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Results for “ANESTHESIA, LOCAL”

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At least 37 records · Page 2Linked to original sources
PubMed1990

[Anesthesia in ear surgery. A resource economical analysis and patient assessment of general anesthesia versus local anesthesia in ear surgery].

Although it has long been known that surgery on the middle ear may be carried out under local anaesthesia (LA), the majority of ear operations in Denmark are carried out under general anaesthesia (GA). A prospective review is presented of 103 ear operations of which 71 were undertaken under local anaesthesia and 32 under general anaesthesia. Local anaesthesia has considerable advantages as compared with general anaesthesia, particularly that the anaesthetic capacity is released and can be employed for other purposes. Employment of local anaesthesia does not present any disadvantages for the surgeon and the procedure appears to be acceptable for the majority of patients. In order not to bring the procedure into disrepute, patients should be assessed meticulously preoperatively by an experienced surgeon so that operation under local anaesthesia is not performed in unsuitable patients.

Adolescent↗
PubMed2002

[Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia].

BACKGROUND: Postoperative bleeding after tonsillectomy is still a life-threatening problem. The incidence of postoperative bleeding, as well as many factors (kind of surgery, hemostasic problems) affecting this risk have been investigated. A possible factor that has not been well studied is the used anaesthetic procedure. METHODS: A prospective study was completed comparing the risk of postoperative bleeding in patients operated in local vs. general anaesthesia. RESULTS: The study enrolled 1063 patients, who consecutively underwent tonsillectomy. In 16 (4.12%) of 388 patients operated under general and 51 (7.55%) of 675 patients operated under local anaesthesia postoperative bleeding occurred. After local anaesthesia postoperative bleeding was seen mainly at the day of operation (46 of 51), there was no late bleeding after the 6th postoperative day. After general anaesthesia in 6 of 16 cases postoperative bleeding occurred after the 6th postoperative day. DISCUSSION: Postoperative bleeding occurs more frequent in patients who underwent tonsillectomy in local anaesthesia. The risk of late postoperative bleeding however is higher with tonsillectomy in general anaesthesia.

Adolescent↗
PubMed1994

Alkalinization of local anesthesia with sodium bicarbonate--preferred method of local anesthesia.

Effective anesthetic techniques include local anesthetic infiltration with or without sedation and general anesthesia. Local anesthesia is a safe and effective anesthetic technique, that when performed properly is applicable to many outpatient urologic procedures. We have found that the pain usually associated with intradermal injection of lidocaine is attenuated by the addition of sodium bicarbonate.

Anesthesia, Local↗
PubMed2001

Successful endovascular repair of a leaking abdominal aortic aneurysm under local anesthesia.

UNLABELLED: Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. PATIENT AND METHODS: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24 mm x 12 mm x 153 mm) was implanted under local anesthesia. RESULTS: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. DISCUSSION: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

Aged↗
PubMed1990

Anesthesia for neonatal circumcision: local anesthesia is better than dorsal penile nerve block.

Several studies document the benefit of dorsal penile nerve block for neonatal circumcision, but the literature does not address the use of local anesthesia. A randomized, controlled, prospective study was conducted to compare the efficacy of dorsal penile nerve block versus local anesthesia. Thirty infants were randomly divided into three equal groups (N = 10): an unanesthetized control group, a group given dorsal penile nerve block, and a group given local anesthesia. Heart rate, transcutaneous oxygen saturation, and crying were monitored continuously before, during, and after circumcision. During circumcision, both the dorsal penile nerve block group and the local-anesthesia group demonstrated smaller increases in heart rate, smaller drops in oxygen saturation, and less crying compared with unanesthetized controls (P less than .05). Both techniques worked well in anesthetizing the dorsal aspect of the penis; however, during those steps of circumcision involving trauma to the ventral aspect of the penis, the local-anesthesia group demonstrated smaller increases in heart rate and less crying compared with infants given dorsal penile nerve block (P less than .05). Cortisol levels measured 30 minutes postoperatively were lower in the local-anesthesia group than in either the controls or the dorsal penile nerve block group (P less than .05). Dorsal penile nerve block had no effect on postoperative cortisol levels. No complications occurred. Although both types of anesthesia attenuated the physiologic responses to circumcision, local anesthesia demonstrated greater efficacy than dorsal penile nerve block while being simpler to perform.

Anesthesia, Local↗
PubMed2002

[Tumescent technique for local anesthesia].

Tumescent local anesthesia was originally used in liposuction but is also carried out for other plastic, cosmetic, dermatological procedures and for surgery of the venous system, often in outpatients. For this purpose, large amounts of fluids containing diluted lidocaine or prilocaine and epinephrine are infused subcutaneously. In this review of the literature, this technique is assessed in view of potential anesthesiological complications such as intoxication with lidocaine, prilocaine, overdosage of epinephrine or overload with fluids. While originally a lidocaine dosage of 35 mg/kg b.w. was considered to be safe, dosages were then increased to 55 mg/kg b. w. and even 90 mg/kg b. w. without data showing the safety of such high doses. Published data of plasma concentrations were obtained from small numbers of patients, showing that the concentrations were below 5 microg/ml which is considered the nontoxic range. The maximum levels were observed after 4 - 12 hours, if epinephrine was used. In a few patients, however, the values had not yet begun to decrease at the end of the 23 hours observation period. Replacing lidocaine by prilocaine shifts the problem of toxicity to that of the formation of methemoglobine, which can reach levels of more than 10 %. Data about effects of high-dose epinephrine in the literature are sparse, but tachycardia, arrhythmias and hypertension remain a major concern. Although fluids are applied subcutaneously, an overload with fluids may occur. Cases of lung edema have been reported, however, hypovolemia caused by a loss of fluid into the third space cannot be excluded. Because of these possible complications, tumescent local anesthesia should be employed in outpatients with great care. Patients should be monitored during the procedure and for a sufficient period of time thereafter by adequately trained staff. Patients with cardiac or pulmonary risk factors should not undergo tumescent local anesthesia.

Anesthesia, Local↗
PubMed1996

Four common mandibular nerve anomalies that lead to local anesthesia failures.

Local anesthesia is essential in treating many dental and oral disorders. However, many types of anatomical anomalies are seen in the nervous system of the mandible that interfere with achieving local anesthesia. The authors describe four such anomalies and offer ways to overcome them when trying to properly anesthetize affected patients.

Anesthesia, Dental↗
PubMedDate not supplied

Outpatient surgery for penile venous patch with the patient under local anesthesia.

Although local anesthesia for penile surgery has been widely reported, its application for penile venous patch, however, has not been published. We evaluated an anesthetic and surgical technique on an outpatient basis. From March 1993 to September 2001, a total of 29 men with penile deformity, aged 27 to 77 years (mean 55 years) received a penile venous patch for morphologic correction. They received autologous grafting of the deep dorsal vein under local anesthesia as an outpatient procedure. The anesthetic effect and postoperative results were satisfactory. The average available area of the deep dorsal vein was 5.7 x 2.5 cm(2). The common immediate side effects included puncture of the vessels, subcutaneous ecchymosis, and transient palpitation, but there were no significant late complications. All patients returned home uneventfully. This has been proven to be a cost-effective, simple, and safe method with fewer complications. It offers the advantages of lower morbidity, protection of privacy, fewer adverse effects of anesthesia, and a more rapid return to activity with minimal complications.

Adult↗
PubMed2006

[Examination of cardiovascular function variables in tooth extraction under local anesthesia].

BACKGROUND/AIM: Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline) in healthy persons, and in the patients with a certain cardiovasccular system disease. The aim of this stady was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. METHODS: The examinees were divided into the group with cardiovascular diseases (CV, n=57) of H and III type, according to the American Society of Anesthesiologists (ASA) qualification, and healthy persons (H, n=55). Both groups were randomly divided into two subgroups: CVa and Ha--where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1: 100,000 adrenaline); CVb and Hb--where the anesthetic solution was without the vasoconstrictor (3% lidocaine). During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc), systolic (TAs) and diastolic arterial blood pressure (TAd) and ECG were registered. RESULTS: The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05) from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05). The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. CONCLUSION: This research shoved that tooth extraction under local anesthesia did not cause complications in cardiovascular patients who were in II or III ASA qualification group, regardless the presence of a vasoconstrictor in the local anesthetic solution.

Adult↗