ABSTRACT
Introduction: Needle prick pain is a distressing event for a pa?ent receiving spinal anaesthesia. A ‘Needle piercing the spine’ might be physically and mentally trauma?zing for many pa?ents. This may lead to unwanted panic and anxiety during the procedure of spinal anaesthesia. To avoid this distressing needle prick pain, many clinicians have resorted to the prac?ce of giving injec?ons of local anaesthe?c or local applica?on of EMLA cream or patch at the site of spinal puncture beforehand for anaesthe?zing the skin and subcutaneous ?ssues. Methods: A prospec?ve cohort study was done. Those enrolled pa?ents were assessed by an expert anesthesiologist, who was not part of the research team, and he prescribed pa?ents either EMLA cream or regular standard lignocaine infiltra?on anaesthesia and labelled them as Group E and Group L respec?vely. The pain score was assessed using a Visual Analogue Scale. Result: A total of 64 pa?ents were enrolled in the study33 in Group E and 31 in Group L. Both groups had an almost similar number of pa?ents who had a similar extent of surgery. Univariate analysis showed that the mean pain score (VAS) was significantly higher in Group E pa?ents compared to that in Group L, p<0.001. The mul?variate analysis had similar findings a?er controlling confounding factors in mul?ple regression analysis. Conclusion: Local 2% lignocaine injec?on achieved significantly more pain reduc?on during spinal needle inser?on compared to the applica?on of an EMLA patch before spinal anaesthesia.
ABSTRACT
Introduction: The extravasation of saliva from the sublingual gland on the floor of the mouth results in a ranula. The most typical presenta?on is swelling under the tongue. The mylohyoid muscle may allow it to herniate, Causing a plunging ranula. Ranula can be treated in many ways, including ranula excision alone, excision of the sublingual gland with or without ranula, aspira?on of cys?c fluid, sclerotherapy, marsupializa?on, incision and drainage. Material and methods: This case study includes six pa?ents with ranula who underwent surgical treatment by marsupializa?on. The indica?ons, age and sex distribu?on, Marsupializa?on methods, pathology reports, recurrence rates, and complica?ons were seen. Results: Out of 6 pa?ents in our case series, no one pa?ent has shown to be any recurrence or complica?ons of marsupializa?on. Conclusions: Management of Ranula by Marsupializa?on is a good op?on, but if it recurs a?er marsupializa?on, Excision of the lesion and the affected gland is the best course of act?on.