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Journal articles on the topic 'Local anesthetic'
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Lim, Jeong Ok, Su Jeong Kim, Roxane Pouliot, and Woon Yi Baek. "Enhanced Transdermal Delivery of Local Anesthetics by Liposome Formulation of Local Anesthetic Mixture." Key Engineering Materials 277-279 (January 2005): 45–50. http://dx.doi.org/10.4028/www.scientific.net/kem.277-279.45.
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Various concentrations of either lidocaine or tetracaine, plus combinations of lidocaine and tetracaine were formulated into liposomes to improve topical anesthesia. The topical anesthetic effects of these liposomal mixtures of local anesthetics (Lipo-MLA) were then compared with those of EMLA (Eutectic Mixture of Local Anesthetics) and single local anesthetic liposomes using a pinprick test on healthy adult volunteers. The Lipo-MLA exhibited significantly improved anesthetic effects compared to the EMLA and single local anesthetic liposomes with a faster onset time of approximately thirty minutes and duration of at least four hours. A dermal toxicity study using rats revealed that Lipo-MLA was safe at greater than 2,000 mg/kg bodyweight.
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Felipe, Bianca, Sofia Chane, Antonio De Mello, and Gabriela Mayrink. "Knowledge of Dental Students in Relation to Local Anesthetics and Associated Complications." International Journal of Medical and Surgical Sciences 2, no. 2 (October 26, 2018): 461–67. http://dx.doi.org/10.32457/ijmss.2015.013.
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Local anesthesia is the most frequently performed procedure for all dentists and, despite their possible complications, often aspects such as dosage, contraindications and systemic effects are neglected. The objectives of this study are to evaluate prospectively the knowledge of undergraduate students for the technical, dosage and indication of local anesthetics in daily dental practice, in addition to clinical observation of possible complications from anesthesia. Questionnaires were distributed to students asking about the procedure undertaken, anesthetic volume used, because of the choice of the anesthetic, anesthetic dosage calculation, habit of relating the patient's weight dosage with the dosage being applied, habit of observing the reflux in cartridge in the anesthetic infiltration act and adverse effects on patients, type of anesthetic technique performed and expected time to onset of action of the drug. At the end of this study, we intend to be a greater awareness of students (undergraduates) about the systemic effects of local anesthetics in patients, and possibly decrease the expenses of the institution with excessive use of anesthetic cartridges arising from incorrect anesthetic technique. The vast majority of undergraduate students have no knowledge about the type of anesthesia to be used, the amount to be administered and the anesthetic action time. The awareness of students about the dosage of anesthetics and their systemic problems, reduces waste and the cost of the institution by the indiscriminate use of anesthetics, therebycontributing to improve the clinical management of students at graduation.
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Schutte, Soleil S., and Tammy Euliano. "Local anesthetic resistance in a Crohn’s patient undergoing cesarean delivery." Regional Anesthesia & Pain Medicine 45, no. 8 (May 23, 2020): 669–70. http://dx.doi.org/10.1136/rapm-2020-101516.
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IntroductionPatient resistance to local anesthetics is rarely considered as the cause of regional anesthesia failure.Case reportWe report a case of resistance to local anesthetics in a patient with Crohn’s disease who underwent cesarean section under continuous spinal anesthesia.DiscussionResistance to local anesthetics may be more common than we think, especially among patients with chronic pain. Providers should consider local anesthetic resistance when regional anesthesia is unsuccessful. Further research is needed to determine if skin wheal tests and/or a different local anesthetic could improve results.
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Eggleston, Steven T., and Lori W. Lush. "Understanding Allergic Reactions to Local Anesthetics." Annals of Pharmacotherapy 30, no. 7-8 (July 1996): 851–57. http://dx.doi.org/10.1177/106002809603000724.
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OBJECTIVE: To review the pharmacology and mechanisms by which local anesthetics cause allergic reactions. Recommendations concerning appropriate use of local anesthetics and alternative therapies in patients with documented local anesthetic allergies are given. DATA SOURCE: A MEDLINE search of the English-language literature identified pertinent clinical studies, case reports, and reviews. The periods of review were Med1, 1990-present; and Med2, 1985-1989, using the MeSH terms drug hypersensitivity and anesthetics. References from the selected studies, case reports, and reviews were reviewed. STUDY SELECTION: Controlled and uncontrolled prospective studies and case reports pertaining to local anesthetic allergies were reviewed. The selection focused on information pertaining to the etiology and diagnosis of allergic reactions to local anesthetics and alternative therapies for patients with local anesthetic allergies. DATA SYNTHESIS: Local anesthetics are classified as either ester or amide compounds. Esters are associated with a higher incidence of allergic reactions, due to a p-aminobenzoic acid (PABA) metabolite. Amide agents do not undergo such metabolism. However, preservative compounds (methylparaben) used in the preparation of amide-type agents are metabolized to PABA. Patients who are allergic to ester local anesthetics should be treated with a preservative-free amide local anesthetic. If the patient is not allergic to ester local anesthetics, these agents may be used in amide-sensitive patients. In the rare instance that hypersensitivity to both ester and amide local anesthetics occurs, or if skin testing cannot be performed, then alternative therapies including diphenhydramine, opioids, general analgesia, or hypnosis can be used. CONCLUSIONS: A true immunologic reaction to a local anesthetic is rare. Intradermal skin testing of local anesthetic compounds, methylparaben, and metabisulfite should be performed in patients when a thorough history does not rule out a possible allergic reaction to local anesthetics and future local anesthesia is necessary. Skin testing enables the clinician to identify autonomic responses to minor surgical procedures and toxic reactions to anesthetics so that patients are not incorrectly labeled as “caine” allergic. Diphenhydramine can be used as an alternative to ester and amide local anesthetics in minor procedures of short duration.
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Deepti, V. "RECENT ADVANCES IN LOCAL ANESTHESIA - OVERVIEW." CODS Journal of Dentistry 3, no. 2 (2011): 34–36. http://dx.doi.org/10.5005/cods-3-2-34.
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ABSTRACT The local anesthetic drugs presently available and used in dentistry represent the safest and most effective drugs in all of medicine for the prevention and management of pain. One drawback associated with intraoral local anesthesia is patients’ fear of injections .and the perception that these are painful. Recent advances have resulted in the use of computer-controlled local anesthetic delivery vehicles to regulate the delivery and rate of flow of local anesthetics at the injection site, lessening potential discomfort associated with injections. New injection techniques that provide reliable anesthesia, depending on the technique and area of anesthesia necessary have been discussed.
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Bendgude, Vikas, Hrishikesh Walimbe, Mohammed Nadeem Ahmed Bijle, Sneha Muchandi, Rahul Deshpande, Arti Dolas, and Shrishti Chaturvedi. "Comparative Evaluation of the Efficacy of Topical Anesthetics in Reducing Pain during Administration of Injectable Local Anesthesia in Children." World Journal of Dentistry 5, no. 2 (2014): 129–33. http://dx.doi.org/10.5005/jp-journals-10015-1273.
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ABSTRACT Introduction Pain control is an integral part of modern dentistry. Needle injection of local anesthetic which is the commonest modality of pain control itself proves to be painful for the child. Hence, it is important for the pediatric dentists to resort to a pain free method of administering local anesthesia for a patient. Topical anesthetics have proven to reduce the pain experience during administration of local anesthetic injection. The aim of this study is to evaluate and compare the efficacy of two topical anesthetic agents—EMLA 5% cream (Eutectic mixture of local anesthetics—Lignocaine 2.5% and prilocaine 2.5%) and Benzocaine 20% gel in reducing the pain during administration of local anesthetic injection in children. Materials and methods EMLA 5% cream and Benzocaine 20% gel were used in the study. Children from mixed dentition age group between 6 and 9 years of age were selected. The two selected topical anesthetics were applied on buccal mucosa at two different appointments in a given child, following which the local anesthetic was administered on the test site. The pain responses of the child were evaluated using the Wong Baker Faces Pain Rating Scale. The results were then statistically analyzed using Mann-Whitney U-test. Results EMLA 5% cream was three times highly effective in pain reduction than Benzocaine 20% gel. Conclusion EMLA 5% cream is comparatively better than benzocaine 20% gel with regards to pain reduction during the administration of local anesthetic injection in children. How to cite this article Walimbe H, Muchandi S, Bijle MNA, Bendgude V, Deshpande R, Dolas A, Chaturvedi S. Comparative Evaluation of the Efficacy of Topical Anesthetics in Reducing Pain during Administration of Injectable Local Anesthesia in Children. World J Dent 2014;5(2):129-133.
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Tadin, Antonija, Klaudia Aleric, Daniel Jerkovic, and Lidia Gavic. "Knowledge, Practice and Self-Reported Confidence Level of Croatian Dentists in the Use of Local Anesthesia: A Cross-Sectional Study." Healthcare 11, no. 14 (July 12, 2023): 2006. http://dx.doi.org/10.3390/healthcare11142006.
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Objectives: To provide safe and effective local anesthesia, dentists must have knowledge of neuroanatomy, anesthesia agents, techniques, equipment, and proper use of local anesthetics. This study aims to explore the knowledge, practices, and confidence regarding local anesthetics and anesthetic techniques in dentistry. Material and Methods: The online cross-sectional questionnaire was conducted via social media, and yielded 441 responses from across the country (69.8% women and 30.2% men; 70.7% general dentists; and 29.3 specialists). The data collected included sociodemographic characteristics, knowledge, and practices pertaining to the usage of local anesthesia. The questionnaire also documents their self-assessed confidence level in applying different local anesthetic techniques and experiences with adverse reactions. The obtained data were processed by description and using a generalized linear model for regression. Results: The respondents had a median knowledge score of 6 out of a possible 14 points regarding local anesthetics in dental medicine, and their median self-confidence level in the successful application of various techniques of local anesthesia was 54 out of a maximum of 85 points. The results showed that a higher knowledge level was associated with the female gender (OR 1.83, CI 1.13–2.98, p = 0.014) and specialization in oral surgery (OR 7.04, CI 1.71–29.07, p = 0.007). In contrast, a lack of confidence in using various local anesthetic techniques was also associated with the female gender (OR 0.63, CI 0.41–0.99, p = 0.047) and specialization in orthodontics (OR 0.16, CI 0.03–0.88, p = 0.035). Of the respondents, 81.4% (n = 371) experienced a local complication, and 42.2% (n = 186) experienced a systemic complication during local anesthesia. The complications experienced cannot be associated with a lack of knowledge or self-confidence (p > 0.05). The majority of respondents (364 of the 441 total—82.5%) expressed interest in receiving further education on the topic of local anesthesia. Conclusions: The research results show that the dentists involved in the study have poor knowledge of local anesthetics and moderate self-reported confidence levels in using various local anesthetic techniques. Moreover, dentists’ self-confidence in applying different techniques of local anesthesia is not related to their knowledge. Therefore, it would be necessary for dentists to undergo a continuing dental education program that enables them to enhance their skills and knowledge in local anesthesia.
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Yagiela, John A. "Local Anesthetics: A Century of Progress." Anesthesia Progress 67, no. 4 (December 1, 2020): 235–44. http://dx.doi.org/10.2344/0003-3006-67.4.235.
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Summary One century after the clinical introduction of cocaine, local anesthesia remains the most important method of pain control in dentistry. Many local anesthetics have been marketed since 1884, and it is likely that attempts to produce drugs that enhance anesthetic efficacy, reduce systemic and local toxicity, and increase nociceptive selectivity, will continue. In addition, new methods of drug administration have been and will be developed to achieve these goals. Of fundamental importance to such improvements are investigations into the pharmacology of drugs with local anesthetic activity and anatomical and physiologic studies pertaining to the reasons why local anesthetics sometimes fail to achieve desired results. This paper reviews recent advances in our understanding of these drugs and their clinical use.
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Raut Dessai, Saiesh, Sanjot Ninave, Amol Bele, and Nitin Alaspukar. "To assess the efficacy of injection nalbuphine as an adjuvant to intrathecal bupivacaine in endoscopic urological surgeries for prolongation of postoperative analgesia." F1000Research 12 (May 4, 2023): 466. http://dx.doi.org/10.12688/f1000research.133274.1.
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Spinal anesthesia has a quicker onset of action and completely blocks all motor functions. It requires less local anesthetic and has a reduced rate of failed blocks hence the preferred anesthetic method for lower abdomen procedures is spinal anesthesia. Intrathecal local anesthetics benefit from adjuvant medications by extending postoperative analgesia and thus improving the sensory blockade's duration and quality. Intrathecal opioids and local anesthetics work together synergistically to increase the sensory block while decreasing the sympathetic block. Adjuvants to local anesthetics for intrathecal administration have certain benefits, including lowered local anesthetic medication dose, improved hemodynamic stability, and fewer adverse effects. The opioid medication nalbuphine has a kappa agonist and mu antagonist action that reduces pain without having many negative side effects. It acts on opoid receptor as both an agonist and an antagonist to offer visceral nociception with a moderately powerful analgesic. Almost all general anesthesia and regional anesthesia treatments employ it. To cause analgesia, nalbuphine adheres to k receptors. Perioperative analgesia is also improved when administered as an adjuvant to bupivacaine. It is a hybrid which has both agonist and antagonist actions that increases and attenuates the effects of -opioids. Numerous researchers have investigated the properties of intrathecal nalbuphine. This study's objective to determine the efficacy of injectable nalbuphine as an augmentation to intrathecal bupivacaine in endoscopic urological surgeries to extend post operative analgesia.
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Mujtaba, Mustafa G., Peter Gerner, and Ging Kuo Wang. "Local Anesthetic Properties of Prenylamine." Anesthesiology 95, no. 5 (November 1, 2001): 1198–204. http://dx.doi.org/10.1097/00000542-200111000-00025.
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Background Local anesthetics that produce analgesia of long duration with minimal impairment of autonomic functions are highly desirable for pain management in the clinic. Prenylamine is a known calcium channel blocker, but its local anesthetic blocking effects on voltage-gated sodium channels have not been studied thus far. Methods The authors characterized the tonic and use-dependent prenylamine block of native Na(+) channels in cultured rat neuronal GH3 cells during whole cell voltage clamp conditions and the local anesthetic effect of prenylamine by neurologic evaluation of sensory and motor functions of sciatic nerve during neural block in rats. Results Prenylamine elicits both use-dependent block of Na(+) channels during repetitive pulses (3 microm prenylamine produced 50% block at 5 Hz) and tonic block for both resting and inactivated Na(+) channels. The 50% inhibitory concentration for prenylamine was 27.6 +/- 1.3 microm for resting channels and 0.75 +/- 0.02 microm for inactivated channels. Furthermore, in vivo data show that 10 mm prenylamine produced a complete sciatic nerve block of motor function, proprioceptive responses, and nociceptive responses that lasted approximately 27, 34, and 24 h, respectively. Rats injected with 15.4 mm bupivacaine, a known local anesthetic currently used for pain management, had a significantly shorter duration of blockade (< 2 h) compared with rats injected with prenylamine. Conclusions The data presented here demonstrate that prenylamine possesses local anesthetic properties in vitro and elicits prolonged local anesthesia in vivo.
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Sharma, Pariksha. "A Clinical Trial to Determine the Efficacy of Abhaya Nagara Churna in the Management of Tamaka Swasa~Bronchial Asthma." International Research Journal of Ayurveda & Yoga 06, no. 10 (2023): 17–24. http://dx.doi.org/10.47223/irjay.2023.61003.
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Introduction: In the 19th century, surgery underwent a transformative moment with the discovery of the first anesthetic. Ayurvedic pioneers like Susrutha and Caraka described surgical techniques devoid of anesthetics, relying on substances such as wine. Recognizing the limited effectiveness of herbal local anesthetics like Akarakarabha and Giri Ardraka, researchers began exploring Aparajitha (Clitorea ternatea) as a potential potent local anesthetic.Methods: To assess Aparajitha as a local anesthetic, water and alcohol extracts were obtained from finely powdered white Clitoria ternatea leaves. These extracts underwent testing at different concentrations using anesthesia methods like the frog’s web, frog pouch, and guinea pig’s wheel.Results: The alcohol extract of Aparajitha acted as an effective anesthetic, with onset from the 7th to the 20th minute, waning by the 35th minute. Both water and alcohol extracts were employed for a comprehensive assessment based on compound solubility. In frog pouch experiments, the test substance induced anesthesia in 10 minutes, while the standard took 3 minutes. Concentrations of 0.2%, 0.4%, and 0.8% had no significant impact, but concentrations of 0.8%, 1%, and 2% showed noticeable anesthesia effects. The 2% alcohol extract achieved the desired effect within 10 applications, matching the standard’s performance, although the standard surpassed the test samples in guinea pig infiltration anesthesia.Discussion: The study indicates that Aparajitha possesses local anesthetic properties, despite limited literature references. Further evaluation, including toxicity studies and clinical trials, is needed to assess its viability as a clinical anesthetic. This research serves as an initial exploration of Ayurvedic anesthesia potential contributions to modern surgery.
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MD, PHD, Masoud Tarbiat, Sayed Ahmad Reza Salimbahrami MD, PHD, Gholamreza Ghorbani Amjad MD, PHD, and Mahmoud Rezaei MD, PHD. "Intrathecal pethidine as a sole anesthetic agent for lower limb surgery: a case report." Journal of Anesthesia and Critical Care: Open access 16, no. 1 (March 12, 2024): 20–21. http://dx.doi.org/10.15406/jaccoa.2024.16.00583.
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Spinal anesthesia is the most preferred method for lower extremity surgery owing to rapid onset, predictable and reliable block, and excellent postoperative analgesia. Pethidine is the only opioid that can be used as a sole anesthetic agent in spinal anesthesia, because of its local anesthetic activity which is unique. As there are scant articles about pethidine as a sole anesthetic agent in spinal anesthesia, this encouraged us to report intrathecal pethidine used for two old patents for their femoral fractures repair. Spinal anesthesia was carried out using 1.6 mL pethidine (50 mg/mL) in the sitting position in the midline approach by a 24-gauge, Quincke point needle. The patients were successfully managed with this method. This report emphasizes that in some situations, intrathecal pethidine technique is a safe, and good alternative inexpensive technique over spinal anesthesia with local anesthetics.
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Gómez-Sánchez, Eduardo, Lorenzo Franco-de la Torre, Ronell Eduardo Bologna-Molina, Nelly Molina-Frechero, Nicolás Addiel Serafín-Higuera, Adriana Hernández-Gómez, Ángel Josabad Alonso-Castro, Daniel Sat-Muñoz, and Mario Alberto Isiordia-Espinoza. "Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis." Healthcare 10, no. 10 (September 25, 2022): 1867. http://dx.doi.org/10.3390/healthcare10101867.
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Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel–Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis (n = 228; I2 = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; p < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics (n = 288; I2 = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; p < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis.
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Korobova, Lyudmila S., and Vladimir V. Lazarev. "Anesthesia in Pediatric Eye Surgery (Review)." General Reanimatology 14, no. 6 (December 27, 2018): 114–25. http://dx.doi.org/10.15360/1813-9779-2018-6-114-125.
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The review dwells on the analysis of anesthetic techniques for pediatric eye surgery, including the use of drugs used and methods of anesthesia. While preparing the paper, Cyberleninka (www.cyberleninka.ru), PubMed, Medline databases were used with the targeted search using the following keywords: propofol, sevoflurane, paracetamol, regional anesthesia, ophthalmology, children. The search was not restricted by the date of paper publishing; the focus was made on papers published within the last 10 years. The purpose of the review was to assess the scope of various anesthetic techniques (general anesthesia and regional blockades), anesthetics (sevoflurane, propofol, paracetamol, local anesthetics) in pediatric eye surgery.
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Liu, Guo-Liang, Wen-Chao Bian, Peng Zhao, and Li-Hua Sun. "Delivery of Local Anesthesia: Current Strategies, Safety, and Future Prospects." Current Drug Metabolism 20, no. 6 (July 17, 2019): 533–39. http://dx.doi.org/10.2174/1389200220666190610155049.
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Background:The systemic administration of anesthesia is associated with severe and undesirable side effects such as sedation, vomiting, nausea, allergies, respiratory problems, and neutrophil dysfunction. With the increase in the procedures of limb surgery, cosmetics, facial, skin, and cancer reconstruction, the demand for local anesthesia has increased multifold during the last one decade. Therefore, novel, safe, and cost-effective methods are being developed to deliver local anesthetics by the surgeons.Methods:To prepare a comprehensive research report on anesthesia, we performed a structured literature search of bibliographic databases for peer-reviewed articles published recently. The studies of different articles were summarized and a deductive qualitative and quantitative data analysis was applied. Subsequently, a comprehensive summary of the analysis was used to frame this review article with ample examples.Results:A thorough analysis of the reports suggested that there have been tremendous developments of synthesizing nanoparticle-based local anesthesia drugs. The active targeting ability of nanoparticle-based drug delivery strategy can further help to deliver the desired anesthetic drug locally. It was also found that different local anesthetic drugs are developed into liposome form and show better efficacy in patients receiving anesthesia.Conclusion:The findings of this review article endorse that safe delivery of anesthesia drugs are essential for the safety of patients. Further, nanotechnology-based strategies are extremely useful for targeted delivery of anesthetic drugs at the required dose without affecting the neighboring tissues.
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Rosa, Andrei, Isabella Candido, Alex Semenoff-Segundo, Ivan Onone Gialain, and Alexandre Meireles Borba. "Use of local anesthetics in individuals with chronic renal failure." Concilium 24, no. 3 (March 1, 2024): 422–35. http://dx.doi.org/10.53660/clm-2915-24d07.
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Individuals with chronic renal failure (CRF) undergoing hemodialysis often develop systemic arterial hypertension (SAH) and have to consider which anesthetic should be used in dental interventions. The objective of this study was to evaluate the action of anesthetics with (AV) and without vasoconstrictor (AWV) in individuals with CRF, in need of dental treatment. Randomly, dental hemiarchs were subjected to anesthetic infiltration with a 1.8 mL tube (for one moment with AV and another moment AWV). Oxygen saturation (SaO2), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before and after anesthesia. The results demonstrated a statistical difference only in SaO2 5 minutes after anesthesia in comparison with the AV and AWV groups, highlighting the safety of its use, as long as in small quantities, in individuals with CRF.
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Dos Santos, Antônio José Silva, Rangel Teles Freire, Klinger de Souza Amorim, Francisco Carlos Groppo, and Liane Maciel de Almeida Souza. "ANESTHETIC PROPERTIES OF TWO SOLUTIONS ADMINISTERED BY A COMPUTERIZED INJECTOR USING THE ALVEOLAR CREST SPONGY BONE AREA TECHNIQUE: A RANDOMIZED CLINICAL TRIAL." Revista Contemporânea 3, no. 07 (July 28, 2023): 9445–65. http://dx.doi.org/10.56083/rcv3n7-108.
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Most dental procedures require the use of local anesthetics. The Morpheus™ anesthetic computerized injector (Morpheus™ injector) provides painless needle insertion and satisfactory anesthesia with lower volumes of local anesthetic. The use of the intraseptal Alveolar Crest Spongy Bone Area (ACSBA) anesthesia technique with the Morpheus™ injector is an alternative to painless treatment. Thus, the objective of this study was to evaluate the anesthetic properties of the ACSBA technique using two different anesthetics, lidocaine and articaine. This randomized, split-mouth, triple-blind clinical trial included 31 volunteers who required restorative treatment of the lower first molars. In two sessions, 2% lidocaine with 1:100000 epinephrine and 4% articaine with 1:100000 epinephrine solutions were administered using the ACSBA technique. Patient physical parameters, pain perception, and degree of anxiety as well as anesthetic properties were evaluated. There were no statistically significant differences between the groups or time points for systolic (p = 0.928) and diastolic (p = 0.450) blood pressure or heart rate (p = 0.624). Moreover, there were no statistically significant differences between the treatments for needle insertion (p = 0.741) or anesthetic deposition (p = 0.810). Both of the anesthetic protocols had a 9.7% failure rate. The Mann-Whitney test showed no statistically significant differences between the groups in anesthesia latency (p = 0.758) or duration (p = 0.791). Articaine and lidocaine were safe drugs, and there was no change in their influence on the evaluated physical parameters. Articaine was similar to lidocaine for anesthesia duration with means of 70.7 and 61.1 min, respectively. The intraseptal ACSBA anesthesia technique was effective, provided sufficient anesthesia duration to perform medium-term dental procedures with articaine and lidocaine, and produced painless anesthesia that provided greater patient comfort.
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Dewi, Ni Putu Alit Listya, Desak Nyoman Ari Susanti, and Sari Kusumadewi. "Gambaran penggunaan bahan anestesi lokal pada praktek dokter gigi Kota Denpasar." Bali Dental Journal 4, no. 1 (March 6, 2020): 21–26. http://dx.doi.org/10.51559/bdj.v4i1.261.
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Background: Local anesthetic agents are drugs used to relieve pain that may occur during dental procedures one of them tooth extraction. Vasoconstrictors are usually added in local anesthetic agents to increase the duration of action. The use of local anesthesia is usually combined with topical anesthesia to relieve pain due to needle injection. Objective: to describe the use of local anesthetic agents in dental practice in Denpasar city. Method: this study used cross sectional descriptive design. The samples of this study were 44 dentists and selected by simple random sampling. The datas were collected by filling the questionnaire. Result: this study shows 93.2% of dentists used local anesthetic agents containing vasoconstrictors and 68.2% of dentists using local anesthetics combined with topical anesthesia. 74.5% of dentists use local anesthetic agents pehacaine (lidocaine containing vasoconstrictors). Conclusion: Dentists in Denpasar city mostly used pehacaine (lidocaine containing vasoconstrictors), and combined with topical anesthesia.
Latar belakang: Bahan anestesi lokal merupakan obat yang digunakan untuk menghilangkan rasa sakit yang dapat terjadi selama prosedur kedokteran gigi salah satunya pencabutan gigi. Vasokonstriktor biasanya ditambahkan pada bahan anestesi lokal untuk memperpanjang durasi kerja. Penggunaan anestesi lokal biasanya juga dikombinasikan dengan anestesi topikal untuk menghilangkan rasa sakit akibat injeksi jarum. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui gambaran penggunaan bahan anestesi lokal pada praktek dokter gigi kota Denpasar. Metode : desain penelitian ini adalah deskriptif cross sectional. Sampel penelitian ini berjumlah 44 dokter gigi dan dipilih dengan metode simple random sampling. Data diperoleh dengan cara pengisian kuesioner. Hasil: penelitian ini menunjukkan bahwa 93,2% dokter gigi menggunakan bahan anestesi lokal yang mengandung vasokonstriktor dan 68,2% dokter gigi menggunakan anestesi lokal yang dikombinasikan dengan anestesi topikal. Sebanyak 74,5% dokter gigi menggunakan bahan anestesi lokal pehacaine (lidokain mengandung vasokonstriktor). Simpulan : dokter gigi di kota Denpasar lebih banyak menggunakan pehacaine (lidokain mengandung vasokonstriktor) dan dikombinasikan dengan anestesi topikal.
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Bachinin, E. A., S. I. Utkin, D. Y. Ignatenko, M. V. Stolyarov, and R. N. Khalfin. "Benefits of local anesthetic Levobupivacaine in ambulatory endovitreal surgery." Modern technologies in ophtalmology, no. 2 (April 13, 2022): 220–27. http://dx.doi.org/10.25276/2312-4911-2022-2-220-227.
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Purpose. Comparative analysis of local anesthetics for retrobulbar block in outpatient endovitreal interventions. Material and methods. The study included 30 patients who underwent combined anesthesia: local (regional) and ataralgesia during outpatient endovitreal operations. Local anesthesia was performed in form of retrobulbar block in the muscle cone delineating the retrobulbar space with introduction of 3.0 ml of local anesthetic. Ataralgesia included benzodiazepines and intravenous fentanyl. According to the type of anesthetic, 2 groups of patients were identified: 1st group – 15 patients who received 2% lidocaine solution; 2nd group – 15 patients – 0.75% solution of levobupivacaine. Results. In all 2 groups, a sufficient level of anesthesia was achieved, which made it possible to perform surgical interventions as planned, without complications. The average duration of operation in each group was 15–20 minutes. Stable course of operation, anesthesia and early postoperative period were allowed patient to be discharged for further treatment at place of residence on day of operation. Conclusion. In all patients, the applied method of combining regional anesthesia with ataralgesia made it possible to achieve an excellent level of pain relief and turned out to be approximately comparable in efficiency with both levobupivacaine and lidocaine. The advantage of using levobupivacaine for regional anesthesia was greater strength and duration of anesthesia. The technique was characterized by development of pronounced neurovegetative blockade and protection from surgical stress response, early activation of patients and ability to discharge patient for further treatment at place of residence on day of surgery. Keywords: endovitreal interventions, outpatient surgery, regional anesthesia, ataralgesia, levobupivacaine, lidocaine.
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Putri, Nurhayani, and Leny Sang Surya. "Use of local anesthesia in children: literature review." Makassar Dental Journal 10, no. 3 (December 13, 2021): 279–82. http://dx.doi.org/10.35856/mdj.v10i3.465.
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Local anesthetic agents are drugs used to relieve pain that may occur during dental procedures, one of them is tooth extraction. Lo-cal anesthetics are divided into two groups, namely esters and amides. Local anesthetics aim to immobilize the sensory nerves locally by administering drugs or other medical interventions so that the patient cannot feel pain for a certain duration of time. The use of local anesthesia is usually combined with topical anesthesia to relieve pain due to needle injection. Giving local anes-thesia to children is a psychological barrier for children because usually children are not tolerant of pain and fear. Providing good dental care without pain and comfort is the dentist's responsibility.
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Yung, Eric M., Faraj W. Abdallah, Carla Todaro, Emily Spence, Andrew Grant, and Richard Brull. "Optimal local anesthetic regimen for saddle block in ambulatory anorectal surgery: an evidence-based systematic review." Regional Anesthesia & Pain Medicine 45, no. 9 (July 22, 2020): 733–39. http://dx.doi.org/10.1136/rapm-2020-101603.
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BackgroundAmbulatory anorectal surgery requires an anesthetic of short duration but profound depth. Saddle block anesthesia (SBA) can provide dense sacral anesthesia with minimal motor blockade, but the ideal local anesthetic agent remains undefined. This systematic review aims to identify the optimal SBA regimen for ambulatory anorectal surgery.MethodsWe sought randomized trials examining SBA for ambulatory anorectal surgery and stratified patients into four subgroups according to local anesthetic type and dose: (1) longer acting, higher dose; (2) longer acting, lower dose; (3) shorter acting, higher dose; and (4) shorter acting, lower dose. Longer acting agents included bupivacaine and levobupivacaine; shorter acting agents included chloroprocaine, mepivacaine, and prilocaine. Lower dose was defined as ≤5 mg and ≤20 mg for longer and shorter acting local anesthetics, respectively. The primary outcome was time to discharge; secondary outcomes included times to sensory and motor block regression, urine voiding, and ambulation, as well as block success.ResultsA total of 11 trials (1063 patients) were included. Overall study quality and reporting consistency was poor. Doses ranged from 1.5–7.5 mg to 3–30 mg of longer and shorter acting local anesthetics, respectively. Hyperbaric local anesthetics were used in eight trials (953 patients, 86%). The median time to discharge appeared similar across all subgroups with an overall time of 182 (IQR 102) min. The use of long-acting, lower dose regimens was associated with a faster median time to motor block regression. Block success approached 99% among all trials.ConclusionsThere is presently insufficient qualitative and quantitative evidence to identify an optimal SBA regimen for ambulatory anorectal surgery. Nonetheless, we found that doses as low as 1.5 and 3 mg of longer and shorter acting hyperbaric local anesthetics, respectively, can achieve effective and reliable SBA with timely hospital discharge. Despite similar discharge times, longer acting, lower dose local anesthetics may produce faster motor block regression following SBA for ambulatory anorectal surgery.
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G. Al-Talabani, Blind, Twana Kareem, Seerwan Hasan, and Jwan Rasheed. "Limb amputation of an infant with transposition of great arteries using spinal anesthesia." Edorium Journal of Anesthesia 4, no. 2 (September 11, 2018): 1–04. http://dx.doi.org/10.5348/100016a05ba2018cr.
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Introduction: Spinal and caudal anesthesia are useful anesthetic techniques for infants compared to general anesthesia. In case of infants lumbar puncture can be safely performed at or just below the intercristal line. Due to the presence of loose fatty tissues in the caudal extradural space, it becomes safe and easy to insert a cannula enabling easy cranial spread of local anesthetic drugs. Increased production and absorption of cerebrospinal fluid in infants lead to administration of higher doses of local anesthetics. However, this spinal and caudal anesthesia has lesser risk of post-operative apnea in infants compared to general anesthesia. Case Report: A three-month-old male infant, whose body weight was seven and half kilograms, was afflicted with ischemia which extended to half of his right leg. There was gangrene on his right big toe as well. These developments occurred after cardiac catheterization was implemented through right femoral vein cannulation. Due to high-risk of transposition of great arteries in general anesthesia, the surgeons finalized under spinal anesthesia in order to bypass the infected respiratory system, prevent aspiration because of full stomach, and to get better postoperative analgesia. Conclusion: Spinal anesthesia is an alternative option to general anesthesia in high risk patients owing to its safety. However, in case of spinal complications or failure of spinal anesthesia, the anesthetist should always get ready with the high risk general anesthesia.
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Miyoshi, Michio, Toshiaki Imoto, and Yasutake Hiji. "Alkalinizing Water-Soluble Local Anesthetic Solutions by Addition of Cyclodextrin." Regional Anesthesia & Pain Medicine 23, no. 2 (March 1998): 176–81. http://dx.doi.org/10.1136/rapm-00115550-199823020-00011.
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Background and objectivesThe use of sodium bicarbonate for alkalinization of local anesthetics to improve their efficacy has some disadvantages including decreased stability of the solutions. The present study was performed to evaluate usefulness of cyclodextrins (CDs) in improving the solubility and stability of local anesthetic solutions at near physiologic pH without precipitation.MethodsSolubility of local anesthetics with or without CDs in physiologic saline was investigated by monitoring cloudiness or precipitate formation visually and by recording absorbance at 620 nm. Interaction of anesthetic and CD was also studied spectrophotometrically using spectral change of the drugs associated with the inclusion complex formation.ResultsCyclodextrins improved the solubility and stability of the four local anesthetics studied (dibucaine, tetracaine, bupivacaine, and lidocaine). In the neutral pH region, the effects of the CDs were more significant with dibucaine and tetracaine, which are more hydrophobic than the other two. A type of effective CD was different for each anesthetic depending partly on the tendency to form inclusion complex with local anesthetic. The local anesthetic solutions solubilized by CDs were found to remain clear for more than 72 hours without any visible precipitation or turbidity at neutral pHs.ConclusionsThe improved solubility of local anesthetics by adding CD may be caused by inclusion complex formation of CD with local anesthetics. This new preparation for the alkalinized water-soluble anesthetic solutions may be useful for practical application in the clinical setting, although this awaits further study.
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Rana, Vishal, Jerusha Fernandes, and Savina Gupta. "Local anaesthesia: Buffered or non-buffered? A comparative study." Indian Journal of Clinical Anaesthesia 9, no. 4 (November 15, 2022): 450–54. http://dx.doi.org/10.18231/j.ijca.2022.091.
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An ideal local anesthetic should act swiftly and be efficacious without causing discomfort or toxicity. Buffered anesthetic is useful when it comes to limiting toxicity because of the reduced volume that is needed and the decreased time it takes to be effective when compared with other conventional means. Buffered anesthesia uses sodium bicarbonate mixed into lidocaine prior to injection to neutralize the acid. All the patients were explicated about the study and its significance and valid informed consent was procured from those who were willing to participate in the study. Patients were divided into two groups according to the right and left sides of patient – side A and side B. Side A included patients that were injected with buffered solution [combination of LA with adrenaline 1:80,000 & sodium bicarbonate] and side B included patients that were injected with LA with adrenaline 1:80,000. The results of this study confirm that the routine use of alkalinized local anesthetic solution in cases of acute head and neck infections may improve patients’ comfort and speed up the time of onset of anesthesia. In conclusion, the use of sodium bicarbonate as an adjunct in local anesthetics is convenient, safe, easy to dispense, and readily available.
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Green, D., J. Walter, R. Heden, and L. Menacker. "The effects of local anesthetics containing epinephrine on digital blood perfusion. 1978." Journal of the American Podiatric Medical Association 82, no. 2 (February 1, 1992): 98–110. http://dx.doi.org/10.7547/87507315-82-2-98.
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Digital perfusion research was conducted with two local anesthetics, lidocaine and bupivacaine. The studies were performed utilizing both anesthetic agents, plain and with various concentrations of epinephrine. The drugs' effects on blood perfusion over a 24-hr. period were recorded and discussed. The onset and duration of anesthesia were also compared.
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Uthirapathy, Subasini. "The Local Anesthetic Activity of Lavandula angustifolia and Eugenia caryophyllata Essential Oils." ARO-THE SCIENTIFIC JOURNAL OF KOYA UNIVERSITY 11, no. 2 (November 10, 2023): 116–21. http://dx.doi.org/10.14500/aro.11426.
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Previous studies show that Lavandula angustifolia (lavender) and Eugenia caryophyllata (clove) essential oils can help relieve dental pain. Clove oil and lavender oil were tested as topical anesthetics in this study on rabbits, and their effects and likely mechanisms of action were analyzed. Clove oil and lavender oil were extracted by hydrodistillation using a Clevenger-setup apparatus. Topically applying lidocaine, clove oil, or lavender oil topically all significantly reduced corneal sensitivity. The sensitivity of the cornea was successfully reduced by treatments consisting of lidocaine at a concentration of 0.5%, 25 μg of clove oil, and 50 μg of lavender oil. When clove oil is applied topically to the cornea, it produces effects similar to those of a local anesthetic due to the involvement of the cholinergic system. To achieve the desired effect of producing local anesthesia in the cornea of the rabbit, lidocaine, clove oil, and lavender oil were applied topically to the animal. A noticeable local
anesthetic effect was produced when sub-anesthetic doses of lidocaine were combined with sub-anesthetic doses of lavender or clove oil.
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Spielman, Andrew I., and Judit Forrai. "History of local anesthesia." Kaleidoscope history 13, no. 26 (2023): 438–40. http://dx.doi.org/10.17107/kh.2023.26.30.
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The history of local anesthesia involves three separate inventions: the pharmacological agent, the local anesthetic, the syringe, and the hollow needle. Each evolved separately and has its history. They were assembled for the first time in 1827 as a syringe with a needle, and in 1884, in combination with cocaine as the first anesthetic injected locally. This is part of the Encyclopedia of the History of Dentistry.
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Gabr, Ahmed F., Badry M. Badry, and Mohammed H. Rabea. "Dexmedetomidine addition to local anesthetic mixture for peribulbar anesthesia in strabismus surgery." Journal of the Egyptian Ophthalmological Society 117, no. 2 (April 2024): 151–59. http://dx.doi.org/10.4103/ejos.ejos_83_23.
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Aim To evaluate the effect of the addition of dexmedetomidine to the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries. Methods A randomized controlled study included 58 patients who were divided into two groups, group І: included 29 patients who received peribulbar block by a mixture of local anesthetics only, and group II: included 29 patients who received peribulbar block by a mixture of local anesthetics with dexmedetomidine. All cases underwent preoperative full ophthalmic examination. The onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, sedation level, and duration of analgesia were assessed. Results The onset of sensory and motor block was shortened (P =0.021 and <0.001, respectively) and their duration was prolonged (P <0.001) and the duration of postoperative analgesia was significantly longer in the dexmedetomidine group (P <0.001). Dexmedetomidine group achieved higher sedation scores and lower intra and early postoperative pain scores (P 0.001 and <0.001, respectively) with higher levels of patient and surgeon satisfaction. Conclusion The addition of dexmedetomidine with the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries accelerates the onset of anesthesia and akinesia of the globe and prolongs their duration. It extends the time to the first analgesic request and enhances the satisfaction of both patients and surgeons.
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Moran, Michael C., Lisa J. Heaton, Brian G. Leroux, and Natasha M. Flake. "Local Anesthetic Efficacy in Marijuana Users and Nonusers: A Pilot Study." Anesthesia Progress 69, no. 4 (December 1, 2022): 15–21. http://dx.doi.org/10.2344/anpr-69-02-08.
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Objective: Despite the common clinical impression that patients with a history of drug use are challenging to anesthetize with local anesthesia, literature on this clinical phenomenon is sparse. The objective of this pilot study was to assess if differences in local anesthetic efficacy for dental treatment exist between marijuana users and nonusers. Methods: Subjects were healthy adult males and females who qualified as either chronic marijuana users or nonusers. All subjects had an asymptomatic, vital maxillary lateral incisor that responded to an electric pulp test (EPT). A standard maxillary infiltration injection technique was employed using 1.7 mL 2% lidocaine with 1:100,000 epinephrine over the test tooth, and the tooth was tested with an EPT at 3-minute intervals. Results: A total of 88% of nonusers (15/17) and 61% of users (11/18) were successfully anesthetized, defined as anesthesia onset within 10 minutes and lasting at least 15 minutes. The difference in the proportion of anesthetized subjects was not statistically significant (P = .073). For subjects with successful anesthesia, there was no significant difference between nonusers and users in the onset or duration of anesthesia. Conclusion: No significant differences in local anesthetic efficacy with respect to local anesthetic success, onset, or duration of action were found between chronic marijuana users and nonusers. However, larger studies are likely needed to provide more definitive evidence.
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Townsend, Janice A., Steven Ganzberg, and S. Thikkurissy. "The Effect of Local Anesthetic on Quality of Recovery Characteristics Following Dental Rehabilitation Under General Anesthesia in Children." Anesthesia Progress 56, no. 4 (December 1, 2009): 115–22. http://dx.doi.org/10.2344/0003-3006-56.4.115.
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Abstract This study is a randomized, prospective, double-blind study to evaluate the effects of the combination of local anesthetics and an intravenous nonsteroidal anti-inflammatory drug (NSAID) vs NSAID alone on quality of recovery following dental rehabilitation under general anesthesia (GA). Twenty-seven healthy children aged 3–5.5 years underwent dental rehabilitation under GA. Fifteen children in the experimental group received oral infiltration of local anesthetic in addition to intravenous ketorolac tromethamine, while 12 children in the control group received intravenous ketorolac tromethamine alone for postoperative pain management. Pain behaviors were evaluated immediately postoperatively using a FLACC scale and 4 hours postoperatively by self-report using various scales. Parents reported perception of child pain and comfort and any occurrences of postoperative cheek biting. The use of intraoral infiltration local anesthesia for complete dental rehabilitation under general anesthesia for children aged 3–5.5 years did not result in improved pain behaviors in the postanesthesia care unit (PACU), nor did it result in improved pain behaviors 4–6 hours postoperatively as measured by the FLACC scale, FACES scale, and subjective reports of parents or a PACU nurse. Those children receiving local anesthesia had a higher incidence of negative symptoms related to local anesthetic administration, including a higher incidence of lip and cheek biting, which was of clinical importance, but not statistically significant. Infiltration of local anesthetic for dental rehabilitation under general anesthesia did not improve quality of recovery in children aged 3–5.5 years.
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Svechnikova, E. V., and S. E. Zhufina. "Topical anaesthesia for invasive procedures in dermatology and cosmetology." Meditsinskiy sovet = Medical Council, no. 2 (March 8, 2024): 136–42. http://dx.doi.org/10.21518/ms2024-032.
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Currently, in dermatology and cosmetology, the range of cosmetic procedures and minor invasive interventions, which use local anesthetics, is expanding. They are used alone or as part of an integrated anesthetic approach. Procedures such as mesotherapy, biorevitalization, contour plastic surgery, removal of skin tumors, and laser procedures require anesthesia in the form of local topical anesthesia. Local anesthetics have long been known and well-studied; they have many advantages, significantly increasing patient comfort during invasive procedures, but they also have some disadvantages, including the risk of toxicity. The purpose of using a local anesthetic is to increase the effectiveness of the procedure, convenience and comfort for the patient, minimize negative emotions associated with pain, and the ability to achieve local anesthesia without anatomical distortion of the tissue (i.e., without the use of infiltration anesthesia). Often, the severity of the pain experienced depends on the individual response of the patient. The characteristics of pain are subjective and can vary depending on the “pain threshold”, type of temperament, and previous negative experience. For some patients, sometimes minimal pain becomes a serious obstacle to performing a particular procedure. Some invasive, painful procedures that are performed on pediatric patients require a particularly careful approach to the choice of anesthesia drug and method of administration. In this article, we analyzed the mechanisms of pain pathogenesis, methods of local anesthesia, focused on the role of local anesthetics in cosmetology and dermatology, examined the features of using a cream for local and external use containing a combination of lidocaine 2.5% and prilocaine 2.5%, its therapeutic effectiveness, clinical recommendations for use in various procedures in dermatology and cosmetology. When choosing a drug for local anesthesia, safety is important for the doctor, when used correctly, a low level of side effects, timely pain relief, effectiveness, ease of use and accessibility.
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Ramamurthi, R. J., and Elliot J. Krane. "Local anesthetic pharmacology in pediatric anesthesia." Techniques in Regional Anesthesia and Pain Management 11, no. 4 (October 2007): 229–34. http://dx.doi.org/10.1053/j.trap.2007.09.003.
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Sakic, Almir, and Bakir Helic. "Advantages of spinal compared to general anesthesia." South-East European Endo-Surgery Journal 2, no. 2 (March 5, 2024): 163–68. http://dx.doi.org/10.55791/5n6mvg14.
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Spinal anesthesia is a regional anesthesia technique achieved by a local subarachnoid anesthetic injection. Local anesthetic blocks conduct of pain on the spinal level and provides analgesia of the body below the navel. It can be used in a wide array of procedures, including laparoscopy. Inguinal hernia surgery is performed under general or regional anesthesia, depending on the indications and the individual approach of the anesthetist and surgeon. This article brings review of the literature and our experience in advantages and disadvantages of spinal anesthesia in open inguinal hernia surgery. We find that spinal anesthesia is cost effective and has advantages in inguinal hernia surgery when compared with general anesthesia, in terms of better postoperative pain control, and less nausea and vomiting, with minimal effects on hemodynamic stability.
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Ciechanowicz, Sarah, and Vinod Patil. "Lipid Emulsion for Local Anesthetic Systemic Toxicity." Anesthesiology Research and Practice 2012 (2012): 1–11. http://dx.doi.org/10.1155/2012/131784.
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The accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although uncommon, local anaesthetic systemic toxicity accounts for a high proportion of mortality, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anesthetic-cardiotoxicity, and anesthetic organisations, over the globe have developed guidelines on the use of this drug. Despite this, awareness amongst practitioners appears to be lacking. All who use local anesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using local anesthetics, and the initial management of systemic toxicity with intravenous lipid emulsion. In this paper we intend to discuss the pharmacology and pathophysiology of local anesthetics and toxicity, and the rationale for lipid emulsion therapy.
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n, Pelin. "Local Anesthetic Systemic Toxicity: Evaluation of Awareness and Knowledge Levels of Anesthesia Technicians." Annals of Medical Research 29, no. 9 (2022): 1. http://dx.doi.org/10.5455/annalsmedres.2022.03.100.
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Objective: The aim of our study is to measure the levels of knowledge about the systemic toxicity of local anesthetics among anesthesia technicians, who will be the first to recognize local anesthetic systemic toxicity in the absence of an anesthesiologist or related physician. Materials and Methods: A total of 196 anesthesia technicians working at different hospitals were included in the study. A questionnaire was used as a data collection tool. The data obtained were evaluated statistically using IBM SSPS Statistics 25.0 for Windows. Results: When the distribution of the participants according to knowledge of systemic toxicity was examined, it was seen that 56.1% of the participants answered “yes” to having such knowledge, 24% of the participants said “no,” and 19.9% of the participants did not remember. Regarding what must be done urgently in the event of local anesthetic systemic toxicity development, 74% of the participants said that the administration of local anesthetic should be stopped, 84.2% said that airway safety should be ensured, 100% said that oxygen should be administered, 65.3% said that a call for help should be made, 65.8% said that preparations for tracheal intubation should be started, 66.3% said that a safe venous line should be opened, 30.1% said that convulsions should be treated, and 51% said that a 20% lipid solution should be administered. Conclusion: Based on our findings, we conclude that anesthesia technicians need training to increase their awareness of and knowledge about the symptomatology, prevention, and treatment of local anesthetic systemic toxicity. Keyword: Drug toxicity, Awareness, Technicians.
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Tani, Ryouji, Sachiko Yamasaki, Atsuko Hamada, Mirai Higaki, Yasuyuki Asada, and Souichi Yanamoto. "Clinical Efficacy and Safety of Lidocaine Tape for Topical Anesthesia of the Oral Mucosa: A Preliminary Controlled Trial." Dentistry Journal 11, no. 12 (November 29, 2023): 276. http://dx.doi.org/10.3390/dj11120276.
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Local anesthesia is administered to reduce pain-induced stress during dental treatment. However, local anesthetic injections are extremely painful; thus, methods to minimize this pain should be developed. Clinical studies on the pain-relieving effects of dental topical anesthetics have shown that few topical anesthetics provide fast and adequate pain relief without harming the oral mucosa. We examined the efficacy and safety of lidocaine tape, which has a potent topical anesthetic effect. Lidocaine tape was applied to the oral mucosa of 14 healthy participants, and its suppression effect was assessed by examining the pain intensity at the non-lidocaine tape-applied site using the visual analog evaluation scale and the verbal evaluation scale. Lidocaine tape application significantly reduced visual analog scale (VAS) scores during mucosal puncture compared to non-application (p < 0.01). Moreover, lidocaine tape application significantly reduced VAS scores during local anesthetic injection compared to non-application (p < 0.001). Adverse events were evaluated using the Common Terminology Criteria for Adverse Events, version 5.0. No adverse events attributed to the application of lidocaine tape were observed in any participant. The findings in this study suggest that the application of lidocaine tape before infiltration anesthesia can reduce patient distress.
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Bhattarai, Sameer, Kumud Pyakurel, Dinesh Nalbo, Kanak Khanal, and Narendra Pandit. "Reduction of postoperative pain after infiltration of local anesthetic at the port site and subdiaphragmatic space in laparoscopic cholecystectomy: A cross-sectional study." Journal of Society of Surgeons of Nepal 25, no. 2 (December 30, 2022): 53–57. http://dx.doi.org/10.3126/jssn.v25i2.50828.
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Introduction: Port site and subdiaphragmatic infiltration of local anesthetics during laparoscopic cholecystectomy (LC) is preferred by surgeons to decrease postoperative pain. LC with local anesthetics infiltration as well as without any local anesthetic both have been standard surgical practice. However, the difference in the reduction of postoperative pain in these two groups is not well known. The objective of the study was to compare the postoperative pain with and without infiltration of local anesthetic at the port site and subdiaphragmatic space in LC.
Methods: A hospital-based cross-sectional study was conducted from 25 April 2021 to 25 October 2021 among 60 patients who underwent elective LC. The patients were divided into two equal groups. The study group received infiltration of 20 ml of bupivacaine (0.5%) at the port site and the subdiaphragmatic space, while the control group did not receive any local anesthetic. The primary outcome measure was the visual analog pain score at 6, 12, 24 and 48hrs postoperatively.
Results: Among 60 patients, the majority were female- 40(66.7%); and 40-50 years age group. The two groups were comparable in terms of age, sex, ASA, BMI and duration of pneumoperitoneum and surgery. Infiltration of a local anesthetic agent produced effective postoperative analgesia in the immediate postoperative hours (6, 12 and 24 hours) and was found to be statistically significant when compared to the no-local anesthesia group.
Conclusion: The intraoperative port site and subdiaphragmatic local infiltration is effective at reducing postoperative pain in the first 12 hours without any adverse events.
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O'Brien, David A. "Local Anesthetic." International Society of Hair Restoration Surgery 7, no. 6 (November 1997): 12.1–12. http://dx.doi.org/10.33589/7.6.12a.
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Lee, H. Thomas, Igor E. Krichevsky, Hua Xu, Ayuko Ota-Setlik, Vivette D. D'Agati, and Charles W. Emala. "Local anesthetics worsen renal function after ischemia-reperfusion injury in rats." American Journal of Physiology-Renal Physiology 286, no. 1 (January 2004): F111—F119. http://dx.doi.org/10.1152/ajprenal.00108.2003.
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Local anesthetics are widely used during the perioperative period, even in patients with preexisting renal disease. However, local anesthestics have been shown to cause cell death in multiple cell lines, including human kidney proximal tubule cells. We questioned whether local anesthetics potentiate renal dysfunction after ischemia-reperfusion (I/R) injury in vivo. Rats were implanted with subcutaneous miniosmotic pumps that continuously delivered lidocaine (2 mg·kg-1·h-1), bupivacaine (0.4 mg·kg-1·h-1), tetracaine (1 mg·kg-1·h-1), or saline vehicle, and 6 h later the rats were subjected to 30 min of renal ischemia or to sham operation. Renal function was assessed by measurement of plasma creatinine at 24 and 48 h after renal I/R injury in the presence or absence of chronic infusions of local anesthetics and correlated to histological changes indicative of necrosis. The degree of renal apoptosis was assessed by three methods: 1) DNA fragmentation detected by terminal deoxynucleotidyl transferase biotin-dUTP nick-end labeling staining, 2) DNA laddering detected after agarose gel electrophoresis, and 3) morphological identification of apoptotic tubules at the corticomedullary junction. We also measured the expression of the proinflammatory markers ICAM-1 and TNF-α. Continuous local anesthetic infusion with renal I/R injury resulted in an increased magnitude and duration of renal dysfunction compared with the saline-infused I/R group. Additionally, both apoptotic and necrotic renal cell death as well as inflammatory changes were significantly potentiated in local anesthetic-treated rat kidneys. Local anesthetic infusion alone without I/R injury had no effect on renal function. We conclude that local anesthetics potentiated renal injury after I/R by increasing necrosis, apoptosis, and inflammation.
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Zivotic-Vanovic, Mirjana, and Marjan Marjanovic. "Examination of cardiovascular function variables in tooth extraction under local anesthesia." Vojnosanitetski pregled 63, no. 1 (2006): 43–47. http://dx.doi.org/10.2298/vsp0601043z.
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Background/Aim. Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline) in healthy persons, and in the patients with a certain cardiovascular system disease. The aim of this study was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. Methods. The examinees were divided into the group with cardiovascular diseases (CV, n = 57) of II and III type, according to the American Society of Anesthesiologists (ASA) qualification, and healthy persons (H, n = 55). Both groups were randomly divided into two subgroups: CVa and Ha - where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1 : 100 000 adrenaline); CVb and Hb - where the anesthetic solution was without the vasoconstrictor (3% lidocaine). During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc), systolic (TAs) and diastolic arterial blood pressure (TAd) and ECG were registered. Results. The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05) from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05). The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. Conclusion. This research shoved that tooth extraction under local anesthesia did not cause complications in cardiovascular patients who were in II or III ASA qualification group, regardless the presence of a vasoconstrictor in the local anesthetic solution.
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Gojkovic, Milica, Milanka Tatic, and Sanja Maricic-Prijic. "Advantages of spinal anesthesia in orthopedic surgery." Medical review 75, no. 5-6 (2022): 199–202. http://dx.doi.org/10.2298/mpns2206199g.
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Introduction. Spinal anesthesia is one of the oldest and most commonly used regional anesthesia techniques. It is based on the injection of a local anesthetic into the subarachnoid space, during which there is a transient interruption of impulse conduction in the spinal nerve roots. Application of spinal anesthesia. The use of spinal anesthesia depends on the following factors: the site of the surgical procedure, the type and duration of the surgical procedure, the degree of necessary surgical relaxation, and presence of accompanying diseases. Local anesthetics used in spinal anesthesia. There are two types local anesthetics used in spinal anesthesia. These are local anesthetics of the ester and amide type. Most frequently applied local anesthetics are those of the amide type. Orthopedic procedures under spinal anesthesia. The most common surgical procedures in orthopedic surgery performed under spinal anesthesia are hip, knee and ankle surgeries. Complications of spinal anesthesia. The most common complications of spinal anesthesia are hypotension, bradycardia, urinary retention, and postpuncture headache. Conclusion. The advantages of spinal over general anesthesia in orthopedic surgery include lower incidence of respiratory and myocardial depression, better peripheral tissue perfusion, minimal coagulation system disorders and prolonged postoperative analgesia.
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Poliakova, K. S., N. A. Kovalev, and N. V. Lavrov. "The most common complications of local anesthesia in pregnant women in dental practice." Stomatology for All / International Dental review, no. 2021 1 94 (March 2021): 45–49. http://dx.doi.org/10.35556/idr-2021-1(94)45-49.
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The article presents the results of a sociological study to identify the variability and frequency of complications caused by the use of local anesthetic drugs in pregnant women at the stomatological appointment. The study was conducted using a Google Forms application based on dental education sites on social media. 155 dentists of various specialties took part in the survey. According to the data obtained, among the doctors participating in the study, 70.3% faced complications of local anesthesia in pregnant women. The most common complications are from the nervous (n=54) and cardiovascular (n=19) systems. Some of them can be attributed to the manifestations of the psychogenic reaction of patients to the introduction of local anesthetic drugs, and not to the immediate undesirable effects of anesthetics. Taking into account the results obtained and the data of literature sources, recommendations are given to prevent the development of complications in pregnant patients from the introduction of local anesthetics. Recommendations can be useful for dentists and dental students.
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Halling, Frank, Andreas Neff, and Thomas Ziebart. "Local Anesthetic Usage Among Dentists: German and International Data." Anesthesia Progress 68, no. 1 (March 1, 2021): 19–25. http://dx.doi.org/10.2344/anpr-67-03-12.
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The aim of this study was to analyze the use of dental local anesthetics in Germany compared with international data. The type and distribution of dental local anesthetics and added vasoconstrictors based on a representative sample of German dentists itemized over a period of 7 years (2011 to 2017) were evaluated and statistically analyzed. The results were compared with international dental local anesthetic consumption data published since 2005. With a consistent market share of nearly 98%, articaine was the first-line local dental anesthetic agent in Germany. During the investigation period, German dental local anesthetics with epinephrine 1:200,000 had ∼50% market shares, whereas formulations with epinephrine 1:100,000 had 40% to 45% market shares. Articaine, with market shares between 38% and 81%, was also the preferred anesthetic agent in various other countries, with the notable exceptions of the United Kingdom and the United States, where lidocaine was the preferred local anesthetic agent. Epinephrine was the preferred vasoconstrictor internationally, similar to Germany. The larger market share of higher concentrated epinephrine 1:100,000 was remarkable, considering the increasing number of medically compromised patients. Increased consideration for using agents with reduced dosages of epinephrine (1:200,000) is generally recommended.
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Sung, Hui-Jin, Seong-Ho Ok, Jin-Young Sohn, Yong Hyeok Son, Jun Kyu Kim, Soo Hee Lee, Jeong Yeol Han, et al. "Vasoconstriction Potency Induced by Aminoamide Local Anesthetics Correlates with Lipid Solubility." Journal of Biomedicine and Biotechnology 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/170958.
Full textAbstract:
Aminoamide local anesthetics induce vasoconstrictionin vivoandin vitro. The goals of thisin vitrostudy were to investigate the potency of local anesthetic-induced vasoconstriction and to identify the physicochemical property (octanol/buffer partition coefficient, pKa, molecular weight, or potency) of local anesthetics that determines their potency in inducing isolated rat aortic ring contraction. Cumulative concentration-response curves to local anesthetics (levobupivacaine, ropivacaine, lidocaine, and mepivacaine) were obtained from isolated rat aorta. Regression analyses were performed to determine the relationship between the reported physicochemical properties of local anesthetics and the local anesthetic concentration that produced 50% (ED50) of the local anesthetic-induced maximum vasoconstriction. We determined the order of potency (ED50) of vasoconstriction among local anesthetics to be levobupivacaine > ropivacaine > lidocaine > mepivacaine. The relative importance of the independent variables that affect the vasoconstriction potency is octanol/buffer partition coefficient > potency > pKa > molecular weight. The ED50in endothelium-denuded aorta negatively correlated with the octanol/buffer partition coefficient of local anesthetics (r2=0.9563;P<0.001). The potency of the vasoconstriction in the endothelium-denuded aorta induced by local anesthetics is determined primarily by lipid solubility and, in part, by other physicochemical properties including potency and pKa.
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Ahmed, Hina, Rutuja P. Sindgi, Bharti Gupta, and Deven M. Rawlani. "Pharmacokinetic Profiling and Optimization of Local Anesthetic Delivery Techniques in Dental Procedures a Prospective Cohort Study." INTERNATIONAL JOURNAL OF DRUG DELIVERY TECHNOLOGY 14, no. 01 (March 25, 2024): 281–84. http://dx.doi.org/10.25258/ijddt.14.1.40.
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The optimization and pharmacokinetic profile of dental local anesthetics are the subjects of this prospective cohort study. Using Chi-square testing, the study analyzes and evaluates cohort data. Various study participants must undergo dental procedures under the influence of a local anesthetic. Local anesthetics may be administered intravenously, orally, or topically. The pharmacokinetic profile assesses a local anesthetic’s transit time, distribution, metabolism, and elimination. The Chi-square test evaluates the efficacy, duration, patient satisfaction, and adverse effects of various ways of administering analgesics. This statistical analysis looks at the impact of distribution technique and other categorical variables on the final product. This study aims to identify the best local anesthetic delivery technique for dental procedures in terms of efficacy, safety, and convenience. The results will enhance dental offices and the way patients feel about their visits. Find out how the variables are related by using the Chi-square test. The optimal delivery strategy may be determined by identifying statistically significant variations between delivery modalities. For the purpose of improving patient care, this prospective cohort study used the Chi-square test to learn more about the distribution of local anesthetics during dental procedures.
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Pepe, Franco, Mariagrazia Stracquadanio, Francesco De Luca, Agata Privitera, Elisabetta Sanalitro, and Puccio Scarpinati. "Epidural Anesthesia for Cesarean Section in a Pregnant Woman with Marfan Syndrome and Dural Ectasia." Case Reports in Obstetrics and Gynecology 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/2126310.
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Marfan syndrome (MFS) is a genetic disorder of connective tissue, characterized by variable clinical features and multisystem complications. The anesthetic management during delivery is debated. Regional anesthesia has been used with success during cesarean delivery, but in some MFS patients there is a probability of erratic and inadequate spread of intrathecal local anesthetics as a result of dural ectasia. In these cases, epidural anesthesia may be a particularly useful technique during cesarean delivery because it allows an adequate spread and action of local anesthetic with a controlled onset of anesthesia, analgesia, and sympathetic block and a low risk of perioperative complications. We report the perioperative management of a patient with MFS and dural ectasia who successfully underwent cesarean section using epidural technique anesthesia. The previous pregnancy of this woman ended with cesarean section with a failed spinal anesthesia that was converted to general anesthesia due to unknown dural ectasia at that time.
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Leonenko, Zoya V., and David T. Cramb. "Revisiting lipid general anesthetic interactions (I): Thinned domain formation in supported planar bilayers induced by halothane and ethanol." Canadian Journal of Chemistry 82, no. 7 (July 1, 2004): 1128–38. http://dx.doi.org/10.1139/v04-023.
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A long-standing question in anesthesia is that of the molecular mechanism. Do anesthetics target proteins or change membrane properties or both? We used temperature-dependent magnetic A/C mode atomic force microscopy (AFM) to study interaction of the volatile anesthetics halothane and ethanol with model membranes made from supported planar bilayers (SPBs) of 1,2-dioleoyl-sn-3-glycero-3-phosphocholine (DOPC), dioleoyltrimethylammonium propane (DOTAP), or 1,2-dipalmitoyl-sn-3-glycero-3-phosphocholine (DPPC). We found that the incorporation of halothane or ethanol induces structural changes in the bilayer. These compounds cause thickness reduction in Lα bilayers (either globally or in domains) and the formation of domains with reduced thickness in Lβ phase bilayers. We propose that an anesthetic-induced increased area per lipid drives local chain disorder, thus promoting local phase change. The characteristics of SPBs with halothane or ethanol incorporated were compared with characteristics of the Lα and Lβ phases of anesthetic-free SPBs.Key words: atomic force microscopy, anesthesia, lipid bilayer domains, phase transition
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Lazar, Alexandra, Marcel Perian, Bogdan Cordoș, Mircea Gherghinescu, and Bianca Liana Grigorescu. "How we did it - an easy and feasible experimental rat model of protective role of Lipid Emulsion in Ropivacaine induced Local Anesthetic Systemic Toxicity - technique presentation and preliminary results." Acta Marisiensis - Seria Medica 67, no. 2 (June 1, 2021): 90–94. http://dx.doi.org/10.2478/amma-2021-0014.
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Abstract Introduction: Local Anesthetic Systemic Toxicity (LAST) is the most feared local anesthesia accident. As the cardiac arrest determined by LAST is mostly refractory to known resuscitation protocols, due local anesthetic blockade produced in the cardiac cells, the Lipid Emulsion (L.E) has been proved to be beneficial in resuscitating the cardiac arrest determined by local anesthetic. The aim for this presentation is to ease future studies on this topic, to ensure a starting point for next related research on LAST and LE mechanism of action. Method: Under genaral anesthesia we induced Local Anesthetic Systemic Toxicity to a rat model, by injecting Ropivacaine into the inferior vena cava. We monitored the cardiac activity of the subjects during the experiment. We used 4 groups of rats, control group- no intervention, lipid group- lipid emulsion was adminsitered, local anesthetic group- local anesthetic was administered and local anesthetic and lipid emulsion group- a dose of lipid emulsion was adminsitered before administering the local anesthetic. Results: After a few attemps to incannulate teh peripheral veins we tried the more complex approach of inferior vena cava, which ensured a secure access which allowed us to repetedly adminster the local anesthetic and the lipid emulsion. Conclusion: The presented experimental animal model of induced LAST and the protective effects of LE is one of the few described in the literature, is a reproducible model, feasible, simple, low cost and can be used as starting point in future LAST research.
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Bina, Babak, Elliot V. Hersh, Micael Hilario, Kenia Alvarez, and Bradford McLaughlin. "True Allergy to Amide Local Anesthetics: A Review and Case Presentation." Anesthesia Progress 65, no. 2 (June 1, 2018): 119–23. http://dx.doi.org/10.2344/anpr-65-03-06.
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Adverse reactions to local anesthetics are usually a reaction to epinephrine, vasovagal syncope, or overdose toxicity. Allergic reactions to local anesthetics are often attributed to additives such as metabisulfite or methylparaben. True allergic reactions to amide local anesthetics are extremely rare but have been documented. Patients with true allergy to amide local anesthetics present a challenge to the dental practitioner in providing adequate care with appropriate intraoperative pain management. Often, these patients may be treated under general anesthesia. We report a case of a 43-year-old female patient that presented to NYU Lutheran Medical Center Dental Clinic with a documented history of allergy to amide local anesthetics. This case report reviews the use of 1% diphenhydramine with 1:100,000 epinephrine as an alternative local anesthetic and reviews the relevant literature.
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Laviola, M., S. K. McGavin, G. A. Freer, G. Plancich, S. C. Woodbury, S. Marinkovich, R. Morrison, A. Reader, R. B. Rutherford, and J. A. Yagiela. "Randomized Study of Phentolamine Mesylate for Reversal of Local Anesthesia." Journal of Dental Research 87, no. 7 (July 2008): 635–39. http://dx.doi.org/10.1177/154405910808700717.
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Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).