Eiji Araki
A 79-year-old post-thoracoplasty patient who had undergone coronary artery bypass grafting (CABG) 20 years before was admitted to our hospital because of chest pain. Coronary angiogram showed occlusion of the both saphenous vein grafts. And the computed tomography revealed severe calcification of the ascending aorta. We performed on-pump beating CABG cannulating his femoral vessels and anastomosed bilateral internal thoracic artery grafts without manipulation of the ascending aorta. On-pump beating CABG is useful for the patients with past medical history of CABG...
March 2011: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Pankaj Kaul
A 56-year-old man with sudden onset chest pain, absent right lower limb pulses and ECG changes suggestive of inferior ST elevation MI underwent coronary angiogram through the right radial artery with a view to primary percutaneous coronary intervention (PCI). The left coronary angiogram demonstrated severe proximal stenotic disease in the left anterior descending and circumflex coronary arteries, but the right coronary artery could not be selectively cannulated. An ascending aortogram to visualise the right coronary artery not only failed to demonstrate it, but revealed, instead, a dissection flap in the ascending aorta, arch and descending thoracic aorta, with moderately severe aortic regurgitation...
May 2011: Perfusion
Kimberly Yu, John P Meehan, Anto Fritz, Amir A Jamali
A 39-year-old man presented with weakness and a nonmobile mass in the buttock of 5 months' duration. Hip flexion was limited to 70 degrees. Strength was diminished for both ankle/foot plantar and dorsiflexion. Sensation was decreased on the plantar and dorsal foot. A pedunculated osseous mass measuring 6x4 cm on the posterior femoral neck was seen on plain radiographs and magnetic resonance imaging. Electromyography showed moderate sciatic neuropathy of the peroneal and tibial branches. The patient underwent excision of the tumor through a posterior approach...
August 2010: Orthopedics
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