Survey of Usage and Type of Topical Anesthesia among Dentists of Tricity

Introduction: Local anaesthesia injection is widely acceptedas the gold standard for pain management during variousdental procedures. Intra-oral topical anaesthesia not onlyreduces the pain of injection prick but also several minordental procedures can be carried out under topical anaesthetic.Study aimed to determine the usage, type & effectiveness ofvarious topical anaesthetics used for minor dental proceduresin pediatric patients.Material and Methods: A self-structured, closed endedquestionnaire was emailed to 100 private dental practitionersin the tricity and were asked to fill and mail it back.Results: 59% dentists responded, out of them 70.7%routinely used topical anesthetic. 64.8% used Lidocaine gelfor administration of local anesthesia. 24.1% used topicalanesthetic for extraction of nearly exfoliating deciduous teeth.42.6% responded that the effect of topical anesthetic wasachieved between 30 seconds to 1 minute.Conclusion: All the dentists were aware of using topicalanesthetic and the most preferred delivery system was gel.

Avaliação da utilização de anestésico tópico para instalação de mini-implantes ortodônticos / Evaluation of the use of tropical anesthetics for installation of orthodontic mini-implants

Objetivos: o objetivo deste trabalho foi avaliar a eficiência do uso de anestésico tópico para inserção de mini-implantes utilizados como meio de ancoragem esquelética em Ortodontia. Material e Métodos:o anestésico tópico a base de lidocaína 20% em gel foi utilizado para inserção de mini-implantes em 40 pacientes em tratamento com aparelhos fixos. A idade média dos pacientes era 23,58 anos. Os pacientes responderam a um questionário com quatro perguntas de múltipla escolha, avaliando a aceitabilidade e o desconforto durante a anestesia e a colocação do mini-implante. Os dados foram avaliados em porcentagem e pelo teste qui-quadrado para avaliação do dimorfismo sexual. Resultados: 92,5% dos pacientes relataram que não sentiram nenhum incômodo durante a aplicação do anestésico tópico e apenas7,5% sentiram uma leve dormência, o que mostra que o anestésico teve boa aceitação pelos pacientes. Em relação ao procedimento de instalação dos mini-implantes, somente 20% dos indivíduos da amostra relacionaram a dor (independente da intensidade) como a sensação mais desagradável durante todo o procedimento de colocação do mini-implante.Entretanto, 47,5% dos pacientes não sentiram dor alguma e apenas10% dos pacientes sentiram dor intensa. Houve diferença entre os gêneros apenas com relação à sensação mais desagradável durante todo o procedimento, sendo que a maioria das mulheres (55%) relatou não ter sentido nada desagradável, comparando com apenas 40% dos homens. Conclusão: a instalação de mini-implantes com anestésico tópico se mostrou viável e eficiente, podendo ser uma alternativa, mas são necessários mais estudos e comparações com outros métodos de anestesia.

Objectives: the objective of this study was to evaluate the efficiency of the use of topical anesthetics for insertion of miniimplants used as skeletal anchorage in orthodontics. Material and methods: the topical anesthetics based in lidocaine gel 20% was used to the insertion of mini-implants in 40 patients in treatment with fixed appliances. The mean age of the patients was 23.58 years. Patients answered to a questionnaire with 4 multiple choice questions, evaluating the acceptability and discomfort of the patients during anesthetics and placement of mini-implant. Data were evaluated by percentage and by the chi-square test to evaluate the sexual dimorphism. Results:92.5% of the patients reported that did not feel any discomfort during the application of the topical anesthetics, and only 7.5% felta slight dormancy, what shows that the anesthetics presented good acceptance by the patients. In relation to the procedure of installation of mini-implants, only 20% of the subjects related pain (regardless ofthe intensity) as the more unpleasant sensation during the procedure of placement of the mini-implant. However, 47.5% of the patients did not feel any pain and only 10% of the subjects felt intense pain. There was difference between sexes only regarding the more unpleasant sensation during the procedure, and the majority of the females (55%)reported not to feel any unpleasant sensation, comparing with only 40% of the males. Conclusion: the installation of mini-implants with topical anesthetics proved to be feasible and effective, it could bean altemative, but more studies and comparisons with other type of anesthesia are necessary.

Efficacy and safety of a lidocaine/tetracaine medicated patch or peel for dermatologic procedures: a meta-analysis / 대한마취과학회지

BACKGROUND: To justify the use of the lidocaine/tetracaine medicated patch or peel as a preventive treatment for reducing pain and discomfort in adults and children. We reviewed randomized controlled trials (RCTs) to evaluate the efficacy and safety of the lidocaine/tetracaine medicated patch or peel compared with placebo. METHODS: Ten RCTs (574 patients) were included in this systemic review. Relevant studies were identified through searches of MEDLINE, SCOPUS and the Cochrane database library. The outcome was the adequacy of cutaneous anesthesia reflected in the patient's assessment of pain intensity during minor dermatologic procedures and adverse effects after application of the lidocaine/tetracaine medicated patch or peel versus placebo. RESULTS: The efficacy of the lidocaine/tetracaine patch or peel was consistently very significantly beneficial 30 or 60 minutes after the application compared to placebo (Relative risk, RR: 2.5; Number needed to treat, NNT: 2.2). We did not identify any difference in the effectiveness of adequate analgesia between the lidocaine/tetracaine patch and peel (the number needed to treat or to harm, NNT 2.4 vs. 2.0). No serious side effects or adverse events were observed with the lidocaine/tetracaine medicated patch or peel and placebo. Minor skin reactions were transient and resolved without treatment (Odd ratio, OR: 1.4 and 95% confidence interval, CI: 0.9-2.1; NNT: 14.9). CONCLUSIONS: The lidocaine/tetracaine medicated patch or peel is a well accepted, effective and safe method for minor dermatologic procedures based on pooled data of trials in terms of adequacy of cutaneous anesthesia and adverse effects.

Influence of topical anesthetics on oculocardiac reflex and corneal healing in rabbits / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the incidence of oculocardiac reflex (OCR) with two anesthetic regimens and its prevention using topical anesthetics in a rabbit model. We also investigated the effect of topical anesthetics on corneal healing.METHODS: Forty-eight clinically healthy adult New Zealand white rabbits of either sex were divided into two groups (Group A and B) and anesthetized with either ketamine (Group A, n=24) or propofol (Group B, n=24). In this study , the incidence of OCR was recorded in each group with a variety of ocular manipulation with or without the use of topical anesthetics (40g/L lignocaine, 5g/L proparacain, 5g/L bupivacaine). Corneal toxicity and healing following the use of each topical anesthetic was assessed one day after surgery and up to 7 days postoperatively by clinical examination of the eye, histopathology and collagen staining and transmission electron microscopy.RESULTS: No incidence of OCR was recorded with ocular manipulation under ketamine anesthesia, whereas significant reduction in heart rate (P<0.01) was recorded under propofol anesthesia. Topical anesthetics could successfully prevent the OCR without affecting the corneal healing.CONCLUSION: Topical anesthetics may be recommended for prevention of OCR without any local adverse effect.

Evaluation of contamination rates and antimicrobial activity of topical anesthetics used in Dentistry

The topical anesthetics are suitable before infiltrative anesthesia. These products cannot be sterilized, so they have been contraindicated in oral surgeries. The aim of this work was to evaluating contamination rates of topical anesthetics, as well as the antimicrobial product activity as it is used by the clinical. Five new products and 10 in use were tested, constituted of benzocaine 20% and lidocaine 5%. After the mixture of 0,5g of anesthetic at 4,5 mL of saline solution, serial dilution was made and the blood agar plates 5% were incubated. In a second phase, suspensions of Candida albicans, Eschrichia coli and Staphylococcus aureus were inoculated in 0,5g of topical anesthetic. The mixture remained in contact for 2 minutes and the dilution in 5mL of saline solution was made. Later on, serial dilutions and inoculation with specific agar plates were accomplished. After incubation, there were no Colony Forming Units (CFUs) and in the evaluation of the antimicrobial activity there was decrease in the number of microorganisms. The results suggest that topical anesthetics possess strong antimicrobial effect and the absence of contamination doesn't contraindicate their use in oral surgeries.

Os anestésicos tópicos são indicados previamente a anestesias por infiltração. Por não serem esterilizáveis, estes tem sido contra-indicados em cirurgias bucais. O objetivo deste trabalho foi avaliar o nível de contaminação de anestésicos tópicos novos e com determinado tempo de uso, assim como o efeito antimicrobiano do produto como é utilizado pelo clínico. Testaram-se 5 produtos novos e 10 em uso, constituídos de benzocaína 20% e lidocaína 5%. Após a mistura de 0,5g de anestésico a 4,5 mL de solução salina, realizou-se diluição seriada e semeadura em placas de Petri contendo ágar-sangue a 5%. Em uma segunda fase, inoculou-se suspensões de candida albicans, Escherichia coli e Staphylococcus aureus em tubos de ensaio contendo 0,5g de anestésico tópico. Deixou-se a mistura em contato por 2 minutos e realizou-se a diluição em 5mL de solução salina. Posteriormente, diluições seriadas e semeadura em placas de Petri contendo meios de cultura específicos foram realizadas. Após o cultivo, não houve formação de Unidades Formadoras de Colônias (UFCs) nas placas contendo ágar-sangue e na avaliação da atividade antimicrobiana houve redução no número de microorganismos. Os resultados sugerem que anestésicos tópicos possuem forte efeio antimicrobiano e que a ausência de contaminação não contra-indica sua utilização em cirurgias bucais.

Anestésicos tópicos: [revisão] / Topical anesthetics: [review]

Os procedimentos cirúrgicos e cosmiátricos realizados pelos dermatologistas, tais como laser para epilação, remoção de tatuagem e rejuvenescimento, curetagem, eletrocoagulação, crioterapia, preenchimentos injetáveis, aplicação de toxina botulínica, escleroterapia, "peelings" químicos, entre outros, requerem muitas vezes o uso de anestésicos locais para o conforto do paciente. Tradicionalmente, o agente anestésico de escolha é a lidocaína injetável. Embora seja muito eficaz na produção de anestesia local total, a injeção causa dor. Há vários anestésicos tópicos disponíveis que podem aliviar o desconforto causado por esses procedimentos, sem a necessidade de injeções.

The Effects of Topical Anesthetic Ointment to the Pain during Electromyographic Examination

OBJECTIVES: To investigate the effects of topical anesthetic ointment (lidocaine 2.5% prilocaine 2.5%) to the pain during electromyographic examination. METHOD: Thirty-two adults without known neurological disorders were studied. The needle Electromyography (EMG) of flexor carpi radialis (FCR) muscle and the motor and sensory conduction studies of median nerve were performed after the application of topical anesthetic ointment in one upper extremity and compared to the other side upper extremity without anesthesia. The intensity of pain was assessed with the Visual Analog Scale (VAS) and the characteristics of pain was evaluated with the modified short-form McGill pain questionnaire. RESULTS: The VAS score of the needle EMG of FCR muscle in the anesthetized side was significantly lower to that of the non-anesthetized side (P<0.01). And the characteristics of pain were shooting (10 cases, 31.3%), or throbbing (6 cases, 18.8%) in the anesthetized side and dull (13 cases, 40.6%), or numb (7 cases, 21.9%) in the non-anesthetized side. The VAS scores of the sensory and motor nerve conduction study of median nerve were not significantly different in both sides. CONCLUSION: The application of topical anesthetic ointment decreases the intensity and changes the characteristics of pain during the needle EMG.

Intraoperative Adjustment with Topical Anesthetics in Strabismus Surgery

For the better correction of strabismus surgery, various adjustable surgical technics are performed with general or retrobulbar anesthesia. Topical anesthetics with IV analgesics (Fentany 1 citrate) and sedative (Valium) can induce adequate pain control without inhibiting extraocular muscle activities and enable intraoperative adjustment easily and conveniently without the troublesome maneuver of postoperative adjustment and accompanying risk of infection Intraoperative adjustable surgery is better than postoperative adjustable surgery because it is easier to perform due to less tissue edema, enables to avoid the risk of retrobulbar or peribulbar anesthesia, and the risk of infection. We operated 20 strabismic patients aging 10 to 48 years using the intraoperative adjustment and topical anesthetics with the good success rate 90%, within +/- 10 delta after 5 weeks follow-up.

Intraoperative Adjustment with Topical Anesthetics in Strabismus Surgery

For the better correction of strabismus surgery, various adjustable surgical technics are performed with general or retrobulbar anesthesia. Topical anesthetics with IV analgesics (Fentany 1 citrate) and sedative (Valium) can induce adequate pain control without inhibiting extraocular muscle activities and enable intraoperative adjustment easily and conveniently without the troublesome maneuver of postoperative adjustment and accompanying risk of infection Intraoperative adjustable surgery is better than postoperative adjustable surgery because it is easier to perform due to less tissue edema, enables to avoid the risk of retrobulbar or peribulbar anesthesia, and the risk of infection. We operated 20 strabismic patients aging 10 to 48 years using the intraoperative adjustment and topical anesthetics with the good success rate 90%, within +/- 10 delta after 5 weeks follow-up.

A Clinical Evaluation of Urethral Topical Anesthetics for Urological Procedures / 대한비뇨기과학회지

In order to find a more satisfactory pain relieving agent for endoscopic examinations and other urological procedures, various urethral topical anesthetics and analgesics were evaluated clinically on a total of 147 male patients. Mean age of three patients was 46 years old with range of 16~78. The procedures performed in this study were: Cystoscopy in 50; cystoscopy and panendoscopy. 77: panendoscopy only 1; cystoscopy and ureteral catheterization, 15; cystoscopy and lithorapaxy, 1 and urethral dilatation, 3. The anesthetics and analgesics used in this study were as follow: Group 1 consisted of 7 patients with intramuscular injection of 50mg of demerol 30 minutes before the procedure and urethral lubrication with surgical jelly, Group II. 10 patients, urethral instillation of 2% procaine solution for 10 minutes and urethral lubrication with surgical jelly. Group III. 13 patients, urethral instillation of 2% lidocaine solution for 10 minutes and urethral lubrication with surgical jelly. Group IV. 112 patients, urethral instillation of 2% lidocaine jelly only for 10 minutes and Group V, 5 patients, urethral instillation of 2% lidocaine jelly with intravenous injection of 50mg of demerol 10 minutes before the procedure. Degree of pain after exposure of the anesthetics was recorded as the following 5 different categories: +++: severe pain, intolerability of the procedures ++ : moderate pain tolerance of the procedures + : mild pain, tolerance of the procedures +/- : slight pain with discomfort - : no pain with only discomfort Tentative criteria of judging effectiveness of anesthetics were as follows: + ~ +++ : unsatisfactory results - ~ +/- : satisfactory results The effectiveness of the anesthetics used for various urological endoscopic procedure was summarized as follows : The satisfactory results were obtained in 20% group II, in 23% group III, it 65% of group IV, and in 80% of group V.