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Comparison of the effects of Valsalva maneuver, EMLA cream, and the combination of both in relieving pain of needle insertion on totally implantable access port: A randomized controlled study.

BACKGROUND: Totally implantable access port (TIAP) is a subcutaneously implanted, long-term infusion device that is widely used in oncology patients. However, multiple needle insertions into TIAP may lead to pain, anxiety, and dread in patients. This study aimed to compare the effectiveness of Valsalva maneuver, eutectic mixture of local anesthetics (EMLA) cream, and the combination of both in relieving pain of cannulations on TIAP. METHODS: This was a prospective randomized controlled study. We included 223 patients treated with antineoplastic drugs and randomized them into four groups: EMLA

Efficacy and safety of ultra-pulsed CO2 fractional laser (UP) for the treatment of periorbital static wrinkles.

To evaluate the efficacy and safety of ultra-pulsed CO2 fractional laser (UP) in the treatment of periorbital static wrinkles in Asians, and … caine ointment (Beijing Ziguang Pharmaceutical Co., Ltd., lidocaine concentration of 5%, containing prilocaine and lidocaine, 25 mg of each per gram, synergistically enhancing the anesthetic effect with minimal skin irritation) was applied for 1 h. After anesthesia, the treatment area was disinfected, and a metal heat-insulating intraocular shield was placed …

Complex regional pain syndrome type I: efficacy of stellate ganglion blockade.

BACKGROUND: This study was performed to evaluate the treatment of complex regional pain syndrome (CRPS) type I with stellate ganglion blockade. MATERIALS AND METHODS: We performed three blockades at weekly intervals in 22 patients with CRPS type I in one hand. The patients were divided into two groups depending on the time between symptom onset and treatment initiation. Group 1and 2 patients had short and long symptom-onset-to-treatment intervals, respectively. Pain intensity, using a visual analog score (VAS), and range of motion (ROM) for the wrist joint were assessed before and 2 weeks aft

Study of topical anaesthetic for paediatric laser procedures (STAPLE): a protocol for a feasibility and pilot randomised controlled trial.

INTRODUCTION: Cutaneous vascular anomalies and scars can cause significant physical and psychosocial difficulties for children, but can be a … ar anomalies. Patients will be randomised in a 1:1 ratio to receive either TA cream (lidocaine 2.5%/prilocaine 2.5% (Numit 5% cream, Ego Pharmaceuticals, Braeside, VIC, Australia)) or a placebo, along with our unit's standard multimodal analgesic agents for laser treatment (including paracetamol, ibuprofen or oxycodone and intraprocedural sucrose solution or …

Comparison of five commonly-available, lidocaine-containing topical anesthetics and their effect on serum levels of lidocaine and its metabolite monoethylglycinexylidide (MEGX).

BACKGROUND: Topical anesthetics are commonly applied for a variety of indications. Several lidocaine-containing topical anesthetics are avai … dale, Michigan), Topicaine (4% lidocaine; Ebsa Laboratories, Jupiter, Florida), 2.5% lidocaine/2.5% prilocaine (generic EMLA preparation; High Tech Pharmaceuticals, Amityville, New York), LET (4% lidocaine, 1:2000 epinephrine, and 0.5% tetracaine), and BLT (20% benzoncaine, 6% lidocaine, and 4% tetracaine). After a patch test for adverse reactions, the topic …

[Nociceptive cancer pain in adult patients: statement about guidelines related to the use of antinociceptive medicine].

OBJECTIVE: The World Health Organization (WHO) published guidelines to improve cancer pain control which allow to relieve noceptive cancer p … dures must be prevented with various and associated treatments: for example, mixed topics lidocaïne-prilocaine for venous or arterial punctures; infiltration of local anaesthetics and inhalation of an oxygen - nitrous oxide mixture for medullary biopsies. CONCLUSION: Oral immediate or controlled release morphine is the most common and effective pain treatme …

Central nervous system effects of local anaesthetic agents.

A review is given of an experimental study on cats where the influence of acid-base changes on central nervous system toxicity of local anaesthetic agents was studied. The conclusion of this study was that a respiratory acidosis increased the central nervous system toxicity of local anaesthetics and that the underlying metabolic conditions modified this increase. Thus a respiratory acidosis increased this toxicity more if it was based on a metabolic acidosis than on a metabolic alkalosis (Englesson, 1974; Englesson and Grevsten, 1974). An extended analysis is presented where automatic frequenc

Management of medically intractable genitofemoral and ilioingunal neuralgia.

AIM: To evaluate the effectiveness of invasive procedures in medically intractable genitofemoral and ilioingunal neuralgia. MATERIAL AND METHODS: This is a prospective study of 20 patients with genitofemoral and ilioinguinal neuralgias who were treated at our medical center between 2007 and 2011. Genitofemoral and ilioinguinal nerve blocks were performed in all cases after medical treatment had failed to alleviate the patients' pain. Neurectomy was performed for the patients whose pain did not improve. Patient histories, physical examinations and visual analogue scale scores before and after

[Acute pain management in proximal femoral fractures: femoral nerve block (catheter technique) vs. systemic pain therapy using a clinic internal organisation model].

BACKGROUND: The aim of this study was to compare safety and efficacy of catheter-mediated femoral nerve block analgesia with systemic pain t … o two equal groups A and B. Group A (n=50) received a catheter-mediated femoral nerve block with 1% prilocaine (40 ml) and post-operatively 0.2% ropivacaine (30 ml) 6 hourly. Group B (n=50) initially received intravenous metamizol (1 g) and a fixed combination of oral tilidine (100 mg) + naloxone (8 mg). Patients aged 90 years or more received a reduced dose …

[The anterior sonographic-guided celiac plexus blockade. Review and personal observations].

The coeliac plexus block is an approved method for the relief of upper abdominal pain due to cancer of the upper intra-abdominal viscera or … ominal region. For the enforcement of a neurolytic coeliac plexus block 10 ml ethanol 96% and 10 ml prilocaine 1% can be administered. The two solutions are applied as small volumes in permanent succession. Thus the burning pain, which is often observed after the injection of alcohol, is avoided. RESULTS. In the literature there are only a few reports, about …

Complications after removal of mandibular third molars with special reference to local anaesthetics with different vasoactive properties.

Nhe symptoms after surgical removal of 379 mandibular wisdom teeth when Xylocain-Exadrin 2% and Citanest-Octopressin 3% were used, were evaluated according to a three grade scale. The severity of the symptoms, which were mild and normal in 53% and severe in 47%, did not demonstrably vary with the type of anaesthetic agent used. The symptoms were, on the average, more severe among the women than among the men. The symptoms were correlated with the duration of the operation, which was most obvious in the men. For the men the frequency of symptoms also increased with age. In the men there was als

Endodontics in Systemically Compromised Patients

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… No more than two carpules of lidocaine 1:100,000, prilocaine HCL (1:200,000) or bupivacaine with 1:200,000 epinephrine should be delivered for anesthesia. In the moderately controlled diabetic patient, a maximum of two carpules of bupivacaine or prilocaine should be used. … Lidocaine and prilocaine are FDA category B rating when given in a therapeutic range and should be the first-line choices for local anesthesia for pregnant women who do not have any contraindications, such as allergy [ 73 , 74 ]. Bupivacaine, mepivacaine, and articaine are FDA category C ratings. …

Trigeminal nerve injuries in relation to the local anaesthesia in mandibular injections.

OBJECTIVE: This study reports the signs and symptoms that are the features of trigeminal nerve injuries caused by local anaesthesia (LA). METHODS: Thirty-three patients with nerve injury following LA were assessed. All data were analysed using the SPSS statistical programme and Microsoft Excel. RESULTS: Lingual nerve injury (LNI; n = 16) and inferior alveolar nerve injury (IANI; n = 17) patients were studied. LNI were more likely to be permanent. Neuropathy was demonstrable in all patients with varying degrees of paraesthesia, dysaesthesia (in the form of burning pain) allodynia and hyperalg

Factors affecting patients' and potential patients' choices among anaesthetics for periodontal recall visits.

OBJECTIVES: Dentinal hypersensitivity and recurrent disease may necessitate the use of anaesthetic during periodontal recall visits. However, an aversion to injections may affect patient compliance. The objectives of this study were to determine choices patients and 'potential' patients make when provided with information on the risks and benefits of alternative anaesthetic choices for root planing during periodontal recalls and to examine which factors influence these choices. METHODS: Using an interactive computer tool, scenarios described the risks and benefits of root planing during perio

[Peribulbar anesthesia versus retrobulbar anesthesia with facial nerve block. Techniques, local anesthetics and additives, akinesia and sensory block, complications].

BACKGROUND: Retrobulbar anesthesia (RETRO), combined with a facial block, is the most frequently employed method of anesthesia in cataract s … porally (disadvantage: worse akinesia). LOCAL ANESTHETICS: A) Short and weak action: lidocaine and prilocaine; advantages: good tissue penetration, low toxicity. - B) Intermediate duration and potency of action: mepivacaine; advantage: pronounced vasoconstrictor activity, alternative to adrenaline. - C) Long and strong action: 1) etidocaine; advantage: pron …

ECG variations in patients pre- and post-local anaesthesia and analgesia.

OBJECTIVES: To determine the incidence of ECG abnormalities in a healthy adults undergoing a surgical extraction of third molar teeth pre-and post-operatively and to study the effect of local anaesthetics, surgical stress and analgesics on cardiac rhythm. METHOD: One hundred and ninety-eight healthy adult patients taking part in a clinical trial of analgesics were randomly selected for this study. All patients required the removal of at least one impacted mandibular wisdom tooth under local anaesthetic. An ECG was taken at a screening visit and repeated post-operatively 30 minutes after analg

Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

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… Multiple studies have been conducted where local anesthetics such as articaine, lidocaine, mepivacaine, and prilocaine with a vasoconstrictor are preferred to be administered intraoperatively to minimize pain. [61] Local anesthesia (LA) results in a numbing effect to the area of operation and prevents …