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At least 19 recordsLinked to original sources
PubMed2002

[Emergencies evolving from local anesthesia].

Local anesthesia is without doubt the most frequently used drug in dentistry and in medicine. In spite of records of safety set by using these drugs, there is evidence to adverse reactions ranging from 2.5%-11%. Most of the reactions originate from the autonomic system. A recent, well-planned study indicates that adverse reactions are highly correlated to the medical status of the patient: the higher the medical risk, the greater the chance to experience an adverse reaction. This study also found that adverse reactions highly correlated to the concentration of adrenalin. Another recent study found a direct relationship between adverse reactions and the level of anxiety experienced by the patient and to the dental procedure. Most of the reactions in this study occurred either immediately at injection time and within 2 hours following the injection. Since the beginning of last century, vasoconstrictors have been added to local anesthesia solutions in order to reduce toxicity and prologue activity of the LA. However, today it is commonly agreed that this addition to local anesthesia should not be administered to cardiac patients especially those suffering from refractory dysrhythmias, angina pectoris, post myocardial infarction (6 months) and uncontrolled hypertension. Other contraindications to vasoconstrictors are endocrine disorders such as hyperthyroidism, hyperfunction of the medullary adrenal (pheochromocytoma) and uncontrolled diabetes mellitus. Cross reactivity of local anesthetic solutions can occur with MAO inhibitors, non specific beta adrenergic blockers, tricyclic antidepressants, phenothiazides and cocaine abusers. Noradrenaline added to local anesthetics as a vasoconstrictor has been described as a trigger to a great increase in blood pressure and therefore has been forbidden for use in many countries. This paper describes 4 cases of severe complications following the injections of local anesthesia of which three ended in fatality.

Anesthesia, Dental↗
PubMed2000

[What is the cause of failure of local anesthesia?].

Local anesthesia fails in 10% of cases of inferior alveolar nerve block and 7% of all cases of local anesthesia in general practice. Possible causes of failure are infection, wrong selection of local anesthetic solution, technical mistakes, anatomical variations with accessory innervation and anxiety of the patient. In this publication we discuss reasons for frequent failure in case of infection and in inferior alveolar nerve block. Understanding the mechanism of failure in local anesthesia, makes it possible to formulate guidelines to guarantee success. These measures are discussed in detail.

Anesthesia, Dental↗
PubMedDate not supplied

A clinical evaluation of the electric pulp tester as an indicator of local anesthesia.

Local anesthesia is the primary method in dentistry to control patients' pain. However, several studies have shown that profound anesthesia is not always achieved. The electric pulp tester has been used to measure the level of local dental anesthesia during endodontic therapy. However, no study has been performed that evaluates the ability of the electric pulp tester to predict the efficacy of local anesthesia prior to as operative procedure. If ineffective anesthesia could be predicted, supplemental injections could be administered to alleviate the anesthetic problem. The purpose of this study was to evaluate the ability of the electric pulp tester to measure the level of local anesthesia prior to operative treatment. The study was performed in vivo on patients requiring operative therapy. All teeth were pulp tested preoperatively for vitality using the electric pulp tester. After injection of local anesthetic, traditional parameters of dental anesthesia were verified (lip numbness, mucosal sticks). Teeth were then retested with the electric pulp tester and the results recorded. The teeth were them prepared for restoration using conventional instrumentation, and the patient's level of anesthesia evaluated using a visual analog scale. The electric pulp tester readings were compared to the patient's responses using Fisher's Exact test (two-tail). The results indicate that the electric pulp tester can be a valuable tool in predicting potential anesthetic problems in operative (restorative) dentistry.

Adolescent↗
PubMed1998

Microlaparoscopic tubal ligation under local anesthesia.

Local anesthesia to perform laparoscopic tubal ligation is of increased interest due to potential safety and cost benefits. We performed tubal ligation using microlaparoscopic techniques with local anesthesia and continuous intravenous sedation in 16 women desiring sterilization. Operating and recovery times and patient satisfaction were recorded and compared with values for 30 similar women undergoing microlaparoscopic tubal ligation under general anesthesia. Mean +/- SD operating and recovery times for local and general anesthesia were 29.3+/- 8.1 versus 33.6 +/- 11.1 minutes, and 83.9 +/- 59.4 versus 114.5 +/- 69.8 minutes, respectively. Patient satisfaction was high. The potential for cost savings when performed in an outpatient or clinic setting is significant.

Adult↗
PubMed1987

[Gynecological surgery under local anesthesia].

Local anesthesia allows interruptions of pregnancy until the 16th week; it also permits endo-uterine exploration, conization and treatment of synechiae. In terms of the breast, local anesthesia is indicated for the excision of palpable lesions, benign a priori, regardless of their size or location. The risk of overdose and vascular crossing is lower than with general anesthesia. It reduces hospital stay to a few hours but must be performed in a well-equipped operating suite in case of a possible complication.

Anesthesia, Local↗
PubMed1982

Penile prosthetic surgery under local anesthesia.

Local anesthesia is effective for implantation of the semirigid rod and the inflatable penile prostheses. Pudendal block, and intracorporeal and local infiltration provide excellent opportunities to perform this operation with rare need for general anesthesia supplementation. The technique is described in 141 cases.

Anesthesia, Local↗
PubMed1990

Towards less painful local anesthesia.

Local anesthesia, used for numerous procedures in all fields of medicine, has the drawback of providing significant pain upon injection. Twenty-eight volunteers were asked to compare a subcutaneous injection of plain lidocaine with an injection of lidocaine plus bicarbonate. Twenty-four of the twenty-eight volunteers reported less pain with the buffered lidocaine. The dilution of 1 part bicarbonate to 10 parts plain lidocaine produced a solution that was less painful and better tolerated. The local anesthetic lidocaine is used prior to many minor and major surgical procedures. Although it induces adequate anesthesia, the pain of injection is nearly always of considerable discomfort to the patient. There are numerous factors that have been shown to influence the pain of injection. These include speed of injection, size of needle used, area of the body injected, and simply individual patient characteristics. Since lidocaine comes as an acid solution, local tissue irritation is likely the primary source of pain.

Adult↗
PubMed1998

[Tumescence local anesthesia. Improvement of local anesthesia methods for surgical dermatology].

The tumescent technique of local anesthesia was developed by J. Klein ten years ago to facilitate liposuction surgery. Tumescent anesthesia not only became the standard technique for liposuction, but proved to be of great value for other surgical problems in dermatology. Meanwhile, several noncosmetic uses for tumescent anesthesia were pioneered by dermatologic surgeons. This first review of the tumescent technique in German literature will focus on its specific advantages and disadvantages when applied in different fields of dermatologic surgery. Our own experience will be discussed, as well as future developments.

Anesthesia, Local↗
PubMed2005

Transient partial ophthalmoplegia and Horner's syndrome after intraoral local anesthesia.

Local neurological symptoms and signs are infrequent after intraoral anesthesia for dental procedures, thus diagnosis may be challenging for a neurologist unfamiliar with this benign phenomenon. Unnecessary diagnostic procedures may be performed and can be associated with complications. We present a 19-year old woman with transient diplopia, miosis, partial enophthalmia and lacrimation on the side of injection after intraoral anesthesia with prilocaine.

Adult↗
PubMed2000

Operative times, postanesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation.

OBJECTIVE: The goal was to compare complication rates and recovery times in patients undergoing elective septoplasty or endoscopic sinus surgery using local anesthesia with sedation (LAS) versus general anesthesia (GA). METHODS AND PATIENTS: A retrospective chart review of a consecutive sample of 177 patients undergoing elective septoplasty or endoscopic sinus surgery between July 1, 1994, and June 30, 1996, was carried out at our university-based outpatient surgery unit. Outcome measures included total operative time, surgical time, recovery time, and perioperative complications. RESULTS: Total operative and recovery times were shorter in patients undergoing LAS. The frequency of emesis, epistaxis, and nausea were less in the LAS population than in the GA population. Three patients who underwent GA required unplanned admissions. CONCLUSION: This study suggests that in selected patients undergoing sinonasal surgery, LAS may result in shorter total operative times, shorter recovery times, and less frequent nausea, emesis, and epistaxis than GA.

Adolescent↗
PubMed1988

[Perioperative anxiety and postoperative pain suppression in intraocular operations using general anesthesia and local anesthesia].

UNLABELLED: Intraocular surgery is performed under local or general anesthesia. The indications for these procedures are often dependent on local circumstances. On the one hand, the optimal conditions for operations under general anesthesia, on the other, the negligible stress of local anesthesia, especially for the elderly, are emphasized. To clarify this question, perioperative anxiety behavior and postoperative pain were investigated in geriatric patients undergoing ophthalmic surgery. METHODS: Spielberger's state trait anxiety inventory (STAI) was performed in 31 patients operated on in general (age 71.0 +/- 6.6 SEM) and 31 operated on in local anesthesia (age 71.6 +/- 6.0 SEM) the day before and 4 h after operation. 10 patients in each group were also tested immediately before surgery in the operating room. Postoperative pain was estimated by the patient and postoperative sedation by the investigator using a 4-point scale for each over 8 h. RESULTS: The state (STAI 1) and trait (STAI 2) anxiety scores did not change in these geriatric patients. There were no significant differences between the groups. Postoperative pain was significantly (p less than 0.05) higher after 15 and 60 min after general anesthesia. There was no difference in the frequency of analgetic therapy in both groups, but most opioids were given in the first 90 min after general anesthesia. The patients were more frequently sedated (p less than 0.05) in the first 90 min after general anesthesia then after local anesthesia. DISCUSSION: The scores of state and trait anxiety behavior are comparable to a normal geriatric population, even if normal data cannot always be applied to clinical situations.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1996

[Practical aspects of local anesthesia. Infiltration anesthesia].

Local anaesthesia through infiltration is daily practiced in dentistry. Infiltration anaesthesia is effective in gums, mucosa and teeth, in the upper jaw and in the front part of the lower jaw. An amount of 0.3-0.5 ml of anaesthetics including vasoconstrictor is sufficient for 1-2 hours. The method is safe; only few contra-indications are known. Infiltration anaesthesia seldom leads to complications. Intravascular injection cannot entirely be excluded. Therefore slow injection and subsequent observation of the patient's reactions are required.

Anesthesia, Dental↗
PubMed2000

[The possible secondary effects in cases of local anesthesia].

Local anesthetics are the safest and most effective drugs for pain control. Over 300 million local anesthetic cartridges are administered by dentists in the United States of America annually, yet serious complications reported number but a handful. Complications are categorised as localised or systemic. Localised complications arise at the site of needle penetration or anesthetic administration while systemic complications involve the entire organism. Localised complications include needle breakage, paresthesia, trismus, haematoma and facial nerve paralysis, while systemic complications are psychogenic to the act of receiving an injection, allergy and drug overdose (toxic reaction). These potential complications are briefly described in the following paper.

Anesthesia, Dental↗
PubMedDate not supplied

The assessment of pain sensation during local anesthesia using a computerized local anesthesia (Wand) and a conventional syringe.

PURPOSE: The purpose of this study was to compare the behavior reaction of children who received local anesthesia with a conventional syringe injection and a computerized device (Wand). METHODS: One hundred and two children ages 3 to 10 years were selected for this study. In 1 group there were 55 children between the ages of 3 to 5 years old, and in the other group there were 47 children ages 6 to 10 years old. They all needed at least 2 clinical sessions of operative procedures, preceded by a local anesthetic injection, 1 on either side of the same jaw. The local anesthesia was delivered using either the Wand or the traditional syringe. A random crossover design was used so that each child served as his/her own control. RESULTS: There were 25 girls and 30 boys in group A (mean 4.1 +/- 0.6 years), and 26 boys and 21 girls in group B (mean 7.2 +/- 1.3 years). Most of the children had a good reaction to both techniques of local anesthesia. No significant difference in either group was found between boys and girls. The children's reactions to injection in the mandible or the maxilla with the Wand or the conventional technique, regarding crying, facial expression, hands, legs and torso movements were similar with no statistically significant difference. There was no statistical difference when the maxillary infiltration was delivered to 1 or multiple teeth. No significant difference was found when the Wand was delivered during the first or second visit. CONCLUSIONS: The results suggested there was no difference in the pain behavior of children during the administration of local anesthesia with a conventional injection or a computerized device when the operator was an experienced pediatric dentist. This was true for maxillary infiltration and mandibular block. For other techniques, such as palatal injection and periodontal ligament injection, more studies should be conducted.

Anesthesia, Dental↗