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Lidocaine Gel (lidocaine + gel)
Selected AbstractsComparison 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] Caudal analgesia for prostate biopsyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010M. CESUR Background: Although various local anesthesia techniques have been suggested to decrease pain and discomfort during a transrectal ultrasound (TRUS)-guided prostate biopsy, the best method has not yet been defined. The present prospective, double-blind, randomized study aims to investigate the clinical efficacy of ,walking' caudal block compared with an intrarectal lidocaine gel for this procedure. Methods: One hundred patients were randomly assigned to two groups. In the lidocaine gel group, 10 ml of gel containing 2% lidocaine was given intrarectally. In the caudal group, 20 ml 0.1% bupivacaine with 75 ,g fentanyl was injected. Pain scores, anal sphincter tone and patient satisfaction were evaluated. Results: The pain scores were significantly lower in the caudal group at all stages. Verbal rating scores (scale 1,4) during probe insertion, probe maneuver and biopsies were 1 (0,2), 1 (0,2) and 1 (0,2) vs. 3 (0,5), 2 (1,3) and 4 (2,6), respectively (P value <0.0001 at all stages). The anal sphincter was more relaxed in the caudal group than in the gel group (P value <0.0001 in all categories). Highly satisfied patients were more frequently encountered in the caudal group, 34 (68%) vs. 8 (16%), P<0.0001, and unsatisfied patients were more frequently found in the gel group 1 (2%) vs. 12 (24%); P<0.001. All patients were able to walk without any assistance immediately after the procedures. Conclusion: ,Walking' caudal analgesia is an efficacious method for relieving the pain during TRUS-guided prostate biopsies in ambulatory practice. [source] Treatment of Distal Colitis with Local Anaesthetic AgentsBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 4 2002Stellan Björck The original observation was an adrenergic hyperinnervation of the inflamed mucosa (hyperinnervation hypothesis). In order to silence local nervous reflexes, the mucosa was treated topically with 2% lidocaine gel. The clinical results are promising and no side effects have been observed. The relapse rate is relatively high and related to the duration of treatment. In studies of experimental colitis a potential antagonism between harmful adrenergic nerves (vasoconstrictor substances and proinflammatory cytokines) and mucosa-protective visceral afferents (antiinflammatory cytokines) in the pathogenesis of colitis is intriguing. Other studies have emphasized the importance of neutrophils for causing damage to the colon epithelium (neutrophil hypothesis) and local anaesthetics have potent effects on several steps of the inflammatory response in addition to the nervous blockade. [source] The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic (Oraqix®) for periodontal scaling/root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2001Johan Friskopp Abstract Background: A new non-injection anesthetic, lidocaine/prilocaine gel (Oraqix®, AstraZeneca) in a reversible thermosetting system, has been developed to provide local anesthesia for scaling/root planing (SRP). The aim of this study was to determine the anesthetic onset and duration of the gel for SRP in patients with periodontitis. Methods: 30 patients were randomized to either 30 s, 2 min, or 5 min of treatment with the gel prior to SRP of a tooth. The gel was applied to periodontal pockets with a blunt applicator. On completion of the SRP of each tooth (2,3 teeth treated/patient), the patients rated their pain on a 100-mm visual analogue scale (VAS). Results: The median VAS pain score was 7.5 mm in the 30-s group, 28.5 mm in the 2-min group, and 15.5 mm in the 5-min group, with a significant difference between the 30-s and 2-min groups (p=0.03). In 2 patients in the 5-min group, but none in the other groups, the SRP was interrupted due to pain. The mean duration of anesthesia measured as pain on probing were 18.1, 17.3, and 19.9 min in the 30-s, 2-min, and 5-min groups, respectively. There were no reports of numbness of the tongue, lip, or cheek, neither were there any adverse local reactions in the oral mucosa. The gel was easy to apply and did not interfere with the SRP procedure. Conclusion: Oraqix® provides anesthesia after an application time of 30 s, with a mean duration of action of about 17 to 20 min. Zusammenfassung Hintergrund: Eine neues nicht zu injizierendes Anästhetikum, Lidocain/Prilocain Gel (Oraqix®, Astra Zeneca) in einem reversiblen thermischen System, wurde entwickelt, um die lokale Anästhesie für die Wurzelreinigung und -glättung (SRP) zu verbessern. Das Ziel dieser Studie war die Bestimmung des Anästhesieeintrittes und der -dauer durch dieses Gel bei SRP bei Parodontitis-Patienten. Methoden: 30 Patienten wurden zufällig zur 30 Sekunden, 2 Minuten oder 5 Minuten Behandlung mit dem Gel vor der SRP eines Zahnes eingeteilt. Das Gel wurde mit einem stumpfen Applikator in die parodontalen Taschen appliziert. Nach der Vollendung der SRP eines jeden Zahnes (2,3 behandelte Zähne/Patient) beurteilten die Patienten ihre Schmerzen auf einer 100 mm visuellen Analogskala (VAS). Ergebnisse: Der mittlere VAS Score war 7.5 mm in der 30 Sekundengruppen, 28.5 mm in der 2 Minutengruppe und 15.5 mm in der 5 Minutengruppe mit einer signifikanten Differenz zwischen der 30 Sekunden und der 2 Minutengruppe (p=0.03). Bei 2 Patienten in der 5 Minutengruppe, aber keinem in einer anderen Gruppe, wurde das SRP wegen Schmerzen unterbrochen. Die mittlere Dauer der Anästhesie, gemessen als Schmerz auf Sondierung, war 18.1, 17.3 und 19.9 Minuten in der 30 Sekunden, 2 Minuten und 5 Minutengruppe. Es gab keine Berichte über eine Taubheit der Zunge, der Lippen oder der Wangen. Irgendwelche negativen lokalen Reaktionen an der Mukosa wurden nicht beobachtet. Das Gel war leicht zu applizieren und beeinflußte die SRP Prozedur nicht. Zusammenfassung: Oraqix® fördert die Anästhesie nach Applikation von 30 Sekunden mit einer mittleren Dauer von ungefähr 17 bis 20 Minuten. Résumé Un nouvel anesthésique non-injectable, un gel de lidocaine/prilocaine (Oraquix®, AstraZeneca) dans un système thermique réversible a été mis au point afin de créer une anesthésie locale lors du détartrage et du surfaçage radiculaire (SRP). Le but de cette étude a été de déterminer la prise et la durée anesthésique de ce gel pour le SRP chez des patients avec parodontite. 30 patients ont été traités avec ce gel pendant 30 s, 2 min ou 5 min avant le SRP d'une dent. Le gel a été placé dans les poches parodontales avec un applicateur arrondi. A la fin du SRP de chaque dent (2 à 3 dents traitées par patient) les patients ont quantifié leur douleur sur une échelle analogue visuelle de 100 mm (VAS). Le score de douleur VAS moyen était de 7.5 mm dans le groupe de 30 s, 28.5 mm dans le groupe 2 min et de 15.5 min dans celui de 5 min avec une différence significative entre les groupes 30 s et 2 min (p=0.03). Chez 2 patients du groupe 5 min mais chez aucun des 2 autres groupes le SRP a été interrompu à cause de la douleur. La durée moyenne d'anesthésie mesurée en tant que douleur au sondage était respectivement de 18.1, 17.3 et 19.9 min pour les groupes 30 s, 2 min et 5 min. Il n'y a eu aucune plainte d'anesthésie de la langue, des lèvres ou des joues ni aucune réaction locale négative de la muqueuse buccale. Le gel a été facilement appliqué et n'a absolument pas gêné le SRP. L'Oraquix® apporte une anesthésie après un temps d'application de 30 s avec une durée d'action de 17 à 20 min. [source] | ||||||||||