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Results for “Local anaesthesia”

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At least 19 recordsLinked to original sources

PubMed1979

Effect of different types of anaesthesia including percutaneous local anaesthesia on survival of experimental skin flaps.

Local anaesthesia by epicutaneous application of the ketocaine solution A2358 gave survival of experimental skin flaps in the guinea pig which corresponded on average to 71% of the total flap. The survival after pentobarbitone anaesthesia, general anaesthesia with ether, and infiltration of prilocaine without and with adrenalin varied between 41 and 53%. The difference in effect between percutaneous anaesthesia with A2358 and the other procedures was statistically significant (p less than 0.001). Epicutaneous application of A2358 followed by one of the other forms of anaesthesia gave a flap survival that did not differ from that following local anaesthesia with A2358 alone, except when followed by injection of prilocaine with adrenalin. The improved survival after epicutaneously applied A2358 is probably attributable to an effect on the peripheral vascular bed resulting in increasing blood supply and nutrition. It may be possible that A2358, for example, could be used in man as a complement to other forms of anaesthesia to provide enhanced tissue survival in skin flaps.

Anesthesia, General↗

PubMed1977

Necessity into choice. An appraisal of inguinal herniorrhaphy under local anaesthesia.

A policy of using local anaesthesia whenever possible for the repair of inguinal hernias was adopted in Seychelles primarily because a constant supply of anaesthetic gases could not be depended upon. The technique adopted is described and the results obtained over an 18-month period are reported. Experience has shown that local anaesthesia for this operation has many advantages and few disadvantages and is now preferred to general anaesthesia except when contraindicated by special circumstances.

Adolescent↗

PubMed1977

Electrocardiogram, arterial and central venous pressure during laparoscopy under local anaesthesia.

Cardiovascular hazards of laparoscopy performed under local anaesthesia and with room air pneumoperitoneum are not well known. Therefore we have recorded electrocardiogram, arterial blood pressure and central venous pressure in 63 consecutive liver patients undergoing this procedure. Electrocardiographic changes were found in 34 cases, and consisted in transistory tachycardia and bradycardia, ectopic supraventricular and ventricular beats, ST segment depression and flattening of T wave. Blood pressure did not change significantly, but five patients had transitory hypotension during the procedure. Central venous pressure did not vary immediately after inflation, but a significant increase was found during the performance of laparoscopy and it was still observed after deflation. Our findings show that cardiovascular changes during laparoscopy under local anaesthesia are minimal, and that they are probably due to neurogenic factors.

Adult↗

PubMed1976

[Local anaesthesia--modern outlook, faults and complications (author's transl)].

Development of general anaesthesia has reduced the amount of operations performed by local anaesthesia considerably. Inevitably this will cause than junior traines in large hospitals will be less informed and instructed in local anaesthesia than his demand will be after he has left the hospital. New results of mechanism of action of local anaesthesia are given and compared with other similar drugs. Tetracain is less efficient than the drugs of the amidtype as far as surface anaesthesia activity is concerned and Procain is surpassed by amidtype anaesthesia drugs for infiltration and conductive anaesthesia use.

Anesthesia, Local↗

PubMed1978

Comparison of diazepam and flunitrazepam for sedation during local anaesthesia for bronchoscopy.

Diazepam and flunitrazepam were compared as amnesic and sedative adjuncts to local anaesthesia for diagnostic bronchoscopy in 92 patients. After local anaesthesia of the pharynx, larynx and trachea with lignocaine, atropine plus diazepam of flunitrazepam was injected i.v. The co-operation of the patients and the technical circumstances under which the bronchoscopy was performed were good in each group. None of the treatments significantly modified arterial pressure or heart rate. Two hours after the injection, flunitrazepam 0.01 mg kg-1 more frequently caused amnesia for pictures shown to the patients during the first 15 min after injection (failure to recall 42--75%, and for bronchoscopy 67%), than did diazepam 0.125 mg kg-1 (failure to recall 21--67%; bronchoscopy 38%). Double doses of the drugs caused amnesic actions similar to those of flunitrazepam 0.01 mg kg-1. When failure to recall was assessed on the following day, 29% and 5% of the patients remembered bronchoscopy after flunitrazepam 0.01 and 0.02 mg kg-1 respectively; after diazepam 0.125 and 0.25 mg kg-1 the corresponding percentages was 59% and 30% (P less than 0.05% v. fluintrazepam). The ability to stand and walk on a stright line was similar after the smaller doses of both drugs, but after the larger doses recovery was slower after flunitrazepam. Psychomotor performance was still distinctly impaired 2 h after the injection of the larger doses.

Adult↗

PubMed1977

Studies on the duration of local anaesthesia: structure/activity relationships in a series of homologous local anaesthetics.

When the number of carbon atoms on the piperidine-nitrogen of the mepivacaine molecule was increased up to four or five carbons, the toxicity of the compounds and the duration of their local anaesthetic effects were increased. With longer N-alkyl-chains, the general toxicity and the local anaesthetic potency - but not the tissue toxicity - were reduced. In dental infiltration anaesthesia only the short-chain compounds offered an acceptable local anaesthesia. In these tests, the medium-chain compounds had a very unfavourable quotient between dental anaesthesia and soft tissue anaesthesia, while the long-chain compounds could not be tested at all in man because of their tissue irritating properties.

Adult↗

PubMed1978

Effect of age on amnesia and sedation induced by flunitrazepam during local anaesthesia for bronchoscopy.

Bronchoscopy was undertaken in 79 outpatients using local anaesthesia plus an i.v. injection of flunitrazepam 0.01 mg kg-1. The co-operation of the patients and the ease of bronchoscopy were good regardless of the age of the patient. There was an increase in amnesia for the bronchoscopy with increasing age, but the most distinct difference between different age groups was that the amnesic action of flunitrazepam was evident earlier and persisted longer in patients of more than 60 yr. Eye co-ordination and ability to stand steadily and walk on a line returned to normal more slowly in patients more than 60 than in those less than 60 yr, but no differences in recovery were noted between patients less than 40 and those of 40--59 yr, or between those 60--69 and those more than 70 yr.

Adult↗

PubMed1978

Studies on the duration of local anaesthesia: a possible mechanism for the prolonging effect of dextran on the duration of infiltration anaesthesia.

The mechanism of the prolonged effect of dextran on the duration of local anaesthesia has been studied. Using radio-active mepivacaine it was found that dextran prolonged the duration of infiltration anaesthesia in guinea-pigs by delaying the absorption of the local anaesthetic agent. Experiments in vitro indicate that molecular complexes between the local anaesthetic and dextran may be formed and it is assumed that the delayed absorption might be due to the formation of such molecular complexes. This hypothesis was strengthened by experiments in which dental infiltration anaesthesias were performed in healthy volunteers.

Adult↗

PubMed1979

Evaluation of dextran with local anaesthesia for short-stay inguinal herniorraphy.

A prospective randomised study of 40 patients undergoing unilateral inguinal herniorrhaphy under local anaesthesia was undertaken. Half the patients received the local anaesthetic (0.25% bupivacaine) mixed with dextran 40 solution. Subjective and objective assessments were made of the postoperative pain experienced in the first 48 h after operation. The use of 0.25% bupivacaine local inguinal block results in a postoperative pain-free period of approximately 10 h. Simple oral analgesics are adequate for postoperative pain relief in 87.5% of patients and are required relatively infrequently. The addition of dextran 40 to the local anaesthetic has no significant effect on its duration of action.

Adult↗

PubMed1976

Arterial and venous blood lidocaine concentrations after local anaesthesia of the respiratory tract using an ultrasonic nebulizer.

Arterial and venous blood lidocaine concentrations were intermittently measured in 15 bronchoscopy patients in whom local anaesthesia was induced by an inhalation technique. A DeVillbiss ultrasonic nebulizer model 3574 was used. The anaesthetic was 10 ml of 4% lidocaine without adrenaline. Blood concentrations were measured 5 min after commencement of inhalation, on completion of inhalation, and then after 10, 30 and 60 min. Statistically significantly higher concentrations were found in the arterial blood at the first two sampling times (P less than 0.01 and P less than 0.05, respectively). The highest average concentration in both arterial and venous blood eas reached 10 min after completion of anaesthesia. After 30 min, there was no difference between the arterial and venous samples; and after 60 min, the concentration was higher in venous blood. The highest individual concentration was 2.8 mug/ml in arterial blood and 2.1 mug/ml in venous blood, well below that reported to cause systemic toxic symptoms. Thus, the inhalation technique may be considered a safe means of inducing anaesthesia in the respiratory tract.

Adult↗

PubMed1979

Penetration enhancers and other factors governing percutaneous local anaesthesia with lidocaine.

The percutaneous penetration of the local anaestetic lidocaine was investigated in the guinea-pig. Three different types of composition were employed: lidocaine hydrochloride in aqueous solution, lidocaine base in an aqueous alcoholic solvent mixture and lidocaine base in aqueous solutions of dipolar aprotic solvents. The latter solvents included simple tertiary aliphatic amides, amides related to dimethylacetamide, some cyclic amides as well as a number of miscellaneous compounds. The degree of dermal anaesthesia was noted in each case. In addition, the uptake and distribution of lidocaine in the skin and its absorption into the blood were studied using tritium-labelled drug. The results show that the percutaneous penetration of lidocaine is dependent on the concentration of the agent, the time of epicutaneous application of the composition, whether the agent was used as salt or free base, and the nature of the solvent medium. Lidocaine base in aqueous dimethylacetamide was most effective in producing percutaneous local anaesthesia.

Amides↗

PubMed2026

Clinical effectiveness of transversus abdominis plane block versus local anaesthesia wound infiltration for postoperative pain relief after laparoscopic appendicectomy in children: A multicentre, double-blind, randomised, controlled phase III trial.

BACKGROUND: Postoperative pain relief after laparoscopic appendicectomy in children provided by transversus abdominis plane (TAP) block and local anaesthesia wound infiltration (LAWI) of trocar insertion sites has never been compared. OBJECTIVE: To investigate whether TAP block could decrease postoperative opioid requirements after laparoscopic appendicectomy in children compared with LAWI. DESIGN: Multicentre, double-blind, phase III randomised trial. SETTING: Two tertiary paediatric surgery centres. PATIENTS: Children aged 3 to 15 years admitted for laparoscopic appendicectomy. MAIN OUTCOME MEASURES: The primary outcome was the total dose of nalbuphine delivered within 24 h after surgery. Secondary outcomes were the Face Legs Activity Cry Consolability (FLACC) scale values at 1, 2, 6, 12 and 24 h, the time from levobupivacaine injection to the first dose of nalbuphine, and the time from the end of surgery to the first mobilisation. Patients received either ultrasound-guided TAP block (TAP group) or LAWI of trocar insertion sites (infiltration group) with 0.6 ml kg -1 of levobupivacaine 2.5 mg ml -1 , combined with standardised systemic multimodal analgesia including paracetamol, ketoprofen, phloroglucinol and nalbuphine. RESULTS: Forty-six and 50 patients were analysed in the TAP and infiltration groups, respectively [age: 10 [7 to 12] versus 10 [8 to 12] years; females: 16 (35%) versus 25 (50%); duration of surgery: 71 [64 to 90] versus 69 [56 to 89] min]. The primary outcome (total nalbuphine dose) was 0.2 [0.0 to 0.2] and 0.2 [0.0 to 0.2] mg kg -1 in the TAP and infiltration groups, respectively ( P  = 0.95). FLACC scale values did not significantly differ between the two groups ( P  = 0.78). Time to the first dose of nalbuphine or to first mobilisation was not significantly different between groups ( P value for log-rank test = 0.095 and 0.18, respectively). CONCLUSION: TAP block does not appear to provide a greater opioid-sparing effect than LAWI of trocar insertion sites after laparoscopic appendicectomy in children, when combined with systemic multimodal analgesia including nonsteroidal anti-inflammatory drugs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04969133.

Humans↗

PubMed1979

Comparison between general and local anaesthesia for repair of groin hernias.

A prospective study of 104 cases has been carried out to compare the use of local and general anaesthesia for the elective repair of groin hernias. There were no apparent disadvantages in using a local anaesthetic procedure. Patients having local anaesthetic herniorrhaphy required postoperative analgesics and antiemetics significantly less often and also returned home sooner (3.2 days) than patients having a general anaesthetic (4.1 days). These findings argue strongly in favour of local anaesthesia as a suitable alternative to general anaesthesia for repair of groin hernias.

Adult↗

PubMed1979

[Can local anaesthesia still be justified in intraocular surgery? (author's transl)].

Even modern long acting local anaesthetics can not avoid hazards encountered by using local anaesthetics. That these hazards are unavoidable by their nature is being shown by detailed analysis of facts conditioning the status of corpus vitreous on the open globe. These facts need not be identical with those that change the intraocular pressure in the closed eye. Intraocular pressure is no useful criterium when the eye is open. General anaesthesia in NLA and non depolarizing agents is presently the safest means not to leave corpus protruding facts to chance. There are no other disadvantages of the method as compared to local anaesthesia. Own experience in 2000 cataract operations confirm the thesis.

Anesthesia, General↗

PubMedDate not supplied