Is subcutaneous local anesthesia in shoulder magnetic resonance arthrography necessary?

2007 ◽  
Vol 48 (7) ◽  
pp. 741-743 ◽  
Author(s):  
M. P. Koivikko ◽  
S. K. Koskinen

Background: Magnetic resonance arthrography is a well-established diagnostic method in degenerative and traumatic disorders of the shoulder. Some radiologists prefer to apply a local anesthetic to the skin prior to performing the joint puncture. However, no information regarding the efficacy of local anesthetics exists. Purpose: To assess patient discomfort in arthrography injection. Material and Methods: A patient survey ( n = 74) utilizing a visual analog scale (VAS) measured the intensity of pain in arthrography injection by those receiving local anesthetics ( n = 36) versus those who did not ( n = 38). Results: Mean VAS scores were 20.8 (median 10.5, SD 24.3) for those receiving local anesthetics versus 19.3 (median 13.0, SD 20.7) for those who did not ( P = 0.83, Mann-Whitney U test). Conclusion: Routine use of local anesthesia of the skin in arthrography injection is unnecessary.

2016 ◽  
Vol 4 (1) ◽  
pp. 17
Author(s):  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Cezar Laurențiu Tomescu ◽  
Cristina Luiza Erimia ◽  
Stelian Paris ◽  
...  

Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.


2018 ◽  
Vol 51 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Paulo César Xavier do Nascimento ◽  
André Maltez Amaral ◽  
João Ricardo Maltez de Almeida

Abstract Objective: To compare the pain expected to that effectively caused by magnetic resonance arthrography of the shoulder and, secondarily, to describe a simplified approach to the technique for articular access. Materials and Methods: We prospectively evaluated 40 participants who used a visual analog scale and a simplified categorical scale to indicate the level of pain expected and that experienced after the procedure, comparing the two with the Wilcoxon matched-pairs test. We also determined gender-related differences in pain conditions using the Mann-Whitney U test. In addition, we described a modified technique involving radiographic localization and the use of standard puncture needles for articular access. Results: Analysis of the visual analog scales showed that the pain experienced was less than had been expected, with median scores of 1.75 and 3.75, respectively (p < 0.001). The level of pain expected was higher among women than among men, with median scores of 8.0 and 3.0, respectively (p = 0.014), as was the level of pain experienced, with median scores of 3.0 and 1.5, respectively (p = 0.139). The overall categorical evaluation corroborated that difference (p = 0.03). Articular access with the modified technique was successful in all patients. Conclusion: Magnetic resonance arthrography of the shoulder is less painful than patients expect. In addition, digital radiographic guidance combined with the use of standard puncture needles appears to improve the efficiency of the method.


2021 ◽  
pp. 22-22
Author(s):  
Rasa Mladenovic

Clinicians should identify the risks associated with the use of anesthetics and understand the maximum recommended doses of local anesthetics. Errors in calculating the dose of local anesthetics are common due to the widespread use of these agents. Different methods of calculating the dose of the drug have different advantages and disadvantages, and no method can guarantee a calculation without errors. Nomogram is a simple graphical tool on which one can read the result of arithmetic operations with given numbers. The nomogram for calculating the maximum dose of local anesthetic enables quick cross-checking of the calculation, based on the patient's age or body weight. They are of special importance in the application of local anesthesia in children.


2015 ◽  
Vol 6 (3) ◽  
pp. 150-153
Author(s):  
Varsha Sunil Manekar

ABSTRACT Introduction Anterior middle superior alveolar (AMSA) block is a nerve block technique in conjunction with computer-controlled local anesthetic delivery (CCLAD) system. Anterior middle superior alveolar produces local anesthesia (LA) to the maxillary teeth from second premolar to the central incisor including the hard palate and corresponding soft-tissue of both buccal and palatal side, with single palatal injection. Aim To evaluate efficacy of AMSA block for extraction of maxillary first premolar. Study design In randomized single blind, split mouth clinical trial, the 14 patients received the conventional buccal-palatal (B-P) anesthesia on one side and CCLAD anesthesia AMSA for other side. The treatment consisted of bilateral extraction of maxillary first premolars for orthodontics. Pain perception ratings were obtained by using 10 point visual analog scale (VAS). Results A total of 100% cases had painless injection with CCLAD, whereas 28.57% patients had painless injection experience with conventional LA. In all cases, there was no pain during extraction on both sides. With CCLAD, buccal retraction was painful in four cases whereas palatal retraction was painful in one case. Conclusion Anterior middle superior alveolar block injected with CCLAD is better as LA technique for extraction of maxillary first premolar as compared to B-P approach. How to cite this article Manekar VS. Comparison of the Pain Perception of Conventional and Computer-controlled Anesthesia Techniques for Extraction of Maxillary First Premolar. World J Dent 2015;6(3):150-153.


2020 ◽  
Vol 41 (10) ◽  
pp. 1240-1248
Author(s):  
Ramazan Akmeşe ◽  
Mehmet Batu Ertan ◽  
Hakan Kocaoğlu

Background: The aim of this study was to evaluate the clinical and radiologic results of 2 different scaffolds with hyaluronan or chitosan-based structure used in the treatment of talus osteochondral lesions. Methods: Eighty-one patients who underwent chondral lesion repair with hyaluronan (n = 42) or chitosan-based (n = 39) scaffold were included. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and at the 3rd, 12th, and 24th month postoperatively. In all patients, magnetic resonance imaging was performed between the 12 and 18th month postoperatively and compared with magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Results: Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 3 and 12 months. The postoperative 24th-month results of AOFAS scores in any group did not differ significantly from the 12th-month results. There was no significant difference between the groups in comparison of AOFAS, VAS, and MOCART scores at any time period. Conclusion: Both scaffolds were found to be effective in cartilage healing but had no clinical or radiologic superiority to each other. This is the first study to compare the use of different cell-free scaffold types in osteochondral defects of the talus. Level of Evidence: Level III, retrospective comparative study.


Author(s):  
K.S. Poliakova ◽  
N.A. Kovalev ◽  
N.V. Lavrov

The article presents the results of a sociological study to identify the variability and frequency of complications caused by the use of local anesthetic drugs in pregnant women at the stomatological appointment. The study was conducted using a Google Forms application based on dental education sites on social media. 155 dentists of various specialties took part in the survey. According to the data obtained, among the doctors participating in the study, 70.3% faced complications of local anesthesia in pregnant women. The most common complications are from the nervous (n=54) and cardiovascular (n=19) systems. Some of them can be attributed to the manifestations of the psychogenic reaction of patients to the introduction of local anesthetic drugs, and not to the immediate undesirable effects of anesthetics. Taking into account the results obtained and the data of literature sources, recommendations are given to prevent the development of complications in pregnant patients from the introduction of local anesthetics. Recommendations can be useful for dentists and dental students.


2019 ◽  
Vol 24 (4) ◽  
Author(s):  
Anna Kołakowska ◽  
Anna Pigan

The article is based on the analysis of the literature and the latest international guidelines of dental associations in order to systematize the knowledge of doctors. The paper discusses local anesthetic agents such as lignocaine, benzocaine, articaine or mepivacaine, many times used in daily practice by dentists. Various anesthetic techniques, including computer-controlled systems for administering anesthesia, are described in the publication. The topic of teething preparations containing anesthetics and the risks associated with their use were also discussed, so that dentists could warn against their use of carers and parents of children and thus reduce the number of complications after their use. Contraindications to the use of analgesia have been presented and the complications that may occur after their administration have been characterized, thanks to which the right choice of the appropriate agent for analgesia will reduce the risk of possible complications after local anesthesia. The authors hope that after reading the article, doctors will be confident in using the benefits of local anesthetics.


2016 ◽  
Vol 2 (1) ◽  
pp. 17
Author(s):  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Cezar Laurențiu Tomescu ◽  
Cristina Luiza Erimia ◽  
Stelian Paris ◽  
...  

Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.


Author(s):  
Nikolaos Karamanis ◽  
Georgia Stamatiou ◽  
Dionysia Vasdeki ◽  
Nikolaos Sakellaridis ◽  
Konstantinos C. Xarchas ◽  
...  

Abstract Introduction Wide awake open carpal tunnel decompression is a procedure performed under local anesthesia. This study aimed to present the effect of various local anesthetics in peri and postoperative analgesia in patients undergoing this procedure. Materials and Methods A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under local anesthesia. Patients were divided in five groups according to local anesthetic administered: lidocaine 2%, ropivacaine 0.75%, ropivacaine 0.375%, chirocaine 0.5%, and chirocaine 0.25%. Total 400 mg of gabapentin were administered to a subgroup of 10 cases from each group (50 cases totally), 12 hours before surgery. Patients were evaluated immediately, 2 weeks and 2 months after surgery according to VAS pain score, grip strength, and two-point discrimination. Results In all patients, pain and paresthesia improved significantly postoperatively, while the use of gabapentin did not affect outcomes. Grip strength recovered and exceeded the preoperative value 2 months after surgery, without any difference between the groups. No case of infection, hematoma, or revision surgery was reported. Conclusion Recovery after open carpal tunnel release appears to be irrelevant of the type of local anesthetic used during the procedure. Solutions of low local anesthetic concentration (lidocaine 2%, ropivacaine 0.375%, and chirocaine 0.25%) provide adequate intraoperative analgesia without affecting the postoperative course.


2011 ◽  
Vol 3 (2) ◽  
pp. 34-36
Author(s):  
V. Deepti

ABSTRACT The local anesthetic drugs presently available and used in dentistry represent the safest and most effective drugs in all of medicine for the prevention and management of pain. One drawback associated with intraoral local anesthesia is patients’ fear of injections .and the perception that these are painful. Recent advances have resulted in the use of computer-controlled local anesthetic delivery vehicles to regulate the delivery and rate of flow of local anesthetics at the injection site, lessening potential discomfort associated with injections. New injection techniques that provide reliable anesthesia, depending on the technique and area of anesthesia necessary have been discussed.


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