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Topical Anesthesia (topical + anesthesia)

Distribution by Scientific Domains

Medical Sciences	81%

Selected Abstracts

Patient Satisfaction and Reported Long-Term Therapeutic Efficacy Associated with 1,320 nm Nd:YAG Laser Treatment of Acne Scarring and Photoaging

DERMATOLOGIC SURGERY, Issue 3 2006
ASHISH C. BHATIA
BACKGROUND AND OBJECTIVE Nonablative laser treatments have become increasingly used for the treatment of acne scarring and photoaging. While nonablative laser treatments are more convenient and relatively safer than ablative laser resurfacing, efficacy and patient satisfaction with the level of improvement of textural abnormalities in acne scarring and rhytids associated with photoaging needs further study. DESIGN/MATERIALS AND METHODS Structured interviews were performed with 34 patients from a referral-based academic practice who each previously received a series of 6 monthly treatments with a 1,320 nm neodymium:yttrium,aluminum,garnet (Nd:YAG) laser for treatment of acne scarring or photoaging. Topical anesthesia was applied 1 hour before each treatment. Patients were interviewed at least 3 months after cessation of treatment (range 3,12 months). RESULTS Patients tolerated the treatments well. Combined results for acne scarring and photoaging patients were as follows: (a) patient satisfaction with treatment was rated at 62%, and (b) textural improvement was reported at 31% at the end of the six treatments, and 30% at the date of interview. When results were stratified by diagnosis, patient satisfaction was slightly higher for treatment of acne scarring than for photoaging. Overall degree of improvement on a 1,10 scale was 5.4 for acne scarring and 3.8 for wrinkling. CONCLUSION Nonablative treatment with the 1,320 nm Nd:YAG laser induced significant patient-reported improvement in both acne scarring and photoaging. The majority of patients reported satisfaction with the degree of improvement. [source]

ORAL SIZE PERCEPTION OF PARTICLES: EFFECT OF SIZE, TYPE, VISCOSITY AND METHOD

JOURNAL OF TEXTURE STUDIES, Issue 4 2005
LINA ENGELEN
ABSTRACT We investigated how different parameters affect oral size perception of small particles of SiO2 and polystyrene particles of varying sizes (2,230 ,m). Eighteen healthy subjects assessed the size of the particles by rubbing the sample between the tongue and the palate. The importance of size and type were studied by direct scaling and forced choice ranking and the results of the two methods were compared. To assess the relative importance of the tongue and the palate in oral size perception topical anesthesia was applied. The size and characteristics of particles are of importance for perception of particle size, where hard and irregular particles are perceived as larger than soft and round particles of similar size. The two methods of size perception, direct scaling and forced ranking produce very similar results on oral size perception. Topical anesthesia of either the tongue or the palate had no significant effect. [source]

Minimally Ablative Erbium:YAG Laser Resurfacing of Facial Atrophic Acne Scars in Asian Skin: A Pilot Study

DERMATOLOGIC SURGERY, Issue 5 2008
YONG-KWANG TAY MD
BACKGROUND Atrophic scars are dermal depressions caused by collagen damage most commonly occurring after inflammatory acne vulgaris. There are little published data regarding the effectiveness and safety of minimally invasive lasers in the treatment of atrophic acne scars in darker skin types. OBJECTIVE The purpose was to evaluate the efficacy and safety of a low-fluence 2,940-nm erbium:YAG laser in the treatment of atrophic acne scars in Asian patients. MATERIALS AND METHODS Nine patients aged 19 to 45 years with mild to moderate atrophic facial scars and Skin Types IV and V were treated with topical anesthesia and one to two passes with an erbium:YAG laser two times at 1-month intervals. Treatment parameters were 6-mm spot size, fluence of 400 mJ, pulse duration of 300 ,s, and repetition rate of 2 Hz. RESULTS At 2 months after the last treatment, mild to moderate clinical improvement was noted in all patients compared to baseline. Treatment was well tolerated. Side effects consisted of posttreatment erythema, peeling, and crusting, which resolved within 1 to 2 weeks. There was no postinflammatory hyper- or hypopigmentation, blistering, or hypertrophic scarring. CONCLUSION Low-fluence erbium:YAG facial resurfacing was effective and safe in patients with mild to moderately severe atrophic acne scarring. [source]

Lidocaine Iontophoresis for Local Anesthesia Before Shave Biopsy

DERMATOLOGIC SURGERY, Issue 6 2003
William 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]

An Effective Treatment of Dark Lip by Frequency-Doubled Q-Switched Nd:YAG Laser

DERMATOLOGIC SURGERY, Issue 1 2001
Somyos Kunachak MD
Background. Dark lip is a common cosmetic problem in Southeast Asia. There is no known effective treatment. Objective. To propose an effective method for treating dark lips of varying causes with frequency-doubled Q-switched Nd:YAG laser. Methods. Seventy patients with dark lip, of which 22 were congenital, 24 acquired, and 24 of uncertain cause, were treated by frequency-doubled Q-switched Nd:YAG laser at a fluence of 2,3.5 J/cm2 (mode 2.5 J/cm2) after application of topical anesthesia. The endpoint of treatment was complete clearance of the pigment. Follow-up time was 24,36 months (mean 29 months). Results. All patients attained complete clearance of the lesion after an average of 2.5 treatments in the congenital group, 2.2 treatments in the acquired group, and 1.8 treatments in the group with uncertain etiology. The mean (±SD) number of treatments required by the whole group was 2.1 ± 1.4. Recurrence was observed in one case of congenital origin 3 months after the last treatment. In the remaining cases, results persisted up to the time of follow-up. Herpes simplex reactivation was noted in one case 3 days after treatment. There was no dyschromia, scar formation, or change of skin texture. Conclusion. Dark lip can be effectively treated by frequency-doubled Q-switched Nd:YAG laser without major adverse effects. [source]

The Efficacy of EMLA versus ELA-Max for Pain Relief in Medium-Depth Chemical Peeling: A Clinical and Histopathologic Evaluation

DERMATOLOGIC SURGERY, Issue 1 2000
Robert A. Koppel MD
Background. Medium-depth chemical peels are an effective and popular treatment for actinic damage, fine wrinkles, and pigmentary dyschromias. However, they are also uncomfortable. A previous attempt to study the effectiveness of a topical anesthetic gel in 35% trichloroacetic acid (TCA) peeling found a reduction in discomfort but an increased depth of penetration and delayed healing. Objective. To evaluate both the efficacy of two topical anesthetic agents in medium-depth combination peeling as well as the histologic result from chemical peeling combined with topical anesthesia. Method. Seventy percent glycolic acid (GA) was applied to the entire face of 10 patients and diluted with water after 2 minutes. This was followed by the sequential application of EMLA cream (lidocaine 2.5% and prilocaine 2.5%), ELA-Max cream (lidocaine 4%), and placebo to selected areas on the face for 30 minutes without occlusion. These agents were then removed and 35% TCA was applied to the entire face. The level of discomfort felt by the patients during the TCA peel was recorded, clinical photographs were taken, and bilateral preauricular biopsies were performed at baseline, 48 hours, and 90 days postoperatively. Results. Clinically there was a statistically significant decrease in pain felt during the 70% GA-35% TCA peel with topical anesthesia when compared to the control. There was no statistically significant difference in efficacy between EMLA and ELA-Max. There was also no difference in either the clinical or the histopathologic appearance between the medium-depth peel combined with topical anesthesia and the medium-depth peel with control. Conclusion. Both EMLA and ELA-Max decrease the discomfort felt during medium-depth combination chemical peeling without influencing either the clinical or the histopathologic result. [source]

Digital versus Local Anesthesia for Finger Lacerations: A Randomized Controlled Trial

ACADEMIC EMERGENCY MEDICINE, Issue 10 2006
Stuart 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]

Comparison of Topical Anesthetics and Lubricants Prior to Urethral Catheterization in Males: A Randomized Controlled Trial

ACADEMIC EMERGENCY MEDICINE, Issue 6 2004
John 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]

ORAL SIZE PERCEPTION OF PARTICLES: EFFECT OF SIZE, TYPE, VISCOSITY AND METHOD

EMLA® Cream coated on the rigid bronchoscope for tracheobronchial foreign body removal in children

THE LARYNGOSCOPE, Issue 1 2009
Hai Yu MD
Abstract Objectives: Removal of a tracheal or bronchial foreign body is a common emergent surgical procedure in children. The anesthetic management can be challenging. EMLA® Cream (EC) has been widely used to provide topical anesthesia. In the present study, we evaluate the efficacy and safety of EC coated on the rigid bronchoscope for tracheobronchial foreign body removal in children undergoing intravenous anesthesia with spontaneous ventilation. Study Design: The authors conducted a randomized, double-blind, placebo-controlled clinical trial. Methods: Thirty patients were randomized to receive either EC or placebo (lubricant ointment) coated on the rigid bronchoscope. Intravenous anesthesia and spontaneous ventilation were performed in all patients. Heart rate, blood pressure, pulse oxygen saturation (SpO2) and frequency and degree of breath holding were recorded. After surgery, the bronchoscopist rated overall surgical manipulation as excellent, fair, and poor. The durations of postoperative care were also recorded. Results: Episodes of oxygen desaturation (SpO2 < 90%) occurred in 3/15 (20%) patients in the EC group and in 9/15 (60%) patients in the control group (P < .05). Occurrences and degrees of breath holding were less in the EC group than that in the control group (P < .05). Ranks of surgical manipulation were excellent in 80% of patients in the EC group versus 13% of patients in the control group (P < .05). The durations of postoperative care were shorter in the EC group than that in the control group (P < .05). Conclusions: EC coated on the rigid bronchoscope combined with intravenous anesthesia could provide more efficacious and safer anesthesia for tracheobronchial foreign body removal in children under spontaneous ventilation. Laryngoscope, 119:158,161, 2009 [source]

4331: Anterior segment optical coherence tomography (AS-OCT): a novel diagnostic instrument for conjunctivochalasis

ACTA OPHTHALMOLOGICA, Issue 2010
K GUMUS
Purpose To evaluate cross-sectional conjunctivochalasis area (CChA) and tear meniscus area (TMA) using Fourier-Domain-RTVue-100 optical coherence tomography (OCT) before and after conjunctival cauterization and to evaluate inter- and intraobserver reliability. Methods A total of twelve eyes of 7 patients with conjunctivochalasis aged 56 to 87 were evaluated. After topical anesthesia, conjunctival cauterization was performed on the inferior bulbar conjunctiva. All patients underwent anterior segment OCT (AS-OCT) imaging prior to and 4 weeks after the procedure. Cross-sectional TMA and CChA at 3 locations (nasal, center and temporal areas) were measured in all patients. Results Non-significant increases (p= 0.177) in TMA as a whole (3 locations combined) were observed at following cauterization. CChA measurements significantly decreased in all 3 locations after cauterization (p< 0.001). Mean CChA decreased from 0.247 ± 0.24 mm2 to 0.054 ± 0.79 mm2. For two measurements of TMA by examiner 1, intraclass correlation coefficients (ICC) ranged from 0.998 to 0.999. Among two examiners, Cronbach's alpha reliability coefficients were as high as 0.993 and 0.997 before and after conjunctival cauterization. Regarding the CChA measurements, ICC values were similar to those of TMA, but Cronbach's alpha reliability coefficients were slightly less. Conclusion This study indicates the AS-OCT is a useful and reproducible instrument to measure cross-sectional area of conjunctiva prolapsing into the tear meniscus of patients with conjunctivochalasis. The method can monitor effectiveness of thermo reduction of conjunctivochalasis. [source]