Patient satisfaction and experience with various modes of Xylocaine administration for cervical dilatation and endometrial curettage: a randomized interventional study

Background: Patient satisfaction after a surgical procedure is an important outcome of hospital care. Many of the gynaecological menstrual problems such as abnormal uterine bleeding, postmenopausal bleeding requires endometrial evaluation which is done traditionally by dilatation and curettage. But this procedure is painful and requires appropriate pain management protocol. The aim is to evaluate the post-operative patient satisfaction following dilatation and curettage procedure.Methods: This study was conducted in a tertiary care hospital belonging to a medical college. A total of 236 patients were recruited for the study who subsequently underwent dilatation and curettage with different mode of Xylocaine anesthesia for pain relief. Of them 16 patients were excluded due to valid reasons and the remaining 220 were interviewed face to face following the procedure. The level of anxiety was assessed using Beck’s Anxiety inventory and also perception of satisfaction was documented along with complication related to the anesthesia.Results: The overall level of satisfaction was higher in the group receiving both paracervical block and intrauterine instillation of lidocaine during the procedure of dilatation and curettage. A further analysis showed that increase in level of satisfaction was due to improvement in pain scores due to combined mode of paracervical and endometrial anesthesia.Conclusions: A multimodal pain management protocol which involves pre-procedural sedation, combined cervical and endometrial anesthesia improves overall outcome with respect to reduction in anxiety scores and postoperative satisfaction levels.

A Study on Sequential Effects of IntrathecalXylocaine and Midazolam for Post-Operative Analgesia in Lower Segment Cesarean Section

Background: Intrathecal xylocaine with midazolam is evermore being used for postoperative pain relief. There were littleconcern like respiratory depression and neurotoxicity with theuse of inthrathecal midazolam.Methods: In this study total 90 patients of with 30 patients ineach group using intrathecal drugs for postoperative pain reliefin Lower segment cesarean section. The three groups wereintrathecal xylocaine, intrathecal xylocaine + 1mg midazolamand intrathecal xylocaine + 2 mg midazolam respectively.Results: The demographic and hemodynamic variables werecomparable between the three groups. Only shivering andhypotension was noted with use of midazolam which was nodifferent from other groups.Conclusion: Intrathecal midazolam as an adjuvant tointrathecal xylocaine was not associated with significantadverse events or complications.

Efficacy of Intravenous Lignocaine 2% Versus Oropharyngeal Topical 10% Xylocaine Spray Before Induction of Anaesthesia in Attenuating the Pressor Response to Direct Lryngoscopy and Endotracheal Intubation

The current Study was done to compare the efficacy of intravenous lignocaine 2% versus oropharyngeal topical 10% xylocaine spray before induction of anaesthesia in attenuating the pressor response to direct laryngoscopy and endotracheal intubation. A total of 60 patients were divided randomly into two groups of 30 patients each. Group I received intravenous lignocaine 2% @ 1.5 mg/kg. Group II received topical 10% xylocaine spray @ 1.5 mg/kg body weight just before induction of anaesthesia. All hemodynamic parameters were measured immediately after laryngoscopy and intubation and at 1, 3, 5 minutes after laryngoscopy and intubation in both the groups. Mean values of haemodynamic parameters in Group I increased after intubation and then started declining but did not reach the baseline even at 5 minutes. In Group II all mean values of haemodynamic parameters increased after intubation and then started declining to almost baseline at 5 minutes. The differences in mean values of haemodynamic between the two groups immediately after intubation and at 1, 3 and 5 minutes thereafter were statistically highly significant (p<0.001). Oropharyngeal topical xylocaine 10% when applied before induction of general anaesthesia is more effective method for attenuating the pressor response to direct laryngoscopy and endotracheal intubation when compared to intravenous lignocaine 2%

Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study / Efeitos do contraste iodado, da xilocaína e da concentração de gadolínio no sinal emitido em exames de artrorressonância magnética: estudo por amostras

Objective: To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality. Materials and Methods: Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration. Results: As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions. Conclusion: Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography. .

Objetivo: Investigar, mediante quantificação da intensidade do sinal emitido em amostras, se a diluição do agente de contraste paramagnético com contraste iodado e xilocaína alteram o sinal emitido pelo meio de contraste paramagnético durante o exame de artrorressonância magnética, e aperfeiçoar a concentração de contraste paramagnético utilizada no exame. Materiais e Métodos: Foi realizada sequência de pulso fast spin eco ponderada em T1 com saturação de gordura, utilizando três diferentes concentrações de contraste paramagnético diluídas em solução salina, contraste iodado e xilocaína. As amostras foram colocadas em frascos e a análise gráfica da intensidade do sinal em função da concentração de contraste paramagnético foi realizada. Resultados: Constatou-se que as diluições de contraste paramagnético em contraste iodado e xilocaína diminuíram, em média, a intensidade do sinal em 20,67% para o contraste iodado e 28,34% para a xilocaína, em comparação com as amostras de concentração idêntica diluídas apenas em solução salina. Porém, o aumento da concentração de gadolínio nas amostras ocasionou a diminuição da intensidade do sinal emitido pelo gadolínio, para todas as diluições. Conclusão: Minimizar o uso do meio de contraste iodado e da xilocaína e/ou a utilização de uma concentração de gadolínio com 2,5 mmol/L, diluída em solução salina, irá aperfeiçoar a sensibilidade do exame de artrorressonância magnética. .

Optimization of Formula of Compound Xylocaine Cream / 中国药房

OBJECTIVE:To optimize the formula of compound xylocaine cream.METHODS:Orthogonal design was employed to optimize the amount of each component in the formula of compound xylocaine cream,and the pain threshold improvement rate in pain-relieving experiment of mice and the mice ear edema inhibition rate in the anti-inflammatory experiment served as indexes to optimize the formula,meanwhile a verification test was conducted.RESULTS:The optimized formula was as follows:xylocaine 20 g,chlorphenamine maleate 5 g,menthol 20 g,mupirocin 20 g in every 1 000 g cream.Both the pain threshold improvement rate and the ear edema inhibition rate in mice were all higher than 60%,which were up to the standard.CONCLUSION:The formula for compound xylocaine cream is reasonable,and this study provids experimental basis for clinical application of compound xylocaine cream.

Effect of Local Anesthesia for Nasogastric Tube Placement

PURPOSE: This study was conducted to assess the effect of sprayed 10% xylocaine as a local anesthesia in reducing the pain associated with nasogastric tube(NGT) placement METHOD: This was a prospective, randomized, case-controlled trial conducted in the emergency department of a university teaching hopital. Study participants were alert patients requiring NGT placement for diagnostic or therapeutic purposes. Patients having NGT placement were randomized to receive either a 10% xylocaine solution or nothing sprayed in the nasopharynx and oropharynx. After 5 minutes, the distal 5 cm of the NGT were lubricated with a liberal amount of sterile, water-soluble, and non-anesthesient jelly before placement. After each procedure, the patient recorded assessment of subjective pain on a 100-mm visual analog scale(VAS). RESULT: A total of 71 patients were evaluated in the study with 32 in the case group and 39 in the control group. The mean VAS value of the case group was 38.8 mm(95% confidence interval[CI] 2.4 to 51.3); that of control group was 63.31 mm. The mean difference between groups was 24.40 mm(95% CI, 26.9 to 75.9). A statistically significant difference was achieved between the case and the control groups(p<0.01). CONCLUSION: Sprayed nasopharyngeal and oropharyngeal 10% xylocaine results in a statistically significant reduction in pain during NGT placement.

Complications in cataract surgery from the use of alpha-chymotrypsin

In this study 143 eye undergoing cataract extraction are divided into two categories in one group, (69 eyes), Quimotrase was used; in the other group the enzyme was not used. The same surgical technique was done in each group except that the lens was delivered by the sliding method in the first group and by the tumbling method in the latterThe complications in each group are classified, analysed and compared. In brief, during the surgery, complications were minimized with the use of Quimotrase. However, in the early postoperative period, there were more complications encountered when this enzyme was used. Moreover, Quimotrase was helpful in cases of immature cataract especially at the ages of 40 to 60. It was not of much use in the age group 80 to 90, and proved even harmful when the cataract was hypermature. (Summary)

A STUDY OF THE DOSAGE AND VOLUME OF LOCAL ANESTHETICS FOR ESWL UNDER EXTRADURAL ANESTHESIA / 重庆医科大学学报

Both dosage and volume of local anesthetics taken for extradural anesthesia in ESWL were studied in 112 cases. The results showed that small dose of coxylacaine (1.33% of xylocaine and 0.16% Bupivacaine in 3-5ml) given extradurally is not only safe but also suitable for ESWL without obvious side effect

A Clinical Study of 123 Cases on the Urethral Anesthesia and Analgesia / 대한비뇨기과학회지

No abstract available.