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A double blind, randomized controlled clinical trial was done to investigate the effect of analgesics aceclofenac and ibuprofen in reducing pre-operative pain following local anesthesia with lidocaine and articaine. One hundred and twenty patients with irreversible pulpitis of the maxillary premolars and first molar region were randomly divided into 2 groups with group 1, 2% lidocaine with 1:200000 epinephrine and group 2, 4% articaine with 1:100000 epinephrine. The two groups were again subdivided into 3 subgroups in which patients were given identical capsules containing ibuprofen 600 mg, aceclofenac 100 mg, placebo (vitamin tablets), half an hour before the administration of buccal infiltration anesthesia. Patients indicated their pain scores on a Heft Parker Visual analog scale (VAS). Infiltration anaesthesia was given under sterile condition.1 min after the injection, electric Imrana Tasneem, B.R. Bharat, Murari Uday Kumar, Srirekha A. Effect of premedication with aceclofenac and ibuprofen on the success rate of two different local anesthetic agents in irreversible pulpitis cases of maxillary posterior teeth (a prospective randomized double-blind clinical trial). IAIM, 2019; 6(5): 40-45. Page 41 pulp test and cold test were done and testing was repeated after every 2 minutes for a total of 10 minutes. Premedication with ibuprofen (600 mg) and aceclofenac (100 mg) resulted in statistically significant increase in onset of action for both the anesthetic agents. There was no significant difference in the time of onset of anesthesia between the two local anesthetic solution (chi-square test/ One way ANOVA).
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Objective To investigate the efficacy of ultrasound-guided cervical plexus block in radiofrequency ablation of thyroid and parathyroid benign lesions . Methods One hundred and twenty-five patients with thyroid nodules or hyperparathyroidism , who were undergone ultrasound guided radiofrequency ablation ,were randomly assigned to receive either ultrasound-guided cervical plexus block or local infiltration anesthesia ,and the pain grading was evaluated by numerical rating scale ( NRS ) . The anesthetic dosage and the effect of thermal ablation surgery of ultrasound-guided cervical plexus block anesthesia and local anesthesia were compared . Results The anesthetic dosage in ultrasound-guided cervical plexus block was lower than that in local infiltration anesthesia( t = 17 .681 , P < 0 .05) . The pain grading of ultrasound-guided cervical plexus block was lower than that of local infiltration anesthesia( χ2 = 33 .738 , P < 0 .05) . Conclusions Ultrasound-guided cervical plexus nerve block has lower anesthetic dosage and pain grading in the radiofrequency ablation of thyroid and parathyroid benign lesions ,which may be widely applied in clinical .
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Objective: To investigate the effect of adductor canal block combined with local infiltration anesthesia on the rehabilitation of primary total knee arthroplasty (TKA). Methods: A total of 104 patients who met the selection criteria for the first unilateral TKA between March 2017 and August 2017 were included in the study. They were randomly divided into trial group (53 cases) and control group (51 cases). In the trial group, the adductor canal block with intraoperative local infiltration anesthesia were performed. In the control group, only intraoperative local infil-tration anesthesia was performed. There was no significant difference in gender, age, body mass index, diagnosis, effected side, and the preoperative American Society of Anesthesiologists (ASA) grading between 2 groups ( P>0.05). The operation time, length of stay, and complications were compared between 2 groups, as well as visual analogue scale (VAS) score of incision at rest and during activity, the range of motion (ROM) of knee flexion and extension activity, limb swelling (thigh circumference), walking distance, and pain VAS score while walking. Results: The operation time of the trial group was significantly shorter than that of the control group ( t=-2.861, P=0.005). However, there was no significant difference in length of stay between 2 groups ( t=-0.975, P=0.332). The wound effusion occurred in 1 patient of trial group and 2 of control group; hematoma occurred in 2 patients of trial group and 3 of control group; no symptom of intermuscular venous thrombosis occurred in 1 patient in each of 2 groups; ecchymosis occurred in 14 patients of trial group and 15 of control group; there was no significant difference in the incidence of related complications between 2 groups ( P>0.05). There was no significant difference in the preoperative VAS score at rest and during activity, ROM of knee flexion and extension activity, and thigh circumference between 2 groups ( P>0.05). However, there were significant differences in the VAS score at rest and during activity after 2, 4, 8, and 12 hours, ROM of knee flexion and extension activity after 1 and 2 days, and the walking distance on the day of discharge, pain VAS scores while walking after 1 and 2 days and on the day of discharge, and thigh circumference after 1 day between 2 groups ( P<0.05). Conclusion: For the primary TKA, the adductor canal block combined with local infiltration anesthesia can early relieve the initial pain of the incision, shorten the operation time, and promote the mobility and functional recovery of the knee joint.
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Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1％ lidocaine local infiltration anesthesia and extrapedicular infiltration anesthesia.The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated.The anaesthetic effect of nerve root block was observed.Results The visual analogue score of all the patients ranged from 1 point to 3 point,averagely (2.5 ± 0.7) point.Among the 20 patients,there were 2 cases of 1 point,7 cases of 2 point and 11 cases of 3 point.No patients required additional sedative anesthesia,and no nerve root block effects were observed.Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications,which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.
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·AIM: To evaluate the effect of bupivacaine in non-catheter infiltration anesthesia during vitretomy operation.·METHODS:Fifty-eight patients (58 eyes) with vitreous retinal surgery were selected. Patients were randomly divided into observation group ( 28 eyes ) and control group ( 30 eyes ) . The observation group were received non-catheter infiltration anesthesia. The control group were received traditional Sub- Tenon's block ( STB ) . Degree of pain, basic vital signs, the duration of anesthesia and analgesia grade were recorded and compared between two groups.·RESULTS: No significant difference was found in the 11-point numeric rating scale ( NRS - 11 scoring ) of anesthesia process, sclera incision, intraocular operation and the end of operation between two groups (P>0. 05). The difference were not significant in heart rate and blood pressure between two groups(P>0. 05). There was statistically significant difference in the duration of anesthesia between two groups (P<0. 05).·CONCLUSION: Both groups can provide the same anesthetic effect. Compared to STB, non - catheter infiltration anesthesia takes short time, and it is a safe and effective anesthesia methods. In addition, compare to the mixture of bupivacaine and lidocaine injection, bupivacaine injection can provide the same anesthetic effect.
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The animal models used in this study were Plexus anesthesia in frogs, Infiltration anesthesia in guinea pigs, Surface anesthesia in rabbits. The drugs were diluted with normal saline. Lignocaine2%: xylocaine hydrochloride injection IP, Bupivacaine 0.5%: Bupivacaine hydrochloride injections IP were prepared. Plexus anesthesia: Frog was pithed and spinal cord was destroyed up to the 3 vertebra. The abdominal pouch was filled with local anesthetic solution. Reflex activity was tested by immersing both feet of the frog every two minutes for not longer than 10 seconds into N/10 Hydrochloric acid. The time was noted. Surface anesthesia: Albino rabbits of either sex weighing 2.5 – 3.0kg ware selected. The conjunctival sac of one eye was held open, thus formed a pouch. 0.5ml of solution of the anesthetic was applied into the conjunctival sac for 30 sec. Infiltration anesthesia: Preparation of guinea pig: Guinea pigs (either sex) weighing 250-300grams were used. Lignocaine produced rapid onset of plexus anesthesia in Frogs in comparison to the bupivacaine at concentration of 0.1% & 0.2% which is statistically significant. Bupivacaine is more potent than the lignocaine as a surface anesthetic agent in the Rabbit, where as lignocaine could produce surface anesthesia at concentration of 0.5% or 0.1% or both. Both bupivacaine and lignocaine produced infiltration anesthesia on intradermal injection in guinea pigs but the duration of infiltration anesthesia produced by bupivacaine is more prolonged which is statistically significant in comparison to the lignocaine at all the three concentrations tested i.e. 0.05%, 0.1% & 0.2%.
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PURPOSE: The repair of groin hernias with local anesthesia has gained popularity. Two main methods have been described for local anesthesia. This study was aimed at comparing percutaneous truncular ilioinguinal-iliohypogastric block and step-by-step infiltration technique by using cadaver dissections. METHODS: The study was performed on an adult male cadaver by using blue dye injection. A percutaneous nerve block simulation was done on right side and the dye was given in between the internal oblique and transversus muscles. On the left side, a skin incision was deepened and the dye was injected under the external oblique aponeurosis. Following the injections, stained areas were investigated superficially and within the deeper tissues with dissection. RESULTS: There was a complete superficial staining covering the iliohypogastric and ilioinguinal nerves in the inguinal floor at both sides. On the right side, intraabdominal observation showed a wide and intense peritoneal staining, while almost no staining was seen on the left side. Preperitoneal dissection displayed a massive staining including testicular vascular pedicule and vas deferens on the right side. The dye solution also infiltrated the area of the femoral nerve prominently. On the contrary, a very limited staining was seen on the left. CONCLUSION: It may not always be easy to keep the percutaneous block within optimum anatomical limits without causing adverse events. A step-by-step infiltration technique under direct surgical vision seems to be safer than percutaneous inguinal block for patients undergoing inguinal hernia repair.
Subject(s)
Adult , Humans , Male , Anesthesia, Local , Cadaver , Femoral Nerve , Floors and Floorcoverings , Groin , Hernia , Hernia, Inguinal , Muscles , Nerve Block , Skin , Vas Deferens , Vision, OcularABSTRACT
Objective To discuss the effect of nursing measure that was carried out among elderly patients during ophthalmological operation under local infiltration anesthesia, in order to improve the quality of nursing. Methods To analyze and summarize the preoperative visit and intraoperative nursing among 251 elderly patients. Results There was no nursing mistake and accident happened in all 251 patients during operations. Postoperative visit showed that there were 216 elderly patients felt very satisfied or satisfied with the nursing (86%), and 16 felt dissatisfied (6%), and 19 lost contact because of discharge (8%). Conclusions There are lots of demands from elderly patients during operation under local in-filtration anesthesia, which are different with others. Particular nursing during operation can make them live through operation safely.