Home About us Contact
|
Home About us Contact | ||
|
|
||
Lidocaine
Kinds of Lidocaine Terms modified by Lidocaine Selected AbstractsSafety of Lidocaine 15% and Prilocaine 5% Topical Ointment Used as Local Anesthesia for Intense Pulsed Light TreatmentDERMATOLOGIC SURGERY, Issue 7 2010J. ALASTAIR CARRUTHERS MD BACKGROUND Literature cautions against applying lidocaine 15%/prilocaine 5% over an area larger than 300 cm2. The area of the face, neck, and chest is 400 cm2 or greater. OBJECTIVE To investigate the safety of lidocaine 15%/prilocaine 5% topical anesthetic ointment used as anesthesia for intense pulsed light (IPL) treatment. METHODS AND MATERIALS Lidocaine 15%/prilocaine 5% ointment was applied to the face only (n=10) for 30 ± 15 minutes or to the face, neck, and chest (n=10) for a total of 60 ± 15 minutes before IPL. Blood lidocaine and prilocaine levels were measured. Adverse events were recorded. RESULTS For the entire cohort, blood was drawn 25.6 ± 6.6 minutes after IPL was completed. In the face only group, the mean lidocaine level was 0.122 ± 0.125 ,g/mL, and the mean prilocaine level was 0.048 ± 0.029 ,g/mL. In the face, neck, and chest group, the mean lidocaine level was 0.272 ± 0.208 ,g/mL, and the mean prilocaine level was 0.087 ± 0.060 ,g/mL. No adverse events related to systemic toxicity were observed or reported to the nurse. At the 24-hour follow-up, no subject reported symptoms of systemic toxicity after leaving the clinic. CONCLUSION Under the conditions of this study, topical lidocaine 15%/prilocaine 5% produces low levels of systemic absorption. The authors have indicated no significant interest with commercial supporters. [source] Intravenous lidocaine for status epilepticus during childhoodDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2006Shin-ichiro Hamano MD; The clinical efficacy of lidocaine for convulsive status epilepticus in 53 convulsive episodes was examined in 37 children (17 males, 20 females). Mean age of patients receiving lidocaine was 3 years 7 months (SD 3y 5mo). Lidocaine administration achieved control of status epilepticus in 19 of 53 convulsive episodes (35.8%). Seizures ceased within 5 minutes of lidocaine administration in all 19 patients who were responsive to the drug. Regarding aetiology of status epilepticus and types of seizures, there was no statistical difference in effectiveness. Mild decrease of oxygen saturation, monitored by pulse oximetry, was observed in one patient, which improved by oxygenation using a mask. Lidocaine is a useful anticonvulsive agent; however, the response rate to lidocaine appears to be quite low, as less than half of the seizures were effectively controlled by lidocaine. Favourable properties of the drug include prompt responses, less alteration of consciousness, and fewer adverse effects, including less respiratory depression. [source] Using Capsaicin Modified Multiwalled Carbon Nanotube Based Electrodes and p -Chloranil Modified Carbon Paste Electrodes for the Determination of Amines: Application to Benzocaine and LidocaineELECTROANALYSIS, Issue 23 2008Roohollah Abstract The utilization of the capsaicin modified carbon nanotube modified basal-plane pyrolytic graphite electrode or p -chloranil modified carbon paste electrodes are presented for the determination of pharmaceutical compounds containing amine functionality, such as benzocaine and lidocaine. In detection of benzocaine at a capsaicin modified electrode, the guaiacol functional group is irreversibly electrochemically oxidized to form the o -quinone derivative which then undergoes nucleophilic attack by the aromatic amine group in benzocaine via a 1,4-Michael addition mechanism forming a catechol-amine adduct. The electrochemically initiated formation of the capsaicin-benzocaine adduct causes a linear decrease in the voltammetric signal corresponding to capsaicin which correlates to the added concentration of benzocaine. [source] Comparison of cardiovascular function and quality of recovery in isoflurane-anaesthetised horses administered a constant rate infusion of lidocaine or lidocaine and medetomidine during elective surgeryEQUINE VETERINARY JOURNAL, Issue 3 2010A. VALVERDE Summary Reasons for performing study: The effects of lidocaine combined with medetomidine or lidocaine alone on cardiovascular function during anaesthesia and their effects on recovery have not been thoroughly investigated in isoflurane-anaesthetised horses. Objectives: To determine the effects of an intraoperative i.v. constant rate infusion of lidocaine combined with medetomidine (Group 1) or lidocaine (Group 2) alone on cardiovascular function and on the quality of recovery in 12 isoflurane-anaesthetised horses undergoing arthroscopy. Hypothesis: The combination would depress cardiovascular function but improve the quality of recovery when compared to lidocaine alone in isoflurane-anaesthetised horses. Methods: Lidocaine (2 mg/kg bwt i.v. bolus followed by 50 µg/kg bwt/min i.v.) or lidocaine (same dose) and medetomidine (5 µg/kg bwt/h i.v.) was started 30 min after induction of anaesthesia. Lidocaine administration was discontinued 30 min before the end of surgery in both groups, whereas medetomidine administration was continued until the end of surgery. Cardiovascular function and quality of recovery were assessed. Results: Horses in Group 1 had longer recoveries, which were of better quality due to better strength and overall attitude during the recovery phase than those in Group 2. Arterial blood pressure was significantly higher in Group 1 than in Group 2 and this effect was associated with medetomidine. No significant differences in cardiac output, arterial blood gases, electrolytes and acid-base status were detected between the 2 groups. Conclusions and potential relevance: The combination of an intraoperative constant rate infusion of lidocaine and medetomidine did not adversely affect cardiovascular function in isoflurane-anaesthetised horses and improved the quality of recovery when compared to an intraoperative infusion of lidocaine alone. [source] In vitro effects of lidocaine on the contractility of equine jejunal smooth muscle challenged by ischaemia-reperfusion injuryEQUINE VETERINARY JOURNAL, Issue 1 2010M. GUSCHLBAUER Summary Reasons for performing study: Post operative ileus (POI) in horses is a severe complication after colic surgery. A commonly used prokinetic drug is lidocaine, which has been shown to have stimulatory effects on intestinal motility. The cellular mechanisms through which lidocaine affects smooth muscle activity are not yet known. Objectives: To examine the effects of lidocaine on smooth muscle in vitro and identify mechanisms by which it may affect the contractility of intestinal smooth muscle. Hypothesis: Ischaemia and reperfusion associated with intestinal strangulation can cause smooth muscle injury. Consequently, muscle cell functionality and contractile performance is decreased. Lidocaine can improve basic cell functions and thereby muscle cell contractility especially in ischaemia-reperfusion-challenged smooth muscle. Methods: To examine the effects of lidocaine on smooth muscle function directly, isometric force performance was measured in vitro in noninjured and in vivo ischaemia-reperfusion injured smooth muscle tissues. Dose-dependent response of lidocaine was measured in both samples. To assess membrane permeability as a marker of basic cell function, release of creatine kinase (CK) was measured by in vitro incubations. Results: Lidocaine-stimulated contractility of ischaemia-reperfusion injured smooth muscle was more pronounced than that of noninjured smooth muscle. A 3-phasic dose-dependency was observed with an initial recovery of contractility especially in ischaemia-reperfusion injured smooth muscle followed by a plateau phase where contractility was maintained over a broad concentration range. CK release was decreased by lidocaine. Conclusion: Lidocaine may improve smooth muscle contractility and basic cell function by cellular repair mechanisms which are still unknown. Improving contractility of smooth muscle after ischaemia-reperfusion injury is essential in recovery of propulsive intestinal motility. Potential relevance: Characterisation of the cellular mechanisms of effects of lidocaine, especially on ischaemia-reperfusion injured smooth muscle, may lead to improved treatment strategies for horses with POI. [source] The Efficacy of Esmolol versus Lidocaine to Attenuate the Hemodynamic Response to Intubation in Isolated Head Trauma PatientsACADEMIC EMERGENCY MEDICINE, Issue 1 2001M. Andrew Levitt DO Abstract. Objective: To assess the effect of esmolol vs lidocaine to attenuate the detrimental rise in heart rate and blood pressure during intubation of patients with isolated head trauma. Methods: This was a prospective, double-blind, randomized study, performed at an urban, county teaching emergency department. Participants were 30 patients with isolated head trauma. Each underwent a standardized intubation protocol including esmolol or lidocaine, both at 2 mg/kg. Results: Esmolol was used in 16 patients and lidocaine in 14. Mechanisms of injury included 12 assaults, 6 motor vehicle collisions, 6 falls, 4 auto-vs-pedestrian crashes, and 2 bicycle incidents. Mean ethanol level was 0.116 ± 0.133 SD (range 0-0.482). Mean Glasgow Coma Scale (GCS) score was 7.9 ± 4.0 SD. Cranial computed tomography (CT) hemorrhagic findings included 9 subdural/epidural hematomas, 6 cortex hemorrhages, and 2 multi-hemorrhages. Eleven patients received surgical intervention: 9 patients received a craniotomy, and 2 a ventricular catheter. The 2-minute time interval around intubation was used to assess each drug's efficacy. The mean difference change between groups for heart rate was 4.0 beats/min (95% CI = -17.7 to 9.7 beats/min), for systolic blood pressure was 1.3 mm Hg (95% CI = -27.8 to 30.4 mm Hg), and for diastolic blood pressure was 2.6 mm Hg (95% CI = -27.1 to 21.9 mm Hg). The power of this study was 90% to detect a 20-beat/min difference in heart rate, a 35-mm Hg difference in systolic blood pressure, and a 20-mm Hg difference in diastolic blood pressure. Conclusions: Esmolol and lidocaine have similar efficacies to attenuate moderate hemodynamic response to intubation of patients with isolated head trauma. [source] Lidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010I. M. SAADAWY Background: This double-blinded study aimed at evaluating and comparing the effects of magnesium and lidocaine on pain, analgesic requirements, bowel function, and quality of sleep in patients undergoing a laparoscopic cholecystectomy (LC). Methods: Patients were randomized into three groups (n=40 each). Group M received magnesium sulfate 50 mg/kg intravenously (i.v.), followed by 25 mg/kg/h i.v., group L received lidocaine 2 mg/kg i.v., followed by 2 mg/kg/h i.v., and group P received saline i.v. Bolus doses were given over 15 min before induction of anesthesia, followed by an i.v. infusion through the end of surgery. Intraoperative fentanyl consumption and averaged end-tidal sevoflurane concentration were recorded. Abdominal and shoulder pain were evaluated up to 24 h using a visual analog scale (VAS). Morphine consumption was recorded at 2 and 24 h, together with quality of sleep and time of first flatus. Results: Lidocaine or magnesium reduced anesthetic requirements (P<0.01), pain scores (P<0.05), and morphine consumption (P<0.001) relative to the control group. Lidocaine resulted in lower morphine consumption at 2 h [4.9 ± 2.3 vs. 6.8 ± 2.8 (P<0.05)] and lower abdominal VAS scores compared with magnesium (1.8 ± 0.8 vs. 3.2 ± 0.9, 2.2 ± 1 vs. 3.6 ± 1.6, and 2.1 ± 1.4 vs. 3.3 ± 1.9) at 2, 6, and 12 h, respectively (P<0.05). Lidocaine was associated with earlier return of bowel function and magnesium was associated with better sleep quality (P<0.05). Conclusion: I.v. lidocaine and magnesium improved post-operative analgesia and reduced intraoperative and post-operative opioid requirements in patients undergoing LC. The improvement of quality of recovery might facilitate rapid hospital discharge. [source] Infiltration anesthetic lidocaine inhibits cancer cell invasion by modulating ectodomain shedding of heparin-binding epidermal growth factor-like growth factor (HB-EGF)JOURNAL OF CELLULAR PHYSIOLOGY, Issue 3 2002Tadanori Mammoto Although the mechanism is unknown, infiltration anesthetics are believed to have membrane-stabilizing action. We report here that such a most commonly used anesthetic, lidocaine, effectively inhibited the invasive ability of human cancer (HT1080, HOS, and RPMI-7951) cells at concentrations used in surgical operations (5,20 mM). Ectodomain shedding of heparin-binding epidermal growth factor-like growth factor (HB-EGF) from the cell surface plays an important role in invasion by HT1080 cells. Lidocaine reduced the invasion ability of these cells by partly inhibiting the shedding of HB-EGF from the cell surface and modulation of intracellular Ca2+ concentration contributed to this action. The anesthetic action of lidocaine (sodium channel blocking ability) did not contribute to this anti-invasive action. In addition, lidocaine (5,30 mM), infiltrated around the inoculation site, inhibited pulmonary metastases of murine osteosarcoma (LM 8) cells in vivo. These data point to previously unrecognized beneficial actions of lidocaine and suggest that lidocaine might be an ideal infiltration anesthetic for surgical cancer operations. © 2002 Wiley-Liss, Inc. [source] Use of intravenous lidocaine to prevent reperfusion injury and subsequent multiple organ dysfunction syndromeJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2003Benjamin H. Cassutto DVM Abstract Objective: The objective of this article is to review the human and veterinary literature and provide evidence for the potential beneficial effects of intravenous (IV) lidocaine hydrochloride in preventing post-ischemic,reperfusion injury, the systemic inflammatory response syndrome (SIRS), and subsequent multiple organ dysfunction syndrome (MODS). Human data synthesis: Lidocaine is a local anesthetic and antiarrhythmic agent that has been used for years in human and veterinary medicine for the treatment of ventricular dysrhythmias associated with blunt cardiac trauma, myocardial ischemia, and cardiac surgery. More recently, the drug has been touted as a scavenger of reactive oxygen species (ROS), and has been used to prevent reperfusion dysrhythmias after treatment of myocardial infarction, cross-clamping of the aorta, and in trauma medicine. Veterinary data synthesis: Although no clinical experiments with prophylactic intravenous lidocaine exist in veterinary medicine, there is a large body of evidence from experimental animals that support the use of lidocaine as a Na+/Ca2+ channel blocker, superoxide and hydroxyl radical scavenger, inflammatory modulator, and potent inhibitor of granulocyte functions. Lidocaine is being used in some clinical situations in an attempt to prevent the SIRS in veterinary trauma patients.a,b Conclusions: A large body of experimental evidence exists supporting the use of lidocaine as an anti-oxidant and inflammatory modulator useful in preventing reperfusion injury. With the lack of cost-effective and safe treatments for reperfusion injury in veterinary and human trauma medicine, the use of IV lidocaine to prevent the ensuing inflammatory response and MODS makes it an attractive addition to existing treatments. Therefore, it is essential that prospective clinical trials involving lidocaine as a treatment for prevention of reperfusion injury be performed in companion animals to demonstrate its safety and efficacy. [source] Effects of Lidocaine Infusion during Experimental Endotoxemia in HorsesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2010J.R. Peiró Background: The clinical efficacy of IV infusion of lidocaine for treatment of equine endotoxemia has not been studied. Hypothesis: Lidocaine infusion after exposure to lipopolysaccharide (LPS) will inhibit the inflammatory response and have inhibitory effects on the hemodynamic and cytokine responses to endotoxemia. Animals: Twelve horses. Methods: Two equal groups (n = 6): saline (GI) and lidocaine (GII). In all animals, endotoxin (500 ng/kg body weight [BW]) was injected intraperitoneally over 5 minutes. Twenty minutes later, animals received a bolus of GI or GII (1.3 mg/kg BW) over 5 minutes, followed by a 6-hour continuous rate infusion of GI or GII (0.05 mg/kg BW/min). Treatment efficacy was judged from change in arterial blood pressure, peripheral blood and peritoneal fluid (PF) variables (total and differential cell counts, enzyme activities, and cytokine concentrations), and clinical scores (CS) for behavioral evidence of abdominal pain or discomfort during the study. Results: Compared with the control group, horses treated with lidocaine had significantly lower CS and serum and PF tumor necrosis factor-, (TNF-,) activity. At several time points in both groups, total and differential cell counts, glucose, total protein and fibrinogen concentrations, and alkaline phosphatase, creatine kinase, and TNF-, activities were significantly different from baseline values both in peripheral blood and in PF. Conclusions and Clinical Importance: Lidocaine significantly decreased severity of CS and inhibited TNF-, activity in PF. [source] Quantitative tests of liver function measure hepatic improvement after sustained virological response: results from the HALT-C trialALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009G. T. EVERSON Summary Backgroud, The impact of virologic response on hepatic function has not been previously defined. Aim, To determine the relationships of quantitative liver function tests (QLFTs) with virological responses to peginterferon (PEG) ± ribavirin (RBV) in patients with chronic hepatitis C and to use serial QLFTs to define the spectrum of hepatic improvement after sustained virological response (SVR). Methods, Participants (n = 232) were enrolled in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial, had failed prior therapy, had bridging fibrosis or cirrhosis and were retreated with PEG/RBV. All 232 patients had baseline QLFTs; 24 patients with SVR and 68 nonresponders had serial QLFTs. Lidocaine, [24- 13C]cholate, galactose and 99mTc-sulfur colloid were administered intravenously; [2,2,4,2- 2H]cholate, [1- 13C]methionine, caffeine and antipyrine were administered orally. Clearances (Cl), breath 13CO2, monoethylglycylxylidide (MEGX), perfused hepatic mass (PHM) and liver volume were measured. Results, Rates of SVR were 18,26% in patients with good function by QLFTs, but ,6% in patients with poor function. Hepatic metabolism, measured by caffeine kelim (P = 0.02), antipyrine kelim (P = 0.05) and antipyrine Cl (P = 0.02) and the portal circulation, measured by cholate Cloral (P = 0.0002) and cholate shunt (P = 0.0003) and PHM (P = 0.03) improved after SVR. Conclusion, Hepatic dysfunction impairs the virological response to PEG/RBV. SVR improves hepatic metabolism, the portal circulation and PHM. [source] The analgesic effect of intravenous ketamine and lidocaine on pain after spinal cord injuryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2004A. Kvarnström Background:, Pain following spinal cord injury (SCI) is a therapeutic challenge. Only a few treatments have been assessed in randomized, controlled trials. The primary objective of the present study was to examine the analgesic effect of ketamine and lidocaine in a group of patients with neuropathic pain below the level of spinal cord injury. We also wanted to assess sensory abnormalities to see if this could help us to identify responders and if treatments resulted in changes of sensibility. Methods:, Ten patients with spinal cord injury and neuropathic pain below the level of injury were included. The analgesic effect of ketamine 0.4 mg kg,1 and lidocaine 2.5 mg kg,1 was investigated. Saline was used as placebo. The drugs were infused over 40 min. A randomized, double-blind, three-period, three-treatment, cross-over design was used. Systemic plasma concentrations of ketamine and lidocaine were assessed. Pain rating was performed using a visual analogue scale (VAS). Sensory function was assessed with a combination of traditional sensory tests and quantitative measurement of temperature thresholds. Results:, Response to treatment, defined as 50% reduction in VAS-score during infusion, was recorded in 5/10 in the ketamine, 1/10 in the lidocaine and 0/10 in the placebo groups. Neither ketamine nor lidocaine changed temperature thresholds or assessments of mechanical; dynamic and static sensibility. Nor could these sensory assessments predict response to treatment in this setting. Lidocaine and particularly ketamine were associated with frequent side-effects. Conclusion:, Ketamine but not lidocaine showed a significant analgesic effect in patients with neuropathic pain after spinal cord injury. The pain relief was not associated with altered temperature thresholds or other changes of sensory function. [source] Lidocaine for airway topicalisationANAESTHESIA, Issue 3 2008B. McGuire No abstract is available for this article. [source] A Randomized, Double-blind Controlled Study of Jet Lidocaine Compared to Jet Placebo for Pain Relief in Children Undergoing Needle Insertion in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 5 2009Marc Auerbach MD Abstract Objectives:, The objectives were to determine whether pretreatment with needleless jet-delivered lidocaine decreases self-reported pain in children undergoing needle insertion in the emergency department (ED) and to explore whether pretreatment with a jet device decreases self-reported pain in children undergoing needle insertion in the ED. Methods:, This study examined needle insertion pain in children 5,18 years of age. In the first phase of this study, children received either pretreatment with jet-delivered lidocaine (0.2 mL of buffered 1% lidocaine; n = 75) or pretreatment with jet-delivered placebo (0.2 mL of preservative-free normal saline; n = 75) 60 seconds before undergoing needle insertion. This phase of the study had a randomized, double-blind, placebo-controlled design. In the second phase, an unblinded, nonconcurrent, nonintervention control group (n = 47) was examined to describe any effect of using the jet device. Patients reported pain upon administration of the jet device and at needle insertion using a 100-mm color analog scale (CAS). Patients also reported their satisfaction with this device. The physicians and nurses performing needle insertions were asked to rate their ability to visualize the vein and their satisfaction with the device. Results:, The mean (±standard deviation [SD]) needle insertion pain score for jet lidocaine, 28 (±7) mm, was similar to the mean needle insertion pain score for jet placebo, 34 (±7) mm. The mean needle insertion pain score for both the jet lidocaine and the jet placebo groups were lower than the needle insertion pain scores for the no device group, 52 (±8) mm. The majority of patients receiving the jet device reported that they would request this device for future needle insertions. Providers' ratings of their ability to visualize veins and the patient cooperation were similar in all three groups. Conclusions:, Jet-delivered lidocaine is no more effective than jet-delivered placebo in providing local anesthesia for needle insertion. Jet lidocaine and jet placebo may provide superior analgesia compared to no local anesthetic pretreatment. [source] Intraarticular Lidocaine versus Intravenous Procedural Sedation with Narcotics and Benzodiazepines for Reduction of the Dislocated Shoulder: A Systematic ReviewACADEMIC EMERGENCY MEDICINE, Issue 8 2008Robert Warne Fitch MD Abstract Background:, Anterior shoulder dislocations commonly present to the emergency department (ED). The time associated with procedural sedation for the reduction of anterior shoulder dislocations can be lengthy and may require use of additional personnel. Complications associated with intravenous (IV) medications for procedural sedation are well documented. Objectives:, The aim was to determine if intraarticular lidocaine (IAL) injection is as effective as IV procedural sedation with narcotics and benzodiazepines for reduction of anterior shoulder dislocations. Methods:, This was a systematic review of randomized controlled trials (RCTs). The authors performed a PubMed, EMBASE, and Cochrane database search using key words: "shoulder dislocation" and "reduction" and retrieved every RCT published that compared the use of IV sedation to IAL as medication for reduction. Each manuscript was reviewed and the results of each was compared regarding medications used, success of reduction, complications, pain perceived, ease of reduction, and time spent in the ED. Results:, Six Level 1 RCTs were identified. No studies showed a statistically significant difference in success rate between IAL versus IV sedation. The complication rate was significantly higher in the IV sedation groups (p < 0.001), and the total time spent in the ED was longer for the IV sedation group. Conclusions:, The use of IAL for reduction of anterior shoulder dislocations should be strongly considered as a first line therapy because it is effective and safe and may potentially reduce time spent in the ED. [source] RSD931, a novel anti-tussive agent acting on airway sensory nervesBRITISH JOURNAL OF PHARMACOLOGY, Issue 3 2003J J Adcock The anti-tussive effects, of the local anaesthetic, lidocaine and carcainium chloride (RSD931) have been investigated in guinea-pigs and rabbits. Pre-treatment of guinea-pigs with aerosols of lidocaine or RSD931 at 0.1, 1.0 and 10 mg ml,1 reduced the number of citric acid-induced coughs by 9.3, 32.6 and 40.9% (P>0.05) for lidocaine and by 25.3% (P>0.05), 40.4% (P>0.05) and 97.6% (P<0.01) for RSD931, respectively and increased the latency to onset of cough at 10.0 mg ml,1 only. In addition, RSD931 at 10 mg ml,1 reduced citric acid-evoked cough responses in rabbits (with prior exposure to ozone at 3 p.p.m. for 1 h) from 22.1±5.1 to 2.7±0.9 coughs (P<0.01). Acute pre-treatment of guinea-pigs with aerosols of lidocaine or RSD931 at 10.0 and 30.0 mg ml,1 reduced the number of capsaicin-evoked coughs by 42.2 and 10.3% (P>0.05) (lidocaine) and by 25% (P>0.05) and 76.9% (P<0.01) (RSD931), respectively. Lidocaine had little effect on the latency of cough onset at either 10.0 or 30.0 mg ml,1, however, RSD at 30.0 mg ml,1 significantly (P<0.05) prolonged the latency of cough onset. RSD931 (10.0 mg ml,1) significantly (P<0.05,<0.01) reduced the spontaneous and histamine-evoked discharges in A,-fibres originating from airway, rapidly adapting stretch receptors (RARs) without affecting histamine-evoked bronchoconstriction. Lidocaine at 10.0 mg ml,1 also significantly (P<0.05) inhibited the spontaneous and histamine-induced discharges of RARs without affecting histamine-evoked bronchoconstriction. Aerosols of RSD931 (10.0 mg ml,1) caused a transient, but significant (P<0.05), activation of pulmonary C-fibre endings 2.5 min after administration started. RSD931 had no significant (P>0.05) effects on discharges in bronchial C-fibres originating from bronchial C-fibre endings, capsaicin-evoked discharges of either pulmonary or bronchial C-fibre endings or on capsaicin-evoked bronchoconstriction. In contrast, lidocaine (10.0 mg ml,1) significantly (P<0.05) inhibited spontaneous and capsaicin-induced discharges in both pulmonary and bronchial C-fibres respectively. Lidocaine also significantly (P<0.05) reduced capsaicin-evoked bronchoconstriction. These studies suggest that the anti-tussive actions of RSD931 are mediated via inhibition of discharges in A,-fibres originating from airway RARs. The mechanism of action of RSD931 is distinct from that of the local anaesthetic lidocaine and RSD931 may represent a novel class of anti-tussive agent. British Journal of Pharmacology (2003) 138, 407,416. doi:10.1038/sj.bjp.0705056 [source] Contact urticaria from Emla® creamCONTACT DERMATITIS, Issue 5-6 2004J. Waton We report the first case of immediate-type hypersensitivity caused by Emla® cream. A 55-year-old woman, after using Emla® cream, went on to develop urticaria. An open test was positive to Emla® cream. Patch tests and prick tests were performed with Emla® cream, the components of Emla® cream (lidocaine, prilocaine and castor oil) and other local anaesthetics. The patch test with lidocaine and the prick test with Emla® cream were both positive. An intradermal test and subcutaneous administration of 3 anaesthetics that had negative patch tests and prick tests were performed and well tolerated, allowing their use. In the literature, anaphylactic reactions to lidocaine injections, delayed-type hypersensitivity after lidocaine subcutaneous injections and contact dermatitis from Emla® cream have all been described. This first case of contact urticaria from Emla® cream was due to lidocaine and did not show any cross-reaction with other local anaesthetics. [source] Digital Block With and Without Epinephrine During Chemical Matricectomy with PhenolDERMATOLOGIC SURGERY, Issue 10 2010H. CEVDET ALTINYAZAR MD BACKGROUND Digital block with epinephrine is safe in selected patients. Chemical matricectomy with phenol is a successful, cheap, and easy method for the treatment of ingrown nails. OBJECTIVE To determine the effect of digital block with epinephrine in chemical matricectomy with phenol. MATERIAL AND METHODS Forty-four patients with ingrown toenail were randomly divided into two groups. The plain lidocaine group (n=22) underwent digital anesthesia using 2% plain lidocaine, and the lidocaine with epinephrine group (n=22) underwent digital anesthesia with 2% lidocaine with 1:100,000 epinephrine. In the postoperative period, the patients were evaluated for pain, drainage, and peripheral tissue destruction and were followed for up to 18 months for recurrence. RESULTS The mean anesthetic volume used in the epinephrine group (2.2±0.4 mL) was significantly lower than the plain lidocaine group (3.1±0.6 mL). There was no statistically significant difference in postoperative pain and recurrence rates, but duration of drainage was significantly shorter in the epinephrine group (11.1±2.5 days) than in the plain lidocaine group (19.0±3.8 days). CONCLUSION Digital block with epinephrine is safe in selected patients, and epinephrine helps to shorten the postoperative drainage period. The authors have indicated no significant interest with commercial supporters. [source] Safety of Lidocaine 15% and Prilocaine 5% Topical Ointment Used as Local Anesthesia for Intense Pulsed Light TreatmentDERMATOLOGIC SURGERY, Issue 7 2010J. ALASTAIR CARRUTHERS MD BACKGROUND Literature cautions against applying lidocaine 15%/prilocaine 5% over an area larger than 300 cm2. The area of the face, neck, and chest is 400 cm2 or greater. OBJECTIVE To investigate the safety of lidocaine 15%/prilocaine 5% topical anesthetic ointment used as anesthesia for intense pulsed light (IPL) treatment. METHODS AND MATERIALS Lidocaine 15%/prilocaine 5% ointment was applied to the face only (n=10) for 30 ± 15 minutes or to the face, neck, and chest (n=10) for a total of 60 ± 15 minutes before IPL. Blood lidocaine and prilocaine levels were measured. Adverse events were recorded. RESULTS For the entire cohort, blood was drawn 25.6 ± 6.6 minutes after IPL was completed. In the face only group, the mean lidocaine level was 0.122 ± 0.125 ,g/mL, and the mean prilocaine level was 0.048 ± 0.029 ,g/mL. In the face, neck, and chest group, the mean lidocaine level was 0.272 ± 0.208 ,g/mL, and the mean prilocaine level was 0.087 ± 0.060 ,g/mL. No adverse events related to systemic toxicity were observed or reported to the nurse. At the 24-hour follow-up, no subject reported symptoms of systemic toxicity after leaving the clinic. CONCLUSION Under the conditions of this study, topical lidocaine 15%/prilocaine 5% produces low levels of systemic absorption. The authors have indicated no significant interest with commercial supporters. [source] In Vitro Resistance to Degradation of Hyaluronic Acid Dermal Fillers by Ovine Testicular HyaluronidaseDERMATOLOGIC SURGERY, Issue 2010DEREK JONES MD BACKGROUND Although adverse events are uncommon with hyaluronic acid (HA) fillers, the use of hyaluronidase permits the reversal of treatment complications or overcorrection. OBJECTIVE This study sought to determine an in vitro dose-response relationship between ovine testicular hyaluronidase (OTH) and three HA dermal fillers (24-mg/mL smooth gel, 20-mg/mL particulate gel, and 5.5-mg/mL particulate gel with 0.3% lidocaine). METHODS AND MATERIALS The dose response of each was measured after incubation for 30 minutes in concentrations ranging between 5 and 40 U of OTH. Timed responses for the 24-mg/mL and 20-mg/mL HA fillers were obtained after incubation with 20 U of OTH for 15 to 120 minutes. RESULTS After all dose responses and timed-interval tests, the 24-mg/mL HA smooth gel filler exhibited more resistance against in vitro enzymatic degradation to OTH than the 20- and 5.5-mg/mL HA particulate gels. CONCLUSION This resistance to degradation in vitro may be attributed to the higher HA content of the 24-mg/mL HA smooth gel, the degree of crosslinking, and the cohesive property of the gel filler. This study was funded by a grant from Allergan, Inc., Santa Barbara, CA. Derek Jones, MD, is a consultant, investigator, advisory board member, and speaker for Allergan, Inc. He received no compensation for this study. Drs. Tezel and Borrell are employed by Allergan, Inc., Santa Barbara, CA. Editorial assistance was provided by Health Learning Systems, a part of CommonHealth, Parsippany, NJ. [source] Viability of Preadipocytes In Vitro: The Influence of Local Anesthetics and pHDERMATOLOGIC SURGERY, Issue 8 2009MAIKE KECK MD BACKGROUND Autogenous fat transfer with lipoinjection for soft tissue augmentation is a commonly used surgical technique. Abundant donor tissue availability and relative ease of harvesting have made autologous fat an attractive soft tissue filler. The overall reliability of this technique is often disputed, and different authors describe different results after autologous fat transplantation despite using similar techniques. In this study, we examined the influence of different local anesthetics commonly used in fat harvest and the pH of the anesthetic solution on the viability of harvested preadipocytes. METHODS AND MATERIALS Preadipocytes were incubated with 1% lidocaine, 1% articaine plus epinephrine 1:200,000, 0.75% ropivacaine, and 1% prilocaine or our standardized tumescent solution (1 L of 0.9% sodium chloride solution plus 25 mL of 1% articaine plus epinephrine 1:200,000 plus 25 mL of bicarbonate) for 30 minutes. Additionally, we incubated cells with the local anesthetics as described above but diluted 1:2 with phosphate buffered saline (pH 7.4). Viability was measured using trypan blue dying as well as propidium iodine staining and fluorescence-activated cell sorting analysis. RESULTS There are significant differences in the viability of preadipocytes under the influence of various local anesthetics. DISCUSSION Our data could partially explain the varying results after autogenous fat transfer. [source] Complications of Minor Skin Surgery Performed under Local AnesthesiaDERMATOLOGIC SURGERY, Issue 8 2008AVSHALOM SHALOM MD BACKGROUND Minor surgical procedures performed under local anesthesia are the most common surgical procedures routinely carried out in every plastic surgical practice. OBJECTIVE The objective was to evaluate the prevalence of immediate local and systemic complications of such procedures. METHODS AND MATERIALS Records of 2,600 procedures performed under local anesthesia on 2,431 patients between November 2001 and May 2004 were reviewed. Local anesthetic complications and all surgical-related complications were recorded. RESULTS Procedure-related complications were 51 presyncope (1.9%), 4 true syncope (0.16%), 2 minor burns (0.08%), and 1 facial laceration (0.04%). CONCLUSIONS True allergic reaction to lidocaine is extremely rare and none was noted in our study. Most patients who claimed that they had suffered from such a reaction were probably experiencing symptoms related to intravenous injection administration, a reaction to the added vasoconstrictor (adrenaline), or a vasovagal reaction, which is a common trait among young adults. [source] A Percutaneous Approach to Eyebrow Lift: The Salvadorean OptionDERMATOLOGIC SURGERY, Issue 8 2003Enrique Hernandez-Perez MD Background Surgical eyebrow lift can result in a number of complications. A nonsurgical simple method of lifting the brow is presented. Objective To raise the eyebrows using a simple, quick, and noninvasive approach. Methods Twenty-nine patients, 27 women and 2 men, whose ages varied from 24 to 56 years (mean of 32 years) were included in the study. Preoperative and postoperative photographs were taken. In two patients, brow suspension was performed at the time of blepharoplasty. Informed consent was signed by all of the patients. For measuring the degree of satisfaction of the patients, we gave to them a sheet grading it from one to three (with one being the least satisfactory). Local anesthesia (1% lidocaine, 1:400,000 epinephrine), a conveniently sized Keith needle, and prolene 3/0 sutures were used. Results Satisfying results were obtained in all cases. The only problem encountered in two patients was temporary edema, and it settled in a few days. Conclusion This is a very simple, quick, and noncomplicated method of raising the eyebrows. It can be repeated, revised easily, or combined with other modalities, such as peels, topical tretinoin, oral isotretinoin, fat injection, Goretex, and Botox as part of a facial rejuvenation program. [source] Lidocaine Iontophoresis for Local Anesthesia Before Shave BiopsyDERMATOLOGIC SURGERY, Issue 6 2003William T. Zempsky MD Background. Lidocaine iontophoresis is a method of topical anesthesia in which lidocaine is driven into the skin under the influence of electric current. Objective. To compare lidocaine iontophoresis to placebo for topical anesthesia before shave biopsy in adult patients. Methods. This was a single-center, double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine in patients undergoing shave biopsy. Patients were evaluated for sensation to pinprick after iontophoresis. After completion of the procedure, those patients who did not receive supplemental lidocaine rated the pain associated with the procedure using a 10-cm visual analog scale. The investigator also evaluated the patient's pain after biopsy. Treatment sites were examined for evidence of adverse events such as erythema, urticaria, or burns. Results. Forty-one patients undergoing shave biopsy for evaluation of skin lesions were enrolled. Nineteen of 21 patients in the lidocaine group versus 2 of 20 placebo patients required no supplemental anesthesia (P<0.001). The pain reported by the patient on the visual analog scale subsequent to the procedure was significantly lower in the lidocaine group (P<0.001). In concordance with the results reported by the patients, investigators rated pain lower in the lidocaine group (P<0.001). Blanching and/or erythema occurring at the iontophoresis-treated site in 37 of 41 patients resolved within 1 hour. There were no other treatment-related events. Conclusions. Lidocaine iontophoresis is a safe and effective method of administering topical anesthesia before shave biopsy in adult patients. [source] Digital versus Local Anesthesia for Finger Lacerations: A Randomized Controlled TrialACADEMIC EMERGENCY MEDICINE, Issue 10 2006Stuart Chale MD Abstract Objectives To compare the pain of needle insertion, anesthesia, and suturing in finger lacerations after local anesthesia with prior topical anesthesia with that experienced after digital anesthesia. Methods This was a randomized controlled trial in a university-based emergency department (ED), with an annual census of 75,000 patient visits. ED patients aged ,8 years with finger lacerations were enrolled. After standard wound preparation and 15-minute topical application of lidocaine-epinephrine-tetracaine (LET) in all wounds, lacerations were randomized to anesthesia with either local or digital infiltration of 1% lidocaine. Pain of needle insertion, anesthetic infiltration, and suturing were recorded on a validated 100-mm visual analog scale (VAS) from 0 (none) to 100 (worst); also recorded were percentage of wounds requiring rescue anesthesia; time until anesthesia; percentage of wounds with infection or numbness at day 7. Outcomes were compared by using Mann-Whitney U and chi-square tests. A sample of 52 patients had 80% power to detect a 15-mm difference in pain scores. Results Fifty-five patients were randomized to digital (n= 28) or local (n= 27) anesthesia. Mean age (±SD) was 38.1 (±16.8) years, 29% were female. Mean (±SD) laceration length and width were 1.7 (±0.7) cm and 2.0 (±1.0) mm, respectively. Groups were similar in baseline patient and wound characteristics. There were no between-group differences in pain of needle insertion (mean difference, 1.3 mm; 95% confidence interval [CI] =,17.0 to 14.3 mm); anesthetic infiltration (mean difference, 2.3 mm; 95% CI =,19.7 to 4.4 mm), or suturing (mean difference, 7.6 mm; 95% CI =,3.3 to 21.1 mm). Only one patient in the digital anesthesia group required rescue anesthesia. There were no wound infections or persistent numbness in either group. Conclusions Digital and local anesthesia of finger lacerations with prior application of LET to all wounds results in similar pain of needle insertion, anesthetic infiltration, and pain of suturing. [source] Intravenous lidocaine for status epilepticus during childhoodDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2006Shin-ichiro Hamano MD; The clinical efficacy of lidocaine for convulsive status epilepticus in 53 convulsive episodes was examined in 37 children (17 males, 20 females). Mean age of patients receiving lidocaine was 3 years 7 months (SD 3y 5mo). Lidocaine administration achieved control of status epilepticus in 19 of 53 convulsive episodes (35.8%). Seizures ceased within 5 minutes of lidocaine administration in all 19 patients who were responsive to the drug. Regarding aetiology of status epilepticus and types of seizures, there was no statistical difference in effectiveness. Mild decrease of oxygen saturation, monitored by pulse oximetry, was observed in one patient, which improved by oxygenation using a mask. Lidocaine is a useful anticonvulsive agent; however, the response rate to lidocaine appears to be quite low, as less than half of the seizures were effectively controlled by lidocaine. Favourable properties of the drug include prompt responses, less alteration of consciousness, and fewer adverse effects, including less respiratory depression. [source] Analyses of second-generation ,legal highs' in the UK: Initial findingsDRUG TESTING AND ANALYSIS, Issue 8 2010Simon D. Brandt Abstract In the UK, mephedrone and other so-called ,legal high' derivatives have recently been classified as Class B, Schedule I under the Misuse of Drugs Act 1971. Since then, alternative products have been advertised on a number of websites. In order to obtain an immediate snapshot of the situation, 24 products were purchased online from 18 UK-based websites over a period of 6 weeks following the ban in April 2010. Qualitative analyses were carried out by gas chromatography ion trap mass spectrometry using electron- and chemical ionization modes, nuclear magnetic resonance spectroscopy, and comparison with reference standards. Overall, the purchased products consisted of single cathinones or cathinone mixtures including mephedrone, butylone, 4-methyl- N -ethylcathinone, flephedrone (4-fluoromethcathinone) and MDPV (3,4-methylenedioxypyrovalerone), respectively. Benzocaine, caffeine, lidocaine, and procaine were also detected. The emphasis was placed on ,Energy 1' (NRG-1), a product advertised as a legal replacement for mephedrone-type derivatives usually claiming to contain naphyrone (naphthylpyrovalerone, O-2482). It was found that 70% of NRG-1 and NRG-2 products appeared to contain a mixture of cathinones banned in April 2010 and rebranded as ,new' legal highs, rather than legal chemicals such as naphyrone as claimed by the retailers. Only one out of 13 NRG-1 samples appeared to show analytical data consistent with naphyrone. These findings also suggest that both consumers and online sellers (unlike manufacturers and wholesalers) are, most likely unknowingly, confronted with the risk of criminalization and potential harm. Copyright © 2010 John Wiley & Sons, Ltd. [source] Using Capsaicin Modified Multiwalled Carbon Nanotube Based Electrodes and p -Chloranil Modified Carbon Paste Electrodes for the Determination of Amines: Application to Benzocaine and LidocaineELECTROANALYSIS, Issue 23 2008Roohollah Abstract The utilization of the capsaicin modified carbon nanotube modified basal-plane pyrolytic graphite electrode or p -chloranil modified carbon paste electrodes are presented for the determination of pharmaceutical compounds containing amine functionality, such as benzocaine and lidocaine. In detection of benzocaine at a capsaicin modified electrode, the guaiacol functional group is irreversibly electrochemically oxidized to form the o -quinone derivative which then undergoes nucleophilic attack by the aromatic amine group in benzocaine via a 1,4-Michael addition mechanism forming a catechol-amine adduct. The electrochemically initiated formation of the capsaicin-benzocaine adduct causes a linear decrease in the voltammetric signal corresponding to capsaicin which correlates to the added concentration of benzocaine. [source] Electrochemistry of Cytochrome P450 2B6 on Electrodes Modified with Zirconium Dioxide Nanoparticles and Platin ComponentsELECTROANALYSIS, Issue 7 2008Lei Peng Abstract The direct electrochemical and electrocatalytic behavior of the immobilized cytochrome P450 2B6 (CYP2B6) on zirconium dioxide nanoparticles (ZrO2) was investigated. The film of nano-structured ZrO2 that incorporated cytochrome P450 2B6 (CYP2B6) with colloidal paltin, which was stabilized by poly-lysine (Pt-PLL), was prepared on glassy carbon electrodes. In anaerobic solutions, the immobilized CYP2B6 exhibited a reversible electron transfer between the heme electroactive center of CYP2B6 and electrodes with a formal potential of ,(0.449±0.004) V at pH,7.4. In air-saturated solutions, an increased bioelectrocatalytic reduction current could be obtained with the CYP2B6-modified electrode with the addition of anticancer drugs, such as lidocaine. This leads to the construction of disposable biosensors for drugs by utilizing the electrochemical activity and catalytic reactions of the immobilized CYP2B6. [source] Comparison of Topical Anesthetics and Lubricants Prior to Urethral Catheterization in Males: A Randomized Controlled TrialACADEMIC EMERGENCY MEDICINE, Issue 6 2004John Siderias DO Abstract Although male urethral catheterization in the emergency department (ED) is both common and painful, few studies have evaluated the use of topical anesthesia prior to catheterization. Objectives: To determine whether pretreatment of the urethra with topical lidocaine reduces the pain associated with urethral catheterization. Methods:This was a prospective, double-blind, randomized clinical trial of 36 alert, cooperative male adult patients requiring urethral catheterization, without allergies to the study medications or contraindications to their use, from a suburban university-based ED. Patients in the experimental group had topical lidocaine 2% gel injected in their urethras, whereas control patients received intraurethral lubrication only. Standardized catheterization with a no. 16 Foley was performed followed by pain assessment. The primary outcome measured was pain of catheterization on a 100-mm visual analog scale. Other outcomes included ease of insertion and procedural bleeding. Results: The authors evaluated 36 patients evenly distributed between study groups. Mean age was 62 years (range 22,85). Compared with controls, patients pretreated with lidocaine experienced significantly less pain of catheterization (38 ± 28 mm vs. 58 ± 30 mm; mean difference 20 mm; 95% confidence interval [95% CI] = 0.4 to 32; p = 0.04) and less pain of injection (23 ± 17 mm vs. 40 ± 25 mm; mean difference 17 mm; 95% CI = 3 to 32 mm; p = 0.02). There were no differences in the number of attempts and incidence of adverse events between the groups. Conclusions: Use of topical lidocaine gel reduces the pain associated with male urethral catheterization in comparison with topical lubricants only. [source] | |||||||||||||||||||||||||||||||||||||||||||