Infiltration with tramadol [1-5%] in comparison with lidocaine [1%] for minor surgery

Previous studies have shown that intradcrrnal tramadol 5% can provide a local anesthetic effect similar to prilocaine 2%. The aim of our study was to determine the most effective local anesthetic concentration of tramadol hydrochloride [1, 3, or 5%] without adverse effects compared with lidocaine 1%. Eighty adult patients scheduled for excision of cutaneous lesion under local anesthesia were randomly divided into four groups. The patients were assigned to receive intradermally either 1 ml of tramadol 1% [group I, n=20], lml of tramadol 3% [group II, n=20], 1 ml of tramadol 5% [group III, n=20] and 1 ml of lidocaine 1% [group IV, n=20]. The degree of sensory block to pin prick, light touch and cold were assessed after I minute of drug administration. Pain to surgical incision was evaluated by the patients using four point scale [0-3]. Local or systemic adverse effects of the drugs were recorded. There is no significant difference as regard to quality of the block between group III and IV in comparison to group I and II [tramadol 1-3%] fail to produce local anesthetic effect similar to that in group III and IV. There is increased incidence of local reaction [rash] in group III [five patients] when compared with group IV [one patient] P<0.05. Five patients complained of burning at site of injection in group III in comparison to three patients in group IV [P>0.05]. We conclude that intradermal tramadol 5% can produce a local anesthesia similar to lidocaine 1% but with high incidence of local adverse effect

Tenosynovitis and rheumatoid nodules in tendons of hands and feet using high frequency ultrasonography and ower doppler sonography

Evaluation of disease activity and therapeutic response in patients with rheumatoid arthritis [RA] was based largely on the clinical findings. Conventional sonography provides accurate method for identification of the tendons changes with RA. The study included 69 patients with RA. Sonographic examination of the tendons in both hands and feet was performed by using B-mode real-time machines [ACUSON SEQUOIA 512, probe 7.5 MHZ]. Rheumatoid nodu1es were detected in 15 patients [21.7%]. The flexor tendons were affected mainly by tenosynovitis and nodules. The ultrasonography identified the RA tendon nodules that can not be detected by clinical examination. Ultrasonography shou1d be considered the screening procedure of choice for the diagnosis of rheumatoid inpalpable nodules in the tendons of hands and feet. It gives good information about the inflammatory synovitis and general idea about the tendon texture, that provides an objective assessment of the treatment efficacy