Prilocaine hyperbar

BACKGROUND: Hyperbaric prilocaine 20 mg/ml may be preferable for perianal outpatient surgery. The aim of this prospective, single-centre, randomised, single-blinded, controlled clinical trial was to determine the optimal dosage of hyperbaric prilocaine 20 mg/ml for a spinal anaesthesia (SPA) in patients undergoing perianal outpatient surgery. METHODS: One hundred and twenty patients (18-80 years/American Society of Anesthesiologists grade I-III) were enrolled in this study...

BACKGROUND: Decisions on local and systemic wound treatment vary among surgeons and are frequently based on expert opinion. The aim of this meta-review was to compile best available evidence from systematic reviews in order to formulate conclusions to support evidence-based decisions in clinical practice. METHODS: All Cochrane systematic reviews (CSRs), published by the Cochrane Wounds and Peripheral Vascular Diseases Groups, and that investigated therapeutic and preventive interventions, were searched in the Cochrane Database up to June 2011...

The occurrence of neurological symptoms after spinal anaesthesia has been reported with several local anaesthetics including lidocaine, prilocaine, mepivacaine, tetracaine and bupivacaine. Although hyperbaric bupivacaine is known to induce neurological symptoms less frequently than lidocaine, a few cases of cauda equina syndrome (CES) following the intraspinal injection of bupivacaine have been reported in the English literature. We describe lumbar MRI findings for a 29-year-old woman presenting with CES after caesarean section...

BACKGROUND: In this prospective, double-blind, randomized trial we compared 60 mg and 40 mg of 2% hyperbaric prilocaine with 60 mg of 2% plain prilocaine for spinal anesthesia in terms of sensory block onset in outpatients undergoing elective short-duration (<60 minutes) surgery under spinal anesthesia. METHODS: Ninety patients were enrolled and randomly allocated to receive 1 of the 3 treatments. Times to sensory and motor block onsets, time to the maximum sensory block level, readiness for surgery, time to first urinary voiding, time to Bromage's score 0, and side effects were registered blindly...

BACKGROUND: Hyperbaric prilocaine 2% is a medium long-acting spinal anaesthetic. There are few data on time to recovery and rate of urinary retention after spinal administration of hyperbaric prilocaine 2%. This prospective study was carried out to evaluate the time to spontaneous micturition, quantify the rate of necessary bladder catheterizations, and identify the risk factors for urinary retention after intrathecal prilocaine administration. METHODS: ASA I/II patients (16-80 yr) undergoing ambulatory lower limb surgery were enrolled and received spinal anaesthesia using hyperbaric prilocaine 2% (60 mg)...

BACKGROUND: Since prilocaine is being increasingly used for day case surgery as a short acting local anaesthetic for spinal anaesthesia and because of its low risk for transient neurological symptoms, we compared it to bupivacaine. PATIENTS AND METHODS: Patients (n=88) who were scheduled for lower limb surgery with spinal anaesthesia randomly received 15 mg hyperbaric bupivacaine 0.5% or 60 mg hyperbaric prilocaine 2% (administered in a sitting position). Onset time, intensity, duration of the sensomotoric block, vital parameters and time of spontaneous miction were recorded and patients were questioned on satisfaction with the anaesthesia procedure and the occurrence of adverse side-effects after 24 h...

BACKGROUND: Although local anesthetics (LAs) are hyperbaric at room temperature, density drops within minutes after administration into the subarachnoid space. LAs become hypobaric and therefore may cranially ascend during spinal anesthesia in an uncontrolled manner. The authors hypothesized that temperature and density of LA solutions have a nonlinear relation that may be described by a polynomial equation, and that conversion of this equation may provide the temperature at which individual LAs are isobaric...

STUDY OBJECTIVE: To evaluate two anesthetic techniques, namely, local anesthesia with sedation, and spinal anesthesia, with respect to recovery times, postoperative side effects, pain scores, patient satisfaction, and hospital costs for ambulatory pilonidal disease surgery. DESIGN: Prospective, randomized study. SETTING: University Hospital of Pamukkale. PATIENTS: 60 consenting patients scheduled for pilonidal disease operation with Limberg flap technique...

Hyperbaric 5% lidocaine has been available for intrathecal use since 1954. The initial studies concluded that it was a safe drug for short procedures. Recently, the use of this drug for spinal anesthesia has been questioned. There were cases of cauda equina syndrome following its use for continuous spinal anesthesia. Following these occurrences, it was felt that lidocaine should not be used for continuous spinal anesthesia, rather for single-shot spinal anesthesia only. Intense follow-up of patients receiving intrathecal lidocaine for single-shot spinal anesthesia revealed a higher incidence of back pain radiating to the thighs and legs as compared to other drugs or general anesthesia...

A universal goal of anesthesia providers is to provide the safest, most effective anesthesia and analgesia for their patients. When reports emerge showing problems or complications with an agent or technique that previously was thought safe, recommendations often are adopted in anesthesia departments to avoid or abandon the agent or technique, or alternatives are sought. Hyperbaric 5% lidocaine has been an effective and safe spinal anesthetic agent for short procedures for years. During the past decade, controversy arose over its use because it was implicated as the cause of transient neurologic symptoms and cauda equina syndrome...

Systemic and localised adverse effects of local anaesthetic drugs usually occur because of excessive dosage, rapid absorption or inadvertent intravascular injection. Small children are more prone than adults to methaemoglobinaemia, and the combination of sulfonamides and prilocaine, even when correctly administered, should be avoided in this age group. The incidence of true allergy to local anaesthetics is rare. All local anaesthetics can cause CNS toxicity and cardiovascular toxicity if their plasma concentrations are increased by accidental intravenous injection or an absolute overdose...

BACKGROUND: Hyperbaric 5% lidocaine has been associated with transient neurologic symptoms (TNSs) after spinal anesthesia. A prospective, masked, randomized study was conducted to compare the incidence of TNSs after spinal anesthesia with hyperbaric 5% lidocaine or 5% prilocaine to assess the utility of prilocaine as an alternative to lidocaine in patients having short surgical procedures. METHODS: The number of patients to be enrolled (100 per group) was determined by power analysis (80%, P = 0...

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During transurethral resection of bladder tumors under either spinal or general anesthesia without muscular relaxation, direct stimulation of the obturator nerve by the electroresectoscope is possible. The resulting obturator reflex may lead to severe complications, at the worst to a perforation of the bladder. Therefore, if resection in lateral bladder regions is necessary, blockade of the obturator nerve is often required to provide optimal conditions for transurethral resection of bladder tumors. To interrupt the obturator reflex are, we blocked the inguinal lumbar plexus using the "3-in-1-block" as described by Winnie because of its advantages compared to isolated blockade of the obturator nerve...

There is little data concerning failures in spinal anaesthesia. A retrospective analysis of 337 spinal anaesthesias performed in a teaching hospital gave a 9.8% failure rate. A failure was defined as the need to carry out part or all of a surgical act under general anaesthesia when spinal anaesthesia had been carried out. The main causes of failure were insufficiently or excessively extended neural blockade, insufficient duration or a poor quality sensory blockade with the patient feeling surgical or tourniquet pain...

This study examined the incidence of osteoradionecrosis after tooth extraction with low-epinephrine or epinephrine-free, nonlidocaine local anesthetics and conservative surgical techniques. Estimates of the absorbed radiation dose on irradiated alveolar bone were made by reviewing radiotherapy records. This investigation included 72 patients ranging in age from 22 to 80 years (median 57.4 years). We removed 449 teeth. Analysis of radiotherapy check films revealed that only 196 teeth (44%) were included within the treatment volume...