Biomedical subjects

Anthony Eidelman

Publications and source records attributed to Anthony Eidelman.

4 recordsLinked to original sources

PubMed2005

Topical anesthetics for dermal instrumentation: a systematic review of randomized, controlled trials.

STUDY OBJECTIVE: We compare the analgesic efficacy of topical anesthetics for dermal instrumentation with conventional infiltrated local anesthesia and also compare topically available amide and ester agents with a eutectic mixture of local anesthetics (EMLA). METHODS: We conducted a systematic review of randomized, controlled trials. Relevant literature was identified through searches of MEDLINE, Cochrane Central Register of Controlled Trials, and the Excerpta Medica Database Drugs and Pharmacology. We limited the type of procedures to puncture of intact skin with a needle. The primary outcome was analgesic efficacy, reflected in the patient's self-report of pain intensity during dermal instrumentation. Where possible, quantitative methods were used to summarize the results. RESULTS: We identified 25 randomized controlled trials including 2,096 subjects. The results of the trials comparing the efficacy of EMLA with infiltrated local anesthetic were inconsistent. Qualitative analysis demonstrated comparable analgesic efficacy between liposome-encapsulated lidocaine and EMLA. The weighted mean difference in 100-mm visual analogue scale pain scores favored topical tetracaine over EMLA (-8.1 mm; 95% confidence interval -15.6 mm to -0.6 mm). Liposome-encapsulated tetracaine provided greater analgesia than EMLA according to the weighted mean difference in 100-mm visual analogue scale scores (-10.9 mm; 95% confidence interval -15.9 mm to -5.9 mm). CONCLUSION: EMLA may be an effective, noninvasive means of analgesia before dermal procedures. However, we identified 3 topical anesthetics that are at least as efficacious as EMLA: tetracaine, liposome-encapsulated tetracaine, and liposome-encapsulated lidocaine. Liposomal lidocaine is commercially available in the United States and offers a more rapid onset and less expensive alternative to EMLA.

Administration, Cutaneous↗

PubMed2005

Fluoroscopic imaging for technically difficult spinal anesthesia.

We report a case of technically difficult spinal anesthesia in a morbidly obese woman, which was successfully implemented under fluoroscopy. Although radiological imaging is well known to guide various regional anesthetic procedures, until now, the utility of fluoroscopic imaging to facilitate spinal anesthesia had not been reported.

Adult↗

PubMed2005

Comparative efficacy and costs of various topical anesthetics for repair of dermal lacerations: a systematic review of randomized, controlled trials.

STUDY OBJECTIVES: To compare the efficacy of infiltrated local anesthesia with topical anesthesia for repair of dermal laceration, to analyze the efficacy of single or multicomponent topical anesthetics, and to identify topical formulations that are potentially less costly and equally efficacious as cocaine-containing topical anesthetics. DESIGN: Systematic review of randomized controlled trials. SETTING: University-affiliated hospital. PATIENTS: Pediatric and adult subjects. MEASUREMENTS AND MAIN RESULTS: Twenty-two trials that randomized more than 3000 patients were identified. The majority of studies demonstrated equivalent or superior analgesic efficacy for topical formulations compared with conventional intradermal infiltration. We found that cocaine is not a mandatory component of topical anesthesia. The literature discloses no significant difference in anesthetic efficacy between topical tetracaine-epinephrine-cocaine and each of the following 6 cocaine-free formulations: lidocaine-epinephrine-tetracaine, lidocaine-epinephrine, tetracaine-phenylephrine, tetracaine-lidocaine-phenylephrine, bupivicaine-norepinephrine, or prilocaine-phenylephrine. CONCLUSION: Topical anesthetics are an efficacious, noninvasive means of providing analgesia before suturing of dermal lacerations. The use of cocaine-containing topical anesthetics can no longer be justified in light of its high cost and potential adverse effects. We have summarized the evidence, mostly favorable, supporting the use of various non-cocaine-containing topical anesthetics.

Anesthetics, Local↗

PubMedDate not supplied

Three-dimensional conformal radiotherapy for treatment of extensive juvenile angiofibroma: report on two cases.

These case reports describe the application of three-dimensional conformal radiotherapy for the treatment of extensive juvenile angiofibroma. The affected areas included the pterygomaxillary fossa, infratemporal fossa, orbit, middle cranial fossa and maxillary sinus. Three-dimensional conformal radiotherapy was used to deliver the tumor dose of 3800-4140 cGy. The radiation dose to the surrounding normal structures including the optic nerve, optic chiasm, spinal cord, parotid and brain was limited. The tumor showed an excellent clinical and radiological response in both patients. There was no appreciable late toxicity. In conclusion, three-dimensional conformal radiotherapy provides several advantages over conventional radiotherapy in the treatment of extensive juvenile angiofibroma.

Adolescent↗