ABSTRACT
It is a common practice for medical practitioners to use subcutaneous infiltration of lidocaine to alleviate the pain of intravenous cannulation or line insertion. Although previous studies have assessed several factors affecting the pain associated with local anesthetic infiltration, there is a paucity of data on the effects of needle bevel position. In this prospective, randomized, controlled trial, we compared the effect of two different needle bevel positions (bevel up versus bevel down) and the pain associated with the subcutaneous injection of 1% lidocaine in 50 adult volunteers. Significantly higher pain scores were observed when the needle was placed bevel down compared with bevel up (P = .02). No significant differences in pain scores were noted between the groups for age and gender.
Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Injections, Subcutaneous/methods , Lidocaine/administration & dosage , Pain/prevention & control , Adult , Anesthesia, Local/nursing , Female , Forearm , Humans , Injections, Subcutaneous/nursing , Male , Middle Aged , Needles , Pain/nursing , Postanesthesia Nursing/methods , Prospective StudiesSubject(s)
Carcinoid Heart Disease/etiology , Carcinoid Tumor/diagnosis , Heart Neoplasms/diagnosis , Peritoneal Neoplasms/pathology , Tricuspid Valve Insufficiency/etiology , Aged , Biopsy , Carcinoid Heart Disease/pathology , Carcinoid Heart Disease/surgery , Carcinoid Tumor/radiotherapy , Carcinoid Tumor/secondary , Carcinoid Tumor/surgery , Cardiac Surgical Procedures , Echocardiography, Doppler, Color , Echocardiography, Transesophageal , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/secondary , Heart Neoplasms/surgery , Heart Valve Prosthesis Implantation , Humans , Male , Radiography , Radiotherapy, Adjuvant , Treatment Outcome , Tricuspid Valve Insufficiency/pathology , Tricuspid Valve Insufficiency/surgeryABSTRACT
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality in the United States. Management is usually supportive, including supplemental oxygen, intravenous fluids, and mechanical ventilation if necessary. Most patients recover within 72 hours. We present a nearly fatal case of TRALI in an obstetric patient, which was successfully managed with extracorporeal membrane oxygenation (ECMO).
