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painless cannulation

Łukasz Bartochowski, Wojciech Jurasz, Jacek Kruczyński
PURPOSE AND HYPOTHESIS: Both spondylolysis and spondylolisthesis come in second place in the causes of pain among athletes. Treatment options include both conservative management and different operative methods. Athletes and adolescents are groups where the priority is to protect tissues from perioperative damage. OBJECTIVE: We present our modification of the Buck's, direct pars repair method, which we believe offers maximum protection of tissues. We used the modified surgical method in young, competitive athletes, in whom non-surgical treatment was not effective...
October 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Shameem Ahmed, Syed Ifthekar, R Pathan Rameez Ahmed Khan, Rahul Ranjan
INTRODUCTION: The management of heel pad avulsion injuries has been challenging because of the precarious blood supply. The difficulties get compounded when it is associated with tendo-achilles rupture and calcaneal fracture. Here, it is a description of a case with the above features managed with a unique technique. CASE REPORT: A 63-year-old woman presented to casualty with injury to right ankle after a road traffic accident. On clinical and radiological examination, there was avulsion of heel pad with calcaneal tuberosity fracture and tendo-achilles rupture...
September 2016: Journal of Orthopaedic Case Reports
Bulent Odemis, Erkin Oztas, Ufuk B Kuzu, Erkan Parlak, Selcuk Disibeyaz, Serkan Torun, Ertugrul Kayacetin
PURPOSE: There are no reports comparing the results of conservative/nonsurgical management with the addition of fully covered self-expandable metallic stents (FCSEMS) with the conservative approach in endoscopic retrograde cholangiopancreatography (ERCP)-related duodenal retroperitoneal (type II) perforations. The aim of this study was to evaluate whether the addition of FCSEMS to conventional treatment provides further benefits in the course of type II perforations. METHODS: A total of 7471 ERCP with sphincterotomy performed between 2007 and 2014 were evaluated, and a total of 25 type II perforations (0...
February 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Jacek Litke, Agnieszka Pikulska, Tomasz Wegner
The majority of children, even those well prepared and with positive attitudes, experiences stress in the operating theatre and during the postoperative period. In some cases, the stress is even stronger for their parents. The role of anaesthetists is to minimize the unpleasant sensations by providing painless vein cannulation, uneventful induction of anaesthesia, suitably planned and timed analgesia, and prevention of postoperative vomiting. The effectiveness of combined analgesics, early administration of saturating doses and analgesia supplemented or based on methods of block anaesthesia - particularly on peripheral and local blocks, less appreciated in children, have been highlighted...
July 2012: Anaesthesiology Intensive Therapy
Mohammad Zahid, Aamir Bin Sabir, Naiyer Asif, Mohammad Julfiqar, A Q Khan, Sohail Ahmad, Yasir S Siddiqui
PURPOSE: To evaluate the use of fibular grafting for fresh femoral neck fractures with posterior comminution. METHODS: 18 women and 15 men aged 20 to 60 years underwent osteosynthesis and fibular strut grafting supplemented with 7.0-mm cannulated hip screws for Garden grades III (n=21) and IV (n=12) femoral neck fractures associated with posterior comminution. All fractures were reduced by closed methods, and no hip was aspirated. Clinical and radiological outcomes were evaluated...
August 2012: Journal of Orthopaedic Surgery
Necmettin Colak, Yunus Nazli, Mehmet Fatih Alpay, Ismail Olgun Akkaya, Omer Cakir
Acute dissection of the aorta can be life-threatening. As a presenting manifestation of aortic dissection, neurologic complications such as paraplegia are rare. Herein, we report the case of a 51-year-old man who presented with sudden-onset paraplegia and ischemia of the legs, with no chest or back pain. His medical history included coronary artery bypass grafting. Physical examination revealed pulseless lower extremities, and computed tomography showed aortic dissection from the ascending aorta to the common iliac arteries bilaterally...
2012: Texas Heart Institute Journal
Hakan Senaran, Guney Yilmaz, Mary K Nagai, Mihir Thacker, Kirk W Dabney, Freeman Miller
BACKGROUND: Valgus deformity of the hindfoot in cerebral palsy (CP) patients is common and causes functional deterioration and shoe fitting problems together with skin ulcerations. Our aims in this study are, to present an intra-articular technique of subtalar fusion using allograft and internal fixation to achieve stabilization and second to report the results and clinical outcome of a series of intra-articular subtalar arthrodesis performed in CP children. METHODS: We performed a retrospective review of radiographs and medical records of 145 children with CP who underwent intra-articular subtalar fusion from January 1994 to December 2004...
March 2011: Journal of Pediatric Orthopedics
Michael J Fredrickson
PURPOSE: Recent reports of painless intraneural injection of low volumes of local anesthetic without subsequent neurological deficit have led to the suggestion that deliberate subepineural injection may be a safe and therefore acceptable practice. CLINICAL FEATURES: This report describes a case where a venous cannulation needle inadvertently penetrated a patient's median nerve. Sudden onset severe lancinating pain occurred in the median nerve sensory distribution...
December 2009: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Keith M Baumgarten
This article describes a case of a patient with a type II-variant, unstable distal clavicle fracture that was successfully treated with a novel arthroscopic technique using the Tightrope system (Arthrex, Naples, Florida). The arthroscope was placed into the anterolateral portal after a bursectomy was performed. An anterior portal was made lateral to the coracoid using superficial landmarks and arthroscopic visualization. A radiofrequency device was inserted through the anterior portal. Following the coracoacromial ligament medially, the radiofrequency device was used to first tactilely then visually identify the coracoid base...
December 2008: Orthopedics
P Chiron, J M Laffosse, N Bonnevialle
Shelf arthroplasty is an old technique which by a classical approach, proposed by Lance in 1925, had a low morbidity rate and long term known results. A minimal invasive approach reduces the magnitude of the operation, its consequences and might allow one to broaden its indications. The approach is 4 cm long at the anterolateral part of the hip, through the space between tensor fascia latae and gluteus muscles. A 3x3 cm cortical-cancellous autograft is applied using a guide wire positioned by fluoroscopy and the osteosynthesis is based on a cannulated screw...
2007: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
A Rochette, A F Hocquet, C Dadure, D Boufroukh, O Raux, J F Lubrano, S Bringuier, X Capdevila
BACKGROUND: Pain on injection limits the use of propofol in children. The combination of lidocaine and propofol is widely used to reduce pain. A new solvent [medium-chain triglyceride (mct)/long-chain triglyceride (lct)] has been advocated to be less painful than standard (lct) propofol in adults, but no information is available of its usefulness in pre-school children. We designed a prospective, randomized, double-blinded, placebo-controlled study to assess injection pain with two different propofol emulsions, each given with or without lidocaine in children <7 yr...
September 2008: British Journal of Anaesthesia
Allan M Cyna, David Tomkins, Todd Maddock, David Barker
We present a case of severe needle phobia in a 5-year-old boy who learned to utilize a self-hypnosis technique to facilitate intravenous (i.v.) cannula placement. He was diagnosed with Bruton's disease at 5 months of age and required monthly intravenous infusions. The boy had received inhalational general anesthesia for i.v. cannulation on 58 occasions. Initially, this was because of difficult venous access but more recently because of severe distress and agitation when approached with a cannula. Oral premedication with midazolam or ketamine proved unsatisfactory and hypnotherapy was therefore considered...
August 2007: Paediatric Anaesthesia
David M A Francis, Yufan Lu, Amanda J Robertson, Robert J Millar, Jayne Amy
BACKGROUND: Many haemodialysis patients are unable to have or maintain distal upper limb arteriovenous (AV) fistulas because of inadequate veins or arteries and therefore require more proximal access. We have reviewed our experience with a two-stage brachiobasilic AV haemodialysis fistula fashioned in the arm. METHODS: Ninety-one brachiobasilic AV fistulas were fashioned in 87 patients between August 1999 and October 2004. Four AV fistulas failed because of early thrombosis...
March 2007: ANZ Journal of Surgery
Adam J Singer, Robert Weeks, Ran Regev
OBJECTIVES: Application of topical anesthetics before intravenous (IV) cannulation is effective yet limited by delayed transdermal absorption. The authors evaluated a handheld laser device to enhance topical anesthetic absorption by ablating the stratum corneum, the major barrier to drug absorption through the skin. The hypothesis was that laser-assisted anesthesia would reduce the pain of IV cannulation in emergency department (ED) patients. METHODS: This was a blinded, randomized, controlled trial...
June 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Thomas Endres, René Grass, Stefan Rammelt, Hans Zwipp
OBJECTIVE: Arthrodesis of the ankle at 90 degrees and perfect axial alignment for restoration of a painless function. Early functional postoperative care. INDICATIONS: Painful posttraumatic or idiopathic osteoarthritis of the ankle either unresponsive to conservative measures or where these measures are not expected to be successful. Posttraumatic malalignment of the ankle, paralysis or instability, that cannot be improved or eliminated by joint-preserving measures...
October 2005: Operative Orthopädie und Traumatologie
Constance S Houck, Navil F Sethna
Topical local anesthetics in one form or another have been used for the past 20 years to alleviate the skin pain associated with needle puncture and venous cannulation in children. Although the application of topical anesthetic creams is painless compared with traditional local anesthetic infiltration of the skin and subcutaneous tissues prior to venipuncture and minor skin procedures, they remain underutilized, primarily due to their slow analgesic onset and inconsistent effectiveness. For a topical local anesthetic to be of practical use in busy clinical settings, it must be easy to apply, have minimal side effects, not require cumbersome equipment and be reasonably cost effective...
September 2005: Expert Review of Neurotherapeutics
J Sherwin, I T Awad, P J Sadler, A M Liddle, D J Rowbotham
We compared the effect of lidocaine injection with lidocaine iontophoresis for pain relief during radial artery cannulation prior to induction of anaesthesia. Patients were allocated randomly to one of two groups. Group 1 (n = 15) received iontophoresis for 10 min prior to cannulation, using 4% lidocaine 4 ml. Group 2 (n = 15) received local infiltration of 1% lidocaine 1 ml using a 25G needle. Pain scores were recorded immediately after cannulation using a 10-cm visual analogue scale (VAS). There was no difference in mean (SD) pain scores [group 1: 2...
May 2003: Anaesthesia
J A Cooper, L M Bromley, A P Baranowski, S G Barker
We evaluated a single-use, disposable, carbon-dioxide-powered, needleless injector (J-Tip, National Medical Products Inc., CA, USA), which is claimed to deliver a virtually painless, subcutaneous injection. Seventy-two patients undergoing various types of surgery had a large-bore intravenous cannula inserted prior to induction of general anaesthesia. Three minutes beforehand, a subcutaneous injection of 0.3 ml of 1% plain lidocaine was administered. Subjects were randomly allocated to receive the lidocaine either by the needleless injector or from a conventional syringe and a 25 G needle...
March 2000: Anaesthesia
S Schwery, J Havelka, P Y Zaugg, H Bühler
Biliary complications are more frequent in laparoscopic than in open cholecystectomy. The aim of the study was to evaluate the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography (ERCP) in the management of complications of laparoscopic cholecystectomy. We therefore report on the result of 49 ERCP after laparoscopic cholecystectomy done at our department between January 1991 and March 1993. Patients were referred from 16 different surgical institutions. In 29 cases endoscopic sphincterotomy was performed without complications...
May 7, 1994: Schweizerische Medizinische Wochenschrift
R L Sheridan, J M Weber, R G Tompkins
Despite the obvious drawbacks associated with prolonged arterial cannulation, arterial catheters are frequently required in paediatric burn patients with respiratory failure to facilitate monitoring of oxygenation, ventilation and blood pressure, and to allow for the painless performance of phlebotomy. Burn patients with respiratory failure frequently require prolonged arterial catheterization, often for more than 72 h, and many of their cannulation sites are burned. We report our favourable 3-year experience with 81 femoral arterial catheters in 36 paediatric burn patients...
October 1994: Burns: Journal of the International Society for Burn Injuries
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