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1.
Rev. cuba. oftalmol ; 34(2): e1064, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1341453

ABSTRACT

Objetivo: Evaluar la seguridad ocular y sistémica de una combinación de lidocaína 2 por ciento y fenilefrina 1 por ciento administrada por vía intracameral para provocar midriasis intraoperatoria en la cirugía de catarata. Métodos: Se realizó un estudio prospectivo de serie de casos en 70 ojos de igual número de pacientes sometidos a facoemulsificación con implante de lente intraocular. El grupo midriasis intraoperatoria en la cirugía lo conformaron 35 pacientes dilatados con una inyección intracameral de lidocaína y fenilefrina antes de la cirugía, mientras otros 35 ojos se dilataron de manera tradicional, con un colirio midriático previo. Para la seguridad ocular se evaluaron múltiples parámetros del examen oftalmológico pre- y posoperatorio. Resultados: La presión intraocular, el espesor corneal central, la densidad celular del endotelio corneal y el edema corneal posoperatorio como hallazgo del segmento anterior se comportaron de manera similar en ambos grupos de estudio. Se reportó una complicación transoperatoria en el grupo de manera tradicional y un caso con edema quístico macular posoperatorio en el grupo midriasis intraoperatoria en la cirugía que no representaron diferencias significativas. Conclusión: La inyección de lidocaína más fenilefrina intracameral es una opción segura tanto ocular como sistémica para provocar midriasis durante la facoemulsificación(AU)


Objective: Evaluate the ocular and systemic safety of a combination of 2 percent lidocaine and 1 percent phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery. Methods: A prospective study was conducted of a case series of 70 patients (70 eyes) who underwent phacoemulsification with intraocular lens implantation. The intraoperative mydriasis group was composed of 35 patients dilated with an intracameral injection of lidocaine and phenylephrine before surgery, whereas another 35 eyes were dilated by the conventional method, with mydriatic eye drops. Ocular safety evaluation was based on the analysis of a wide variety of pre- and postoperative ophthalmological examination parameters. Results: Intraocular pressure, central corneal thickness, corneal endothelial cell density and postoperative corneal edema as an anterior segment finding, behaved in a similar manner in both study groups. An intraoperative complication was reported in the conventional method group and a case with postoperative cystoid macular edema in the intraoperative mydriasis group group, neither of them exhibiting significant differences. Conclusion: Intracameral lidocaine plus phenylephrine injection is a safe ocular and systemic option to achieve mydriasis during phacoemulsification(AU)


Subject(s)
Humans , Phenylephrine/therapeutic use , Cataract Extraction/methods , Mydriasis/drug therapy , Lidocaine/therapeutic use , Case-Control Studies , Prospective Studies
2.
Revista Digital de Postgrado ; 10(1): 262, abr. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147578

ABSTRACT

El bloqueo del nervio peri prostático con lidocaína, proporciona un buen alivio del dolor en la realización de la biopsia prostática guiada por ultrasonido, pero el dolor post-procedimiento, puede llegar a ser significativo, la adición del supositorio de diclofenac, podría proporcionar alivio adicional. Se asignaron al azar pacientes en 2 grupos el grupo 1 bloqueo con lidocaína del plexo peri prostático + supositorio de diclofenac sódico y el grupo 2 bloqueo con lidocaína del plexo peri prostático + supositorio de placebo, realizando biopsia doble sextante, el dolor a varios intervalos después del procedimiento se registró en una escala visual análoga (EVA) de 0 a 10. Los 2 grupos fueron similares en cuanto a edad, volumen de próstata, antígeno prostático específico, diagnóstico histopatológico. Los pacientes que recibieron diclofenac tuvieron puntajes de dolor significativamente más bajos que los que recibieron placebo (2 frente a 3,35) p 0,02. La administración rectal de diclofenac antes de la realización de la biopsia de próstata es un procedimiento simple que alivia significativamente el dolor experimentado sin aumento en la morbilidad(AU)


The peri-prostatic nerve block with lidocaine, provides good pain relief in performing ultrasoundguided prostate biopsy, but the postprocedure pain can be significant, the addition of diclofenac suppository, could provide additional relief. Patients were randomly assigned in 2 groups to group 1 blockade with lidocaine of the prostatic peri plexus + suppository of diclofenac sodium and group 2 blockade with lidocaine of the prostatic peri plexus + placebo suppository, performing double sextant biopsy, pain at several intervals after the procedure was recorded on a visual analog scale (EVA) from 0 to 10. Thee 2 groups were similar in terms of age, prostate volume, prostate-specific antigen, histopathological diagnosis. Patients who received diclofenac had pain scores significantly lower than those who received placebo (2 vs. 3.35) p 0.02. Rectal administration of diclofenac before performing a prostate biopsy is a simple procedure that relieves significantly pain experienced without increased morbidity(AU)


Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Prostate/pathology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Diclofenac/therapeutic use , Anesthetics, Local/therapeutic use , Lidocaine/therapeutic use , Nerve Block/methods , Placebos/therapeutic use , Prostate/diagnostic imaging , Administration, Rectal , Prospective Studies , Pain Management/methods , Image-Guided Biopsy , Anesthesia, Local
3.
Rev. cuba. anestesiol. reanim ; 20(1): e681, ene.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156364

ABSTRACT

Introducción: El estudio y tratamiento del dolor ha sido una de las preocupaciones más importantes en los últimos 30 años en el ámbito médico mundial. Desde hace varias décadas a nivel internacional se realizan estudios sobre el efecto del tramadol y la lidocaína como analgésicos intraoperatorio, con el fin de obtener una adecuada analgesia durante el procedimiento quirúrgico y el periodo posoperatorio inmediato. Objetivo: Comparar el efecto analgésico del tramadol y la lidocaína durante el período transoperatorio en caninos programados para intervención quirúrgica. Método: Se realizó un estudio prospectivo, comparativo, con animales programados para tratamiento quirúrgico por presentar tumores periféricos. Se incluyeron 10 animales divididos en 2 grupos. El grupo control (G-C) que recibió lidocaína sin preservo (lidocaína SP) en infusión continua durante el procedimiento quirúrgico y el grupo 1 (G-1) que se le administró tramadol endovenoso previo al acto quirúrgico. Se evaluaron variables hemodinámicas y de oxigenación como indicadores indirectos de dolor transoperatorio. Resultados: La muestra fue homogénea para la edad y el sexo. El comportamiento de las variables hemodinámicas resultó más estable durante la infusión de lidocaína. La saturación periférica de oxígeno fue similar con ambos medicamentos, así como la temperatura. Conclusiones: La infusión intravenosa de lidocaína SP durante el periodo transoperatorio en caninos oncológico demostró una mejor efectividad analgésica en comparación con el tramadol aplicado preoperatoriamente, según los parámetros evaluados(AU)


Introduction: Study and treatment of pain has been one of the most important concerns in the last thirty years in the worldwide medical field. For several decades, international studies have been carried out on the effect of tramadol and lidocaine as intraoperative analgesics, in order to achieve adequate analgesia during surgical procedures and the immediate postoperative period. Objective: To compare the analgesic effect of tramadol and lidocaine during the intraoperative period in canines scheduled for surgical intervention. Method: A prospective, comparative study was carried out with animals scheduled for surgical treatment due to peripheral tumors. Ten animals were included, divided into two groups: the control group, which received lidocaine without preservation in continuous infusion during the surgical procedure, and group 1, which was administered intravenous tramadol prior to the surgical act. Hemodynamic and oxygenation variables were assessed as indirect indicators of intraoperative pain. Results: The sample was homogeneous for age and sex. The behavior of the hemodynamic variables was more stable during the lidocaine infusion. Peripheral oxygen saturation was similar in both drugs, as well as temperature. Conclusions: Intravenous infusion of lidocaine without preservation during the intraoperative period in oncological canines showed better analgesic effectiveness compared to tramadol applied preoperatively, according to the parameters assessed(AU)


Subject(s)
Animals , Dogs , Tramadol/therapeutic use , Anesthesia and Analgesia/methods , Lidocaine/therapeutic use , Prospective Studies , Dog Diseases/drug therapy
4.
Rev. cuba. oftalmol ; 33(2): e818, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139072

ABSTRACT

RESUMEN Objetivo: Evaluar la eficacia de una combinación de lidocaína 2 por ciento y fenilefrina 1 por ciento administrada intracameralmente para provocar midriasis intraoperatoria en la cirugía de catarata. Métodos: Realizamos un estudio prospectivo, comparativo, de serie de casos en 70 ojos de igual número de pacientes quienes fueron sometidos a cirugía de catarata mediante facoemulsificación con implante de lente intraocular, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre septiembre del año 2017 y febrero de 2018. 35 pacientes fueron dilatados con una combinación de fenilefrina y lidocaína inyectada en la cámara anterior justo antes de la cirugía (grupo midriáticos intracamerales) y otros 35 ojos se dilataron con un colirio midriático como se realiza cotidianamente y de manera tradicional (grupo midriáticos tópicos). La eficacia se evaluó mediante la medición del diámetro pupilar (pupilometría) realizada con un compás quirúrgico en diferentes momentos de la cirugía en ambos grupos de estudio. Los resultados de ambos grupos se compararon entre sí. Resultados: En ambos grupos de pacientes se lograron diámetros pupilares superiores a los 7 mm justo antes de la capsulorrexis, aunque fueron ligeramente mayor en el grupo midriáticos tópicos (8,17 vs. 7,55 mm). En las mediciones posteriores todas las pupilometrías del grupo midriáticos intracamerales fueron superiores y se mantuvieron por encima de los 7 mm, mientras las del grupo midriáticos tópicos sufrieron una reducción paulatina hasta el final de la cirugía (5,68 mm). Conclusiones: La combinación de lidocaína más fenilefrina aplicada de manera intracameral es efectiva para provocar una midriasis adecuada y mantenida durante la cirugía de catarata(AU)


ABSTRACT Objective: Evaluate the efficacy of the combination 2 percent lidocaine / 1 percent phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery. Methods: A prospective comparative study was conducted of a case series of 70 patients (70 eyes) who underwent cataract surgery by phacoemulsification with intraocular lens implantation at Ramón Pando Ferrer Cuban Institute of Ophthalmology from September 2017 to February 2018. Of the total eyes, 35 were dilated with a combination of phenylephrine and lidocaine injected into the anterior chamber just before surgery (MIC group), whereas the remaining 35 were dilated with mydriatic eye drops in the habitual traditional manner (MT group). Efficacy was evaluated in the two study groups measuring the pupil diameter (pupilometry) with a surgical compass at several moments during the surgery. The results for each group were compared. Results: In both groups patients achieved pupil diameters above 7 mm just before capsulorhexis, though values were slightly higher in the MT group (8.17 vs. 7.55 mm). Later measurement showed that in the MIC group all pupilometries were higher, remaining above 7 mm, whereas in the MT group they underwent gradual reduction until the end of surgery (5.68 mm). Conclusions: The combination of lidocaine and phenylephrine administered intracamerally is effective to achieve appropriate, sustained mydriasis during cataract surgery(AU)


Subject(s)
Humans , Phenylephrine/therapeutic use , Cataract Extraction/methods , Phacoemulsification/methods , Lens Implantation, Intraocular/adverse effects , Lidocaine/therapeutic use , Comparative Study , Prospective Studies , Drug Therapy, Combination/methods
5.
Rev. cuba. anestesiol. reanim ; 19(1): e579, ene.-abr. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1093133

ABSTRACT

Introducción: El paraganglioma es un tumor neuroendocrino poco frecuente que surge de los paraganglios autonómicos extraadrenales en diversos lugares del organismo. También se les conoce como feocromocitomas extraadrenales. Alrededor de 90 por ciento son benignos y se curan mediante la extirpación quirúrgica, el restante 10 por ciento son malignos, y pueden provocar metástasis a distancia. El diagnóstico es importante por su riesgo de malignidad, por las implicaciones de otras neoplasias asociadas y dada la posibilidad de realizar estudios genéticos para la detección de otros casos dentro de una misma familia. Objetivo: Exponer aspectos clínico-epidemiológicos de esta enfermedad y las implicaciones perioperatorias concernientes a la conducta anestésica perioperatoria de estos pacientes. Caso clínico: Paciente femenina, de 56 años de edad con antecedentes de hipertensión arterial de más dos años de evolución y difícil control, diabetes mellitus e historia de cefalea, palpitaciones y sensación de calor. Diagnóstico imagenológico de una masa pararrenal sospechosa de paraganglioma que se confirmó por estudio histopatológico posterior a la exceresis. Conclusiones: La técnica anestésica para la resección de estos tumores es un desafío importante para el anestesiólogo que debe enfrentar dicha intervención quirúrgica, planteándose los riesgos de las etapas pre-, intra- y posoperatoria(AU)


Introduction: Paraganglioma is a rare neuroendocrine tumor that emerging from the extra-adrenal autonomic paraganglia and it may occur in several parts of the body. Paraganglioma is also named extra-adrenals pheochromocytomas. Roughly 90 percent of these tumors are benign and can be excised through surgery whereas 10 percent of them are malignant and cause distant metastasis. Paragangliomas are closely linked to pheochromocytomas because they cannot be differentiated at cell level and often share the same clinical manifestations such as hypertension, episodic headache, sweating and tachycardia. The diagnosis of these tumors is important because of risk of becoming malignant, the implications of other related neoplasias and the possibility of making genetic studies to detect other cases in the same family. Objective: To expose about epidemiology, clinical manifestations, diagnostic tests and perioperative management of these tumors by a presentation of a clinical case. Case Report: Female 56 years old, clinical history of 2 years of uncontrolled hypertension, diabetes mellitus, who presented with headache, palpitations and feeling of warm. She was diagnosed with a pararrenal mass suspected of paraganglioma associated with catecholamine hypersecretion, confirmed by histopathology. Conclusions: The treatment of these tumors requires a more complete surgical resection possible since the prognosis depends. Surgical management of pheochromocytoma needs special perioperative requirements. The anesthesiologist must observe this surgery, establish the risks of the phase pre-intra and postoperative(AU)


Subject(s)
Humans , Female , Middle Aged , Paraganglioma/surgery , Paraganglioma/diagnostic imaging , Surgical Procedures, Operative , Midazolam/therapeutic use , Early Detection of Cancer/methods , Lidocaine/therapeutic use , Anesthesiologists
6.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 62-67, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090549

ABSTRACT

Abstract Introduction Posttonsillectomy pain results in significant morbidity to the patients. There is a disagreement in the literature regarding the use of local anesthetics during tonsillectomy. The aim of this placebo-controlled, double-blind study is to evaluate the effect of peritonsillar administration of local anesthetics. Objective To evaluate the role of intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale (VAS) scores in achieving pain relief after tonsillectomy procedure Methods In this study, 180 patients were randomized to 1 of the 6 groups: bupivacaine infiltration, lidocaine infiltration, normal saline infiltration, bupivacaine packing, lidocaine packing, and normal saline packing. Pain caused by speaking, swallowing, and on rest was assessed using VAS at 4, 8, 12, 16 hours, and at discharge. Results Significant analgesia was obtained in patients who received bupivacaine infiltration and packing compared with placebo (p < 0.05). The majority of the study subjects had no postoperative complications, and patients receiving bupivacaine infiltration required less additional analgesics in the first 24 hours after surgery. Conclusion We advocate the use of bupivacaine infiltration or packing immediately following the procedure to achieve adequate postoperative analgesia.


Subject(s)
Humans , Male , Female , Child , Adolescent , Pain, Postoperative/drug therapy , Tonsillectomy , Analgesia , Analgesics/administration & dosage , Analgesics/therapeutic use , Intraoperative Care , Pain, Postoperative/diagnosis , Pain, Postoperative/prevention & control , Pakistan , Placebos/administration & dosage , Postoperative Complications , Pain Measurement/methods , Bupivacaine/administration & dosage , Bupivacaine/therapeutic use , Double-Blind Method , Prospective Studies , Injections, Intravenous , Lidocaine/administration & dosage , Lidocaine/therapeutic use
8.
Rev. Assoc. Med. Bras. (1992) ; 65(4): 535-540, Apr. 2019.
Article in English | LILACS | ID: biblio-1003065

ABSTRACT

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Subject(s)
Humans , Cystitis, Interstitial/drug therapy , Pentosan Sulfuric Polyester/therapeutic use , Administration, Intravesical , Brazil , Dimethyl Sulfoxide/therapeutic use , Chondroitin Sulfates/therapeutic use , Treatment Outcome , Botulinum Toxins, Type A/therapeutic use , Diterpenes/therapeutic use , Clinical Decision-Making , Hyaluronic Acid/therapeutic use , Lidocaine/therapeutic use , Mycobacterium bovis
9.
Clinics ; 74: e905, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001819

ABSTRACT

OBJECTIVES: Poststroke shoulder pain occurs very frequently and compromises function and quality of life. Because treatment depends on a multidisciplinary approach, it is desirable to optimize effectiveness. Myofascial pain syndrome is defined by the presence of trigger points that can also be found in spastic stroke patients. The aim of this study was to evaluate the frequency of myofascial pain in the shoulder girdle muscles in patients with poststroke shoulder pain and to document the clinical and functional results obtained with specific treatment for this condition. METHODS: Spastic stroke hemiplegic patients undergoing rehabilitation at the Rehabilitation Center of the Hospital das Clínicas of the Ribeirão Preto Medical School of the University of São Paulo were evaluated regarding the intensity and characteristics of shoulder pain, previous therapeutic interventions, shoulder goniometry and the presence of trigger points. Patients underwent trigger point blockade by intramuscular infiltration of 1% lidocaine. The evaluation and treatment procedures were repeated in the subsequent 3 weeks as long as the pain intensity was greater than 5 on a visual analog scale (VAS). In the fourth week, the evaluation procedures were repeated. Patients who were in a multiprofessional rehabilitation program were instructed to continue the treatment, and the others received complementary therapeutic advice if necessary to initiate it. The evaluations were performed at 0, 1, and 3 weeks and after 4 months. RESULTS: Twenty-one patients (13 men; age=67.8±10.2 years; right hemiparesis: 11) participated in the study, and there was a reduction in pain assessed by VAS from baseline (7.6±2.7) to the first week (5.8±3.6; p<0.05) through the end of the third week (5.2±3.5; p<0.05), but not at the end of four months (6.6±2.9; p=0.11). Good responders had significantly lower pain levels after the third week and presented with a larger range of motion for passive abduction by the end of 4 months. These results demonstrate that the myofascial component of pain should be considered in poststroke shoulder pain and that its treatment may be a pathway for the rapid and long-lasting relief of symptoms. CONCLUSION: Trigger point blockade with lidocaine can reduce pain perception in spastic hemiplegic shoulder in as much as 50% of stroke survivors for four months.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Shoulder Pain/drug therapy , Anesthetics, Local/therapeutic use , Lidocaine/therapeutic use , Myofascial Pain Syndromes/drug therapy , Quality of Life , Pain Measurement , Treatment Outcome , Shoulder Pain/etiology , Stroke/complications , Trigger Points , Hemiplegia/etiology , Hemiplegia/drug therapy , Myofascial Pain Syndromes/etiology
10.
Int. j. odontostomatol. (Print) ; 12(1): 76-85, Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-893305

ABSTRACT

SUMMARY: The aim of this research was to assess the hemodynamic variations during the extraction of impacted lower third molars using lidocaine 2 % or articaine 4 %, as local anesthetics. Fourteen patients with a mean age of 22.4 (SD=3.25), were submitted to the bilateral extraction of lower third molars, with an interval of three to four weeks between the two extractions. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and oxygen saturation in the blood were assessed at seven specific time points: baseline; anesthetic puncture; two minutes after anesthesia; osteotomy; suture and five minutes after the procedure had been completed. The statistical analysis involved descriptive analysis, the Shapiro-Wilk test, the Mann-Whitney test, the t-test and the repeated measurements test. No significant differences were found for any of the hemodynamic behavior variables when comparing lidocaine 2 % and articaine 4 %. Significant differences were found between the time points assessed within each group, particularly in relation to the variable heart rate. In the articaine group, systolic blood pressure exhibited a significant decrease five minutes after the procedure. There were no significant variations in hemodynamic behavior between the two different anesthetic groups (articaine 4 % and lidocaine 2 %).


RESUMEN: El objetivo de esta investigación fue evaluar las variaciones hemodinámicas durante la extracción de terceros molares inferiores impactados utilizando lidocaína al 2 % o articaína al 4 %, como anestésicos locales. Catorce pacientes con una edad promedio de 22,4 (SD = 3,25), fueron sometidos a la extracción bilateral de terceros molares inferiores, con un intervalo de tres a cuatro semanas entre las dos extracciones. Se evaluaron la presión arterial sistólica, la presión arterial diastólica, la presión arterial media, la frecuencia cardíaca y la saturación de oxígeno en la sangre, en siete momentos específicos: línea base; punción anestésica; dos minutos después de la anestesia; osteotomía; sutura y cinco minutos después de que el procedimiento fue completado. El análisis estadístico involucró el análisis descriptivo, la prueba de Shapiro-Wilk, la prueba de Mann-Whitney, la prueba t y la prueba de mediciones repetidas. No se encontraron diferencias significativas para ninguna de las variables de comportamiento hemodinámico al comparar lidocaína 2 % y articaína 4 %. Se encontraron diferencias significativas entre los puntos de tiempo evaluados dentro de cada grupo, particularmente en relación con la frecuencia cardíaca variable. En el grupo de articaína, la presión arterial sistólica exhibió una disminución significativa cinco minutos después del procedimiento. No se observaron variaciones significativas en el comportamiento hemodinámico entre los dos grupos anestésicos diferentes (articaína 4 % y lidocaína 2 %).


Subject(s)
Humans , Male , Female , Adult , Tooth Extraction , Anesthetics, Local/therapeutic use , Molar, Third/surgery , Oxygen/blood , Blood Pressure , Carticaine/therapeutic use , Ethics Committees, Research , Hemodynamic Monitoring , Heart Rate , Lidocaine/therapeutic use
11.
Rev. bras. anestesiol ; 67(6): 615-618, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-897771

ABSTRACT

Abstract Background and objectives Reducing pain on injection of anesthetic drugs is of importance to every anesthesiologist. In this study we pursued to define if pretreatment by granisetron reduces the pain on injection of etomidate similar to lidocaine. Methods Thirty patients aged between 18 and 50 years of American Society of Anesthesiologists physical status class I or II, whom were candidates for elective laparoscopic cholecystectomy surgery were enrolled in this study. Two 20 gauge cannulas were inserted into the veins on the dorsum of both hands and 100 mL of normal saline was administered during a 10 min period from each cannula. Using an elastic band as a tourniquet, venous drainage of both hands was occluded. 2 mL of granisetron was administered into one hand and 2 mL of lidocaine 2% at the same time into the other hand. One minute later the elastic band was opened and 2 mL of etomidate was administered to each hand with equal rates. The patients were asked to give a score from 0 to 10 (0 = no pain, 10 = severe pain) to each the pain sensed in each hand. Results Two patients were deeply sedated after injection of etomidate and unable to answer any questions. The mean numerical rating score for injection pain of intravenously administered etomidate after intravenous granisetron was 2.3 ± 1.7, which was lower when compared with pain sensed due to intravenously administered etomidate after administration of lidocaine 2% (4.6 ± 1.8), p < 0.05. Conclusion The result of this study demonstrated that, granisetron reduces pain on injection of etomidate more efficiently than lidocaine.


Resumo Justificativa e objetivos A redução da dor causada pela injeção de anestésicos é importante para todos os anestesiologistas. Neste estudo buscamos definir se o pré-tratamento com granisetrona reduz a dor causada pela injeção de etomidato de forma semelhante à lidocaína. Métodos Trinta pacientes entre 18 e 50 anos, estado físico ASA I ou II (de acordo com a classificação da Sociedade Americana de Anestesiologistas) e candidatos à colecistectomia laparoscópica eletiva foram incluídos neste estudo. Duas cânulas de calibre 20 foram inseridas nas veias do dorso de ambas as mãos e 100 mL de soro fisiológico foram administrados durante 10 minutos através de cada cânula. Com um torniquete elástico, a drenagem venosa de ambas as mãos foi ocluída. Granisetrona (2 mL) foi administrado em uma das mãos e lidocaína a 2% (2 mL) na outra mão ao mesmo tempo. Após um minuto, o torniquete foi afrouxado e 2 mL de etomidato foram administrados em velocidade igual a cada uma das mãos. Solicitamos dos pacientes uma classificação de 0 a 10 para a dor sentida em cada uma das mãos (0 = sem dor, 10 = dor intensa). Resultados Dois pacientes estavam profundamente sedados após a injeção de etomidato e, portanto, incapazes de responder a qualquer pergunta. O escore médio de classificação da dor à injeção de etomidato administrado por via endovenosa após granisetrona intravenoso foi de 2,3 ± 1,7, o que foi menor em comparação com a dor sentida à administração intravenosa de etomidato após a administração de lidocaína a 2% (4,6 ± 1,8), p < 0,05. Conclusão O resultado deste estudo demonstrou que granisetrona reduz a dor causada pela injeção de etomidato com mais eficácia do que lidocaína.


Subject(s)
Humans , Male , Female , Adult , Pain/chemically induced , Pain/drug therapy , Granisetron/therapeutic use , Anesthetics, Intravenous/adverse effects , Etomidate/adverse effects , Pain Management/methods , Lidocaine/therapeutic use , Double-Blind Method , Injections, Intravenous , Middle Aged
12.
Actual. osteol ; 13(2): 104-115, Mayo - Ago. 2017. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1117988

ABSTRACT

La osteonecrosis de maxilar asociada a aminobisfosfonatos (BRONJ) constituye un efecto secundario del tratamiento crónico con los más potentes. Un modelo experimental permitiría determinar la patogenia de dicha alteración. La oveja presenta características orales y del metabolismo óseo similar al humano y permite realizar manipulaciones bucales. Se evaluaron cambios clínicos, remodelación ósea y masa ósea maxilar en ovejas hembras adultas tratadas con zolendronato (ZOL), durante 22 meses y utilizando dosis equivalente al tratamiento de neoplasias. Seis ovariectomizadas (OVX) recibieron ZOL; 5 OVX y 4 SHAM (control) recibieron solución fisiológica. Al inicio, 4 y 22 meses se evaluó calcemia, fosfatemia, crosslaps (CTX) y fosfatasa alcalina ósea. Al final, se evaluó contenido mineral óseo de la hemimandíbula superior (CMO: mg/cm2). Al final del estudio, CTX disminuyó significativamente en ZOL (p<0,05) sin diferencias entre SHAM y OVX. En maxilar, los contenidos de Ca y P (g/g tejido) y CMO (g/cm2 ) disminuyeron en OVX vs. SHAM (p<0,05) y solo Ca y CMO respecto de ZOL (p<0,05). ZOL incrementó el contenido de Ca y CMO, mientras que el de P permaneció significativamente disminuido respecto de SHAM. La sobrevida en SHAM y OVX fue del 100% y en ZOL 77% (2 muertes); 2 ovejas del grupo ZOL presentaron necrosis de maxilar. Conclusiones: fue posible obtener desarrollo de BRONJ por tratamiento crónico con ZOL, el cual redujo notablemente la resorción y, según la relación Ca/P, posiblemente haya afectado la mineralización ósea. (AU)


Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a complication of chronic treatment with the most powerful aminobisphosphonates (BPs). An experimental animal model would allow to determine the pathogenesis of this complication. Ewes exhibit similar oral cavity characteristics and bone metabolism as humans, and they are suitable for oral cavity interventions. We examined herein the clinical manifestations, bone remodeling status, and maxillary bone mass in adult female ewes treated with zoledronate (ZOL) for 22 months. Six ovariectomized (OVX) ewes received ZOL; and 5 OVX and 4 SHAM animals received saline solution. At the start of the experiment, and at the 4 and 22 month-time points serum Ca, P, crosslaps (CTX), and bone alkaline phosphatase were measured. Bone mineral content (BMC) of the superior hemimandible was measured at the end of the experiment. At this time point, CTX was significantly decreased only in the ZOL group (p<0.05). Ca and P content (g/g tissue) and BMC in the mandible were significantly decreased in the OVX group compared to SHAM animals (p<0.05) and only Ca content and BMC were decreased when compared to ZOL (p<0.05). ZOL treatment increased the Ca content and BMC, whereas the P content remained low compared to the SHAM group (p<0.05). All ewes from the SHAM and OVX groups and 77% of the animals from the ZOL group survived until the end of the experiment, whereas two ewes of ZOL group exhibited BRONJ. Conclusion: under our experimental conditions, it was possible to induce BRONJ by the chronic ZOL administration, which in turn induced a high reduction in bone resorption as well as possibly impaired bone mineralization, based on the Ca/P ratio in the mandible. (AU)


Subject(s)
Animals , Diphosphonates/adverse effects , Bisphosphonate-Associated Osteonecrosis of the Jaw/pathology , Zoledronic Acid/adverse effects , Tooth Extraction , Bone Diseases, Metabolic/chemically induced , Sheep/metabolism , Sheep/blood , Biomarkers/blood , Bone Density/drug effects , Bone Remodeling/drug effects , Densitometry , Experimental Development , Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology , Bisphosphonate-Associated Osteonecrosis of the Jaw/immunology , Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control , Zoledronic Acid/administration & dosage , Glucocorticoids/therapeutic use , Analgesics/therapeutic use , Ilium/cytology , Anesthetics, Dissociative/therapeutic use , Lidocaine/therapeutic use , Maxilla/cytology , Maxilla/drug effects , Maxilla/metabolism , Maxilla/diagnostic imaging , Anti-Bacterial Agents/therapeutic use
13.
Rev. cuba. anestesiol. reanim ; 16(2): 40-51, may.-ago. 2017. tab
Article in Spanish | LILACS, CUMED | ID: biblio-960307

ABSTRACT

Introducción: La administración de lidocaína intravenosa para el control del dolor posoperatorio ha ganado interés. Su aplicación en el periodo perioperatorio a dosis baja reduce el dolor y el consumo de opioides en el posoperatorio. Objetivo: Evaluar la eficacia de la administración de lidocaína en infusión continua en el tratamiento del dolor posoperatorio en pacientes intervenidos quirúrgicamente por enfermedad abdominal oncológica. Métodos: Se realizó un estudio cuasi experimental en pacientes intervenidos por procedimiento quirúrgico abdominal oncológico a quienes se les administró infusión continua de lidocaína. Seguidamente se les evaluó la intensidad del dolor con la escala visual análoga. Esta se aplicó a los 30 min, 2, 6, 12 y 24 h después de la operación. Se determinó la presencia o no de complicaciones intra- y posoperatorias. Resultados: Los pacientes entre 31 y 50 años de edad prevalecieron en ambos grupos. El sexo masculino predominó en el grupo estudio y el femenino en el control. En el grupo estudio la respuesta no fue satisfactoria solo en dos pacientes, en 11 pacientes fue satisfactoria, en el testigo en cinco pacientes fue no satisfactoria. En el grupo estudio tres pacientes tuvieron dolor por menos de 2 h y fue catalogado entre ligero y moderado. En el control 12 presentaron dolor por más de 4 h catalogado entre moderado y grave. En dos pacientes aparecieron efectos adversos. Conclusiones: Con la administración de lidocaína se logra una disminución del dolor y del consumo de opioides(AU)


Introduction: The intravenous administration of lidocaine for postoperative pain control has gained interest. Its administration in the perioperative period and at a low dose reduces postoperative pain and opioid use. Objective: To evaluate the effectiveness of continuous infusion of lidocaine in the treatment of postoperative pain in surgically intervened patients with oncologic abdominal disease. Methods: A quasiexperimental study was performed in patients undergoing oncologic abdominal surgical procedures and who were given continuous infusion of lidocaine. The pain intensity was then evaluated with the analogue visual scale. This was applied after 30 minutes, two, six, twelve and twenty-four hours after the operation. The presence or absence of intraoperative and postoperative complications was determined. Results: Patients aged 31-50 prevailed in both groups. The male gender predominated in the study group and the female gender, in the control group. In the study group, the response was not satisfactory only in two patients, while it was satisfactory in 11 patients; in the control group, it was not satisfactory in 5 patients. In the study group, three patients had pain for less than 2 hours and this was classified as mild to moderate. In the control group 12 of them presented pain for more than 4 hours, which was classified as moderate and severe. Adverse effects appeared in two patients. Conclusions: The administration of lidocaine leads to a decrease in pain and opioid consumption(AU)


Subject(s)
Humans , Pain, Postoperative/drug therapy , Cancer Pain/drug therapy , Lidocaine/therapeutic use , Infusions, Intravenous/methods , Cardiac Surgical Procedures/methods
14.
Revista Digital de Postgrado ; 6(1): 38-45, jun. 2017. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1096849

ABSTRACT

La presente investigación tuvo como objetivo general evaluar el efecto de la terapia neural e infiltración paravertebral segmentaria con ozono en el dolor lumbar somático de los pacientes que asistieron a la consulta de terapia del dolor en el Hospital Dr. Pedro García Clara, Ciudad Ojeda Estado Zulia-Venezuela, en el periodo comprendido del 01 de abril al 31 de mayo del 2016. Fue un estudio prospectivo, explicativo-comparativo y el diseño fue cuasi-experimental. Se seleccionaron 60 pacientes de ambos sexos entre edades comprendidas de 18 a 60 años, se dividieron en dos grupos de 30 pacientes, al primer grupo denominado A, se le realizó terapia neural segmentaria lumbar utilizando procaína al 1% y consecutivamente se le aplicó infiltración paravertebral con ozono a una concentración de 15ug; y al grupo B, se le realizó terapia neural con lidocaína al 1% y posteriormente se le aplicó la infiltración paravertebral con ozono a una concentración de 15ug, ambos grupos con un volumen de 10mL. Para el análisis de los datos se utilizó estadística descriptiva e inferencial, específicamente la prueba t de Student para las muestras relacionadas. Resultados: indicaron que en ambas terapias, al evaluar el dolor con la escala visual análoga, se encontraron diferencias estadísticamente significativas (p<0,05), en ambos grupos. Conclusiones: no hubo diferencias estadísticamente significativas con respecto a los cambios hemodinámicos y la disminución del dolor fue significativa en ambos grupos, pero más notable en el grupo A(AU)


The present study was aimed at evaluating the overall effect of neural therapy and segmental paravertebral ozone infiltration in lumbar somatic pain patients attending the consultation of pain therapy Dr. Pedro Garcia Clara Hospital of Ciudad Ojeda Estado Zulia-Venezuela, in the period from 01 April to 31 May 2016. It was a comparative-explanatory, prospective study design was quasi-experimental, 60 patients of either sex between aged from 18 to 60 years were selected, they were divided into two groups of 30 patients, the first group called A, underwent neural therapy lumbar segmental using procaine 1% and consecutively was applied paravertebral infiltration with ozone at a concentration of 15ug; and group B, underwent neural therapy with lidocaine 1% and was subsequently applied the paravertebral infiltration with ozone at a concentration of 15ug, both groups with a volume of 10mL. For data analysis the mean, standard deviation, and inferential statistics, specifically the Student t test for related samples was used. Results: indicated that both therapies, to assess pain with visual analogue scale, statistically significant differences (p<0.05) in both groups. Conclusions: There were no statistically significant differences with respect to hemodynamic changes and pain reduction was significant in both groups, but more remarkable in group A(AU)


Subject(s)
Humans , Procaine/therapeutic use , Low Back Pain/therapy , Lidocaine/therapeutic use , Nervous System/physiopathology , Drug Therapy, Combination , Anesthetics/administration & dosage
15.
Brasília; CONITEC; mar. 2017. g, tab.
Non-conventional in Portuguese | LILACS, BRISA | ID: biblio-906981

ABSTRACT

CONTEXTO: Otite externa aguda é uma inflamação que ocorre na orelha externa ­ pavilhão e canal auditivos. Essa condição clínica é caracterizada pelo acometimento da pele e do tecido subcutâneo, sendo a infecção bacteriana a principal causa. O paciente com essa doença tem inflamação no local, acompanhada de intensa dor e secreção. Além disso, experimenta dificuldades de audição, que deixam de existir com a cura da condição clínica. São alternativas terapêuticas para pacientes com otite externa aguda a assepsia (remoção de cerume e limpeza local), aplicação tópica de antibióticos, anti-inflamatórios esteroides e anestésicos, além da administração por via oral de analgésicos e antibióticos. Há no Brasil diversas apresentações farmacêuticas registradas para o tratamento da otite externa aguda. Contudo, nenhuma delas integra a Relação Nacional de Medicamentos Essenciais ­ RENAME. PERGUNTA: Qual alternativa terapêutica é mais eficaz/efetiva e segura para o tratamento de pacientes com otite externa aguda? EVIDÊNCIAS CIENTÍFICAS: Evidências clínicas: foi realizada revisão sistemática para sintetizar as evidências disponíveis sobre eficácia/efetividade e segurança de alternativas terapêuticas para o tratamento de pacientes com otite externa aguda. Foram incluídos dois estudos que avaliam alternativas terapêuticas disponíveis no Brasil. Um dos estudos aponta que a utilização de ciprofloxacino 2 mg/mL se mostrou mais eficaz em curar a doença em menos tempo que a associação entre polimixina B 10.000 UI, neomicina 3,5 mg/mL, hidrocortisona 10 mg/mL. O outro estudo concluiu que tanto ciprofloxacino 2 mg/mL associado a hidrocortisona 10 mg/mL quanto polimixina B 10.000 UI, neomicina 3,5 mg/mL, hidrocortisona 10 mg/mL são semelhantes em resolver o quadro de dor entre seis e sete dias. Para ampliar a análise, nova seleção de estudos foi feita incluindo a avaliação de medicamentos com equivalentes classes farmacêuticas no Brasil. Foram incluídos doze estudos. Foi notada maior eficácia da utilização de quinolona em relação à associação entre não quinolonas e anti-inflamatório esteroide em relação à cura em sete a dez dias de acompanhamento. Avaliação de custo-efetividade: foi realizada avaliação de custo-efetividade em virtude da diferença na eficácia entre quinolona e a associação entre não quinolonas e anti-inflamatório esteroide. Os preços considerados para as alternativas foram os Preços Fabrica definidos pela Câmara de Regulação do Mercado de Medicamentos ­ CMED. Foi construída árvore de decisão para avaliar o desfecho de cura clínica em sete a dez dias. O custo foi representado pelo valor monetário do medicamento e a efetividade pela cura clínica em sete a dez dias. A razão de custo-efetividade incremental de quinolona em relação à associação entre não quinolonas e anti-inflamatório esteroide foi de R$ 136,25. Esse é o valor necessário para que o tratamento com quinolona proporcione uma cura clínica a mais em relação à associação entre não quinolonas e anti-inflamatório esteroide. Avaliação de Impacto Orçamentário: Compreendendo o período entre os anos de 2017 e 2021, foram consideradas as projeções populacionais calculadas pelo IBGE, as taxas de atendimentos de pacientes com otite externa aguda e a cobertura da atenção básica pelo SUS no Brasil. Considerando a perspectiva de financiamento pelo Componente Básico da Assistência Farmacêutica, além do impacto orçamentário total, foram calculados o impacto orçamentário médio por município e por habitante. O impacto orçamentário total em cinco anos para a potencial incorporação de quinolona foi de R$ 87.362.082,52 e para a da associação entre não quinolonas e anti-inflamatório esteroide foi de R$ 16.373.657,88. Os respectivos valores médios por município foram de R$ 15.684,40 e R$ 2.939,62. O impacto orçamentário médio por habitante foi de R$ 0,4148 para quinolona e R$ 0,0778 para a associação entre não quinolonas e anti-inflamatório esteroide. DISCUSSÃO: São escassos os estudos sobre alternativas terapêuticas disponíveis no Brasil. A avaliação por classes farmacêuticas deve se dar com cautela, haja vista a pequena quantidade de estudos disponíveis e a heterogeneidade entre eles. Por meio da evidência disponível, pouco se sabe sobre os efeitos atribuídos a cada princípio ativo. Para a seleção de medicamentos antimicrobianos, pode ser importante avaliar, em vez de uma infecção isolada, um conjunto de infecções para verificar os potenciais benefícios e riscos de se optar por um determinado medicamento. RECOMENDAÇÃO DA CONITEC: A matéria será disponibilizada em Consulta Pública com recomendação preliminar desfavorável à incorporação de medicamentos tópicos para o tratamento de otite externa aguda. CONSULTA PÚBLICA: Foram recebidas três contribuições técnico-científicas e 2 contribuições de experiência ou opinião. Todas as contribuições técnico-científicas continham argumentação técnico-científica contra a recomendação inicial da Conitec. As contribuições de experiência ou opinião também foram contra a recomendação inicial da Conitec. No geral, houve evidências com potencial de alteração desta recomendação. DELIBERAÇÃO FINAL: Por recomendar a incorporação da associação entre sulfato de polimixina B 10.000 UI, sulfato de neomicina 3,5 mg/mL, fluocinolona acetonida 0,25 mg/mL e cloridrato de lidocaína 20 mg/mL, apresentada em frasco com 5 mL, para otite externa aguda. DECISÃO: Incorporar a associação de sulfato de polimixina B 10.000 UI, sulfato de neomicina 3,5 mg/mL, fluocinolona acetonida 0,25 mg/mL e cloridrato de lidocaína 20 mg/mL, apresentada em frasco com 5 mL, para otite externa aguda no âmbito do Sistema Único de Saúde ­SUS. Decisão dada pela Portaria SCTIE-MS nº 15 publicada no Diário Oficial da União (DOU) nº 58, de 24 de março de 2017, pág. 107.(AU)


Subject(s)
Humans , Fluocinolone Acetonide/therapeutic use , Lidocaine/therapeutic use , Neomycin/therapeutic use , Otitis Externa/drug therapy , Polymyxin B/therapeutic use , Brazil , Cost-Benefit Analysis , Drug Combinations , Technology Assessment, Biomedical , Unified Health System
16.
Rev. Hosp. Ital. B. Aires (2004) ; 36(4): 143-149, dic. 2016. graf, ilus, tab
Article in Spanish | LILACS | ID: biblio-1145235

ABSTRACT

El virus del papiloma humano (VPH) es una de las enfermedades de transmisión sexual más comunes. Puede afectar tanto el aparato genital masculino y femenino, como también el área perianal, ano, y diversas áreas de cabeza y cuello y otorrinolaringológicas, ya sea como lesiones benignas o como promotor de lesiones malignas. Las lesiones benignas por VPH en genitales masculinos se caracterizan fundamentalmente por la aparición de lesiones verrugosas, aunque también puede manifestarse mediante lesiones planas atípicas. En algunos casos hay ausencia de lesiones macroscópicamente visibles que pueden hacerse evidentes con la prueba de ácido acético. La biopsia de la lesión, su evaluación anatomopatológica y, sobre todo, la determinación de la existencia y el tipo de virus involucrado mediante PCR (reacción en cadena de la polimerasa) permiten confirmar el diagnóstico. En algunas ocasiones es necesario realizar una cistoscopia para diagnosticar lesiones intrauretrales y vesicales. Los tratamientos propuestos son muy variados y de eficacia dispar, desde las topicaciones y la electrocirugía o la criocirugía, hasta el empleo de la tecnología láser. La prevención con el uso de protección durante el acto sexual así como la educación sexual son fundamentales. En los últimos 10 años se ha implementado el uso de la vacuna para el VPH en niñas con el fin de disminuir la incidencia de lesiones de alto grado y de cáncer de cuello uterino, pero su indicación en varones es menos clara y aún no ha sido consensuada. (AU)


Human papiloma virus (HPV) is one of the most common sexual transmitted diseases. It can affect the male genitalia, as well as the perianal and anal regions and multiple areas of the head and neck and otorhinolaryngological structures, as benign lesiones or as a promoter of malignant lesions. Benign male genitalia lesions are characterized mainly by verrucous lesions, although flat atypical lesions can be found, as well as the abscence of macroscopic visible lesions that in some cases can become evident using the acetic acid test. Lesion biopsy, its histological evaluation, and the determination of the existence and type of virus using PCR (Polymerase Chain Reaction) can confirm the diagnosis. In some cases is necessary to do a cistoscopy to diagnose intraurethral and vesical lesions. Proposed treatments are varied and with a wide range of efficacy, from topications to electro or cryosurgery, and the use of laser technology. Sexual education and the use of sexual protection are essential in prevention. In the last 10 years the use of VPH vaccine in girls was widely spread, in order to decrease the incidence of high grade lesions and cervix cancer. Its indication in male patients is less clear and not yet consented among specialists. (AU)


Subject(s)
Humans , Male , Papillomavirus Infections/therapy , Reproductive Tract Infections/therapy , Podophyllin/therapeutic use , Podophyllotoxin/therapeutic use , Sex Education , Trichloroacetic Acid/therapeutic use , Condylomata Acuminata/etiology , Polymerase Chain Reaction , Condoms , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/drug therapy , Alphapapillomavirus/pathogenicity , Papillomavirus Vaccines/therapeutic use , Laser Therapy , Reproductive Tract Infections/diagnosis , Reproductive Tract Infections/etiology , Reproductive Tract Infections/pathology , Reproductive Tract Infections/drug therapy , Fluorouracil/administration & dosage , Fluorouracil/therapeutic use , Lidocaine/administration & dosage , Lidocaine/therapeutic use
17.
Rev. Col. Bras. Cir ; 43(5): 348-353, Sept.-Oct. 2016. tab, graf
Article in English | LILACS | ID: biblio-829607

ABSTRACT

ABSTRACT Objective: to evaluate the effects of blocking the regulation of vascular tone on the ischemia and reperfusion syndrome in rats through the use of lidocaine in the postconditioning technique. Methods: we randomized 35 rats into seven groups of five animals: Group 1- Control; Group 2- Ischemia and Reperfusion; Group 3- Ischemia, Reperfusion and Saline; Group 4- Ischemic Postconditioning; Group 5- Ischemic Postconditioning and Saline; Group 6- Lidocaine; Group 7- Ischemic Postconditioning and Lidocaine. Except for the control group, all the others were submitted to renal ischemia for 30 minutes. In postconditioning groups, we performed ischemia and reperfusion cycles of five minutes each, applied right after the main ischemia. In saline and lidocaine groups, we instilled the substances at a rate of two drops per minute. To compare the groups, we measured serum levels of urea and creatinine and also held renal histopathology. Results: The postconditioning and postconditioning + lidocaine groups showed a decrease in urea and creatinine values. The lidocaine group showed only a reduction in creatinine values. In histopathology, only the groups submitted to ischemic postconditioning had decreased degree of tubular necrosis. Conclusion: Lidocaine did not block the effects of postconditioning on renal ischemia reperfusion syndrome, and conferred better glomerular protection when applied in conjunction with ischemic postconditioning.


RESUMO Objetivo: avaliar os efeitos do bloqueio da regulação do tônus vascular por meio do uso da lidocaína na técnica de pós-condicionamento isquêmico na síndrome de isquemia e reperfusão renal em ratos. Métodos: trinta e cinco ratos foram randomizados em sete grupos de cinco animais: Grupo 1- Controle; Grupo 2- Isquemia e Reperfusão; Grupo 3- Isquemia, Reperfusão e Solução Salina; Grupo 4- Pós-condicionamento Isquêmico; Grupo 5- Pós-condicionamento Isquêmico e Solução Salina; Grupo 6- Lidocaína; Grupo 7- Pós-condicionamento Isquêmico e lidocaína. Com exceção do grupo controle, todos os demais foram submetidos à isquemia renal de 30 minutos. Nos grupos de pós-condicionamento, foi realizado o ciclo de isquemia e reperfusão de cinco minutos cada, aplicado logo após a isquemia principal. Nos grupos salina e lidocaína foram instiladas as substâncias numa taxa de duas gotas por minuto. Para comparar os grupos, foram dosados os níveis séricos de ureia e creatinina e análise histopatológica renal. Resultados: os grupos pós-condicionamento e pós-condicionamento + lidocaína apresentaram uma redução nos valores de ureia e creatinina. O grupo lidocaína apresentou apenas uma redução nos valores de creatinina. Na análise histopatológica, apenas os grupos submetidos ao pós-condicionamento isquêmico apresentaram redução do grau de necrose tubular. Conclusão: a lidocaína não bloqueou os efeitos do pós-condicionamento na síndrome de isquemia e reperfusão renal, mas conferiu melhor na proteção glomerular quando aplicada em conjunto com o pós-condicionamento isquêmico.


Subject(s)
Animals , Male , Rats , Reperfusion Injury/prevention & control , Ischemic Postconditioning/methods , Kidney/blood supply , Anesthetics, Local/therapeutic use , Lidocaine/therapeutic use , Random Allocation , Rats, Wistar
18.
Rev. bras. anestesiol ; 66(3): 242-248, May.-June 2016. tab, graf
Article in English | LILACS | ID: lil-782883

ABSTRACT

ABSTRACT Postoperative sore throat is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10% lidocaine hydrochloride spray, or normal saline were applied on endotracheal tube cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24 h after extubation. The results were collected, analyzed and presented in table and figure. The highest incidence of postoperative sore throat occurred at 6 h after extubation in all groups. There was a significantly lower incidence of postoperative sore throat in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of postoperative sore throat compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of postoperative sore throat after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of postoperative sore throat. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat. Application of 10% lidocaine spray should be avoided because of worsening of postoperative sore throat where incidence increased but not the severity in relation to 5% lidocaine gel. Applying 5% lidocaine on the endotracheal tube cuff does not prevent postoperative sore throat but its application is better than lidocaine 10% spray or saline.


RESUMO A dor de garganta pós-operatória (DGPO) é uma complicação comum após a intubação traqueal. Em seguida a esse procedimento, a incidência de dor de garganta varia de 14,4 a 50%. O objetivo do estudo foi comparar os efeitos da aplicação de cloridrato de benzidamina em gel, lidocaína a 5% em gel e lidocaína a 10% em spray no balonete do tubo endotraqueal, no que diz respeito à dor de garganta pós-operatória. O presente estudo foi feito com 124 pacientes internados em hospitais universitários de Alexandria para cirurgia de fixação lombar que necessitavam de anestesia geral. Os pacientes foram aleatoriamente alocados em quatro grupos. Procedeu-se à aplicação de cloridrato de benzidamina em gel, cloridrato de lidocaína a 5% em gel, cloridrato de lidocaína a 10% em spray ou salina normal nos balonetes do TET antes da intubação endotraqueal. Os pacientes foram examinados para dor de garganta (nenhuma, leve, moderada ou intensa) a 0, uma, seis, 12 e 24 horas após a extubação. Os resultados foram coletados, analisados e apresentados em tabelas e figuras. A maior incidência de DGPO ocorreu seis horas após a extubação em todos os grupos. Houve incidência significativamente menor de DGPO no grupo de benzidamina versus grupos de lidocaína a 5% em gel, lidocaína a 10% em spray e salina normal. O grupo tratado com benzidamina exibiu redução significativa na intensidade da DGPO, em comparação com os grupos de lidocaína a 10%, lidocaína a 5% e salina normal no ponto no tempo de observação. Em comparação com lidocaína a 5%, o grupo tratado com lidocaína a 10% exibiu incidência e intensidade significativamente aumentadas na DGPO após a extubação. Em comparação com salina normal, o grupo tratado com lidocaína a 10% exibiu maior incidência de DGPO. Não foram observadas diferenças significativas entre grupos quanto a efeitos colaterais locais ou sistêmicos. Assim, em conclusão, o uso de cloridrato de benzidamina em gel no balonete do TET é um método simples e eficaz para reduzir a incidência e a gravidade da DGPO. Deve-se evitar a aplicação de lidocaína a 10% em spray, devido ao agravamento da DGPO, visto ter ocorrido aumento na incidência, mas não na severidade, em relação à lidocaína a 5% em gel. A aplicação de lidocaína a 5% no balonete do TET não impede a ocorrência da DGPO, mas a sua aplicação oferece melhores resultados do que lidocaína a 10% em spray, ou solução salina.


Subject(s)
Humans , Male , Female , Adult , Postoperative Complications/prevention & control , Benzydamine/therapeutic use , Intubation, Intratracheal/adverse effects , Lidocaine/therapeutic use , Severity of Illness Index , Administration, Inhalation , Nebulizers and Vaporizers , Benzydamine/administration & dosage , Pharyngitis/prevention & control , Treatment Outcome , Dose-Response Relationship, Drug , Gels/therapeutic use , Anesthetics, Local/administration & dosage , Anesthetics, Local/therapeutic use , Lidocaine/administration & dosage , Middle Aged , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use
19.
Acta cir. bras ; 31(5): 333-337, May 2016. graf
Article in English | LILACS | ID: lil-783795

ABSTRACT

ABSTRACT PURPOSE: To evaluate the effects of an intraperitoneal solution of methylene blue (MB), lidocaine and pentoxyphylline (PTX) on intestinal ischemic and reperfusion injury METHODS: Superior mesenteric artery was isolated and clamped in 36 adult male Sprague Dawley rats. After 60 minutes, clamp was removed and a group received intraperitoneally UNITO solution (PTX 25mg/kg + lidocaine 5mg/kg + MB 2mg/kg), while the other group was treated with warm 0.9% NaCl solution. Rats were euthanized 45 min after drug administration. Lung and bowel were collected for histological evaluation (using Park's score) and determination of myeloperoxidase (MPO) and malondialdehyde (MDA) levels. RESULTS: Control samples showed lymphoplasmocytic infiltrate and crypt necrosis of villi. MPO and MDA measurements shown no differences between treated and control groups. CONCLUSION: The combination of lidocaine, methylene blue and pentoxyphylline administered intraperitoneally at the studied dose, did not decreased histological lesion scores and biochemical markers levels in intestinal ischemia/reperfusion injury.


Subject(s)
Animals , Male , Pentoxifylline/therapeutic use , Reperfusion Injury/drug therapy , Intestines/blood supply , Lidocaine/therapeutic use , Methylene Blue/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Pentoxifylline/administration & dosage , Random Allocation , Peroxidase/metabolism , Models, Animal , Drug Combinations , Drug Synergism , Inflammation/prevention & control , Inflammation/drug therapy , Infusions, Parenteral , Intestines/enzymology , Lidocaine/administration & dosage , Lung/blood supply , Lung/metabolism , Malondialdehyde/metabolism , Methylene Blue/administration & dosage , Anti-Inflammatory Agents/administration & dosage
20.
Rev. latinoam. enferm. (Online) ; 23(6): 1000-1006, Nov.-Dec. 2015. tab, graf
Article in Spanish, Portuguese | LILACS, BDENF | ID: lil-767114

ABSTRACT

Objective: to assess the analgesic efficacy of subcutaneous lidocaine and multimodal analgesia for chest tube removal following heart surgery. Methods: sixty volunteers were randomly allocated in two groups; 30 participants in the experimental group were given 1% subcutaneous lidocaine, and 30 controls were given a multimodal analgesia regime comprising systemic anti-inflammatory agents and opioids. The intensity and quality of pain and trait and state anxiety were assessed. The association between independent variables and final outcome was assessed by means of the Chi-squared test with Yates' correction and Fisher's exact test. Results: the groups did not exhibit significant difference with respect to the intensity of pain upon chest tube removal (p= 0.47). The most frequent descriptors of pain reported by the participants were pressing, sharp, pricking, burning and unbearable. Conclusion: the present study suggests that the analgesic effect of the subcutaneous administration of 1% lidocaine combined with multimodal analgesia is most efficacious.


Objetivo: avaliar a eficiência analgésica de lidocaína subcutânea e analgesia multimodal na remoção do dreno torácico após cirurgia cardíaca. Método: sessenta voluntários foram alocados aleatoriamente em dois grupos; 30 participantes no grupo experimental receberam lidocaína subcutânea 1%, e outros 30 do grupo controle receberam o regime de analgesia multimodal compreendendo agentes anti-inflamatórios e opióides sistêmicos. A intensidade e qualidade da dor e Ansiedade Traço Estado foram avaliados. A associação entre variáveis independentes e desfecho final foi avaliada através do Teste Qui-quadrado com correção de Yates e o Teste exato de Fisher. Resultados: os grupos não apresentaram diferenças significante, no que diz respeito à intensidade da dor na remoção do dreno torácico (p= 0,47). Os descritores de dor mais comuns relatados pelos participantes foram dor: de pressão, aguda, como uma picada, queimar/arder e intolerável. Conclusão: o presente estudo sugere que o efeito analgésico da administração de lidocaína 1% combinada com a analgesia multimodal é mais eficiente.


Objetivo: evaluar la eficacia analgésica de la lidocaína subcutánea y la analgesia multimodal para la remoción del tubo torácico después de la cirugía cardíaca. Métodos: sesenta voluntarios fueron asignados aleatoriamente en dos grupos; 30 participantes en el grupo experimental recibieron lidocaína subcutánea al 1%, y 30 controlos recibieron un régimen de analgesia multimodal que comprende agentes antiinflamatorios sistémicos y opioides. La intensidad y calidad del dolor y rasgo y estado de ansiedad se evaluaron. La asociación entre las variables independientes y el resultado final han sido evaluados por medio de la prueba de Chi-cuadrado con corrección de Yates y la prueba exacta de Fisher. Resultados: los grupos no mostraron diferencias significativas con respecto a la intensidad del dolor después de la retirada del tubo torácico (p= 0,47). Los descriptores de dolor más frecuentes informados por los participantes fueron apretado, agudo, punzante, ardiente e insoportable. Conclusión: el presente estudio sugiere que el efecto analgésico de la administración subcutánea de lidocaína al 1% combinada con la analgesia multimodal es eficaz.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Chest Tubes , Device Removal/adverse effects , Pain, Procedural/drug therapy , Analgesia , Anesthetics, Local/therapeutic use , Lidocaine/therapeutic use , Pain, Postoperative/drug therapy , Pain Measurement
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