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PubMedDate not supplied

[Different information patterns and their influence on patient anxiety prior to dental local anesthesia].

In 240 patients the correlation between different patterns of pretreatment verbal information on local anesthesia and perioperative patient anxiety was studied. Emphasis has been placed on the importance of "local anesthesia" itself as an anxiety factor as compared with other dental treatment measures and on legal aspects. The 240 patients were randomized into 3 groups of 80 patients each receiving minimum, basic, or extended information on local anesthesia. Anxiety was measured using the STAI test before and after the delivery of information, after local anesthesia, and finally after dental treatment. The significance of different anxiety factors was assessed with a questionnaire. Local anesthesia, pain sensation, and drilling were found to be the main anxiety factors. Higher STAI scores were observed in women and prior to surgical treatment, and the scores increased after minimum and extended information. Anxiety decreased after basic information, and significantly so in patients with high preoperative STAI scores. Disregarding the forensic aspects, our results suggest that basic information prior to dental treatment could be a useful method for reducing anxiety and improving the patients' confidence in the dentist or surgeon.

Adult↗
PubMed1997

[Optimization of local anesthesia in ambulatory surgery].

The optimization of local anesthesia will be one essential condition to enlarge and improve the ambulatory surgery and its acceptation by the patients. Indication to local anesthesia can be increased by prolongation of its duration through adjunction of adrenaline to lidocaine at a 1:200,000 concentration and by diminishing injection-related pain through buffering the anesthetic solution with a 8.4% sodium bicarbonate solution at a concentration of 1 ml to 10 ml of lidocaine. However, this preparation is unstable and must be utilized within a few days.

Ambulatory Surgical Procedures↗
PubMed1987

The unheralded value of arthroscopy using local anesthesia for diagnostic specificity and intraoperative corroboration of therapeutic achievement.

The senior author has performed more than 600 "therapeutic" arthroscopies under local anesthesia since 1978. The authors believe that the cases presented illustrate the increased diagnostic accuracy offered by performing arthroscopy of the knee under local anesthetic in certain types of cases. We are by no means advocating that all arthroscopies of the knee be performed under local anesthesia. Certainly, the majority of knee arthroscopies need not be performed under local anesthesia, because the diagnosis is usually evident. Perhaps when the diagnosis is not clear, a combination of local with regional or with general would be best, with performance of the diagnostic portion of the arthroscopy under local anesthesia. When an instantaneous improvement is possible, such as change in joint motion, or when some change in joint dynamics may be visualized, local should then be continued through the therapeutic conclusion of the procedure. Arthroscopy under local anesthesia has also been performed by the authors on the shoulder, elbow, and ankle, where the diagnostic benefits have been realized. Certain reconstructive operations, such as patellar realignments, are worthy of performance under local anesthesia in selected cases. In conclusion, the authors believe that arthroscopy of the knee and other joints under local anesthesia may add measurably to the diagnostic capability of the arthroscopist, and not infrequently to a therapeutic advantage.

Adult↗
PubMed1990

Arthroscopic surgery of the knee under local anesthesia.

This report delineates the efficacy of local anesthesia in the performance of arthroscopic surgery of the knee. A retrospective review of 500 cases revealed that only three required administration of general anesthesia to successfully complete the procedure. A prospective study comparing fentanyl, midazolam, and fentanyl/midazolam combinations as intravenous supplements was performed. Meticulous surgical technique combined with local anesthesia and some form of intravenous sedation in minimal therapeutic dosage will provide satisfactory conditions to perform surgical arthroscopy of the knee.

Adult↗
PubMed1987

Performance of disposable needle syringe systems for local anesthesia.

The performance of different disposable needle syringe systems was determined by measuring needle-puncture pain, needle-bending forces, and the fluid dynamics of the systems. Thirty-gauge needles cause less needle-puncture pain than any other needle. The force required to bend the 30-gauge needle irreversibly was lower than that for the other needles. Studies of the fluid dynamics of different needle syringe assemblies demonstrated that the flow rate can be limited by using large-size syringes (30 mL) and needles with the smallest internal diameter. On the basis of the results of this study, 30-gauge needles attached to 10-mL syringes are recommended for infiltration anesthesia, and 25-gauge needles with 10-mL syringes are advocated for regional nerve blocks. In infiltration anesthesia, the local anesthetic agent should be injected slowly into the subdermal tissue over a 10-second period. When performing regional nerve blocks, it is also advisable to inject the local anesthetic agent over a 10-second time interval.

Anesthesia, Local↗
PubMedDate not supplied

Use of an anesthetic cream before infiltration with local anesthesia in aesthetic surgery.

The use of local anesthesia in aesthetic surgery must be provided to the patient based on its risk/benefit ratio, effective control of postoperative pain, and lower incidence of postoperative disorders. The use of a new anesthetic cream before infiltration with a local anesthetic may cause reduction or elimination of the pain provoked by the needle during the infiltration, increasing the compliance of local anesthesia. Here we describe the modalities and the advantages of using anesthetic cream.

Anesthesia, Local↗
PubMed1994

[A five-step technique for local anesthesia in inguinal hernia repair].

One century ago, in his 1990 Annals of Surgery article, Cushing indicated that except for children, all hernias can be repaired under local anesthesia [1]. Since then, local anesthesia has been successfully used for the repair of all reducible groin hernias in adult patients at many centers. For the last 25 years, more than 12000 groin hernia repairs have been performed under local anesthesia at the Lichtenstein Hernia Institute. Initially, field block was our method of choice for achieving local anesthesia. During the last 5 years, a simple infiltration technique has been used because the field block was more time consuming and required larger volume of the local anesthetic solution. Furthermore, because of the blind nature of the procedure, it did not always result in satisfactory anesthesia and at times accidental needle puncture of the ilio-inguinal nerve resulted in prolonged postoperative pain, burning, or electric shock sensation within the field of the ilio-inguinal nerve innervation. The purpose of this article is to introduce a simple 5-step infiltration technique that results in satisfactory local anesthesia and prolonged post-operative analgesia requiring a maximum of 30-40 cc of local anesthetic solution.

Anesthesia, General↗