Tumescent Local Anesthesia for the Surgical Treatment of Burns and Postburn Sequelae in Pediatric Patients

2004 ◽  
Vol 48 (5) ◽  
pp. 243-244 ◽  
Author(s):  
Charlotte Bell
Keyword(s):  
Surgical Treatment ◽  
Local Anesthesia ◽  
Pediatric Patients ◽  
Tumescent Local Anesthesia

Tumescent Local Anesthesia for the Surgical Treatment of Burns and Postburn Sequelae in Pediatric Patients

2003 ◽  
Vol 99 (6) ◽  
pp. 1371-1375 ◽  
Author(s):  
Leonardo Bussolin ◽  
Paolo Busoni ◽  
Letizia Giorgi ◽  
Massimo Crescioli ◽  
Andrea Messeri
Keyword(s):  
Nitrous Oxide ◽  
Surgical Treatment ◽  
Local Anesthesia ◽  
Pediatric Patients ◽  
Maximum Dose ◽  
Temporary Increase ◽  
Tumescent Local Anesthesia ◽  
Locoregional Anesthesia ◽  
Nitrous Oxide Oxygen ◽  
Anesthesia Technique

Background Tumescent local anesthesia is a technique for regional anesthesia of the skin and the subcutaneous tissue, using infiltration of large volumes of local anesthetic. The advantages of this technique are (1) simplicity, (2) prolonged postoperative analgesia, (3) low incidence of bleeding, and (4) anesthetization of a large area of the body. There are no reports on the use of tumescent local anesthesia in pediatric patients. Methods In 30 consecutive pediatric burn patients with American Society of Anesthesiologists physical status class I or II who were 1-120 months old (34 +/- 31.6 months), after induction of anesthesia with nitrous oxide-oxygen-sevoflurane, infiltration with 0.05% (14 ml/kg) or 0.1% (7 ml/kg) lidocaine solution was performed. Anesthesia was maintained with patients spontaneously breathing with 1.5% sevoflurane in nitrous oxide-oxygen (50%). The maximum dose of lidocaine used was 7 mg/kg. Postoperative pain was assessed by using the Children's Hospital of Eastern Ontario Pain Scale (for patients aged up to 5 yr) and by using a visual analog scale (for patients older than 5 yr). A comparison with a historic control group not treated with the tumescent local anesthesia technique was performed. Results No patients were excluded from the study, and no significant variations in the monitored intraoperative parameters were observed. Five patients had an increase in heart rate and respiratory rate at the beginning of surgery, and of these, two needed a temporary increase in sevoflurane concentration. After the initial incision, no response to painful stimulus was observed. No complications occurred. Six patients required postoperative acetaminophen administration, and 24 patients did not require analgesic treatment. Conclusions Tumescent local anesthesia with maximum dose of 7 mg/kg lidocaine seems to be safe and the sole possible effective locoregional anesthesia technique for the surgical treatment of noncontiguous pediatric burns.

Effect of Time Interval Between Tumescent Local Anesthesia Infiltration and Start of Surgery on Operative Field Visibility in Hand Surgery Without Tourniquet

2015 ◽  
Vol 40 (8) ◽  
pp. 1606-1609 ◽  
Author(s):  
Muhammad Mustehsan Bashir ◽  
Rehan Qayyum ◽  
Muhammad Hammad Saleem ◽  
Kashif Siddique ◽  
Farid Ahmad Khan
Keyword(s):  
Local Anesthesia ◽  
Hand Surgery ◽  
Time Interval ◽  
Operative Field ◽  
Tumescent Local Anesthesia ◽  
Without Tourniquet

Optimization of lidocaine application in tumescent local anesthesia

2009 ◽  
Vol 61 (4) ◽  
pp. 641-653 ◽  
Author(s):  
Krystyna Głowacka ◽  
Krystyna Orzechowska-Juzwenko ◽  
Andrzej Bieniek ◽  
Anna Wiela-Hojeńska ◽  
Magdalena Hurkacz
Keyword(s):  
Local Anesthesia ◽  
Tumescent Local Anesthesia

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients

2015 ◽  
Vol 39 (5) ◽  
pp. 470-474 ◽  
Author(s):  
M Mittal ◽  
A Kumar ◽  
D Srivastava ◽  
P Sharma ◽  
S Sharma
Keyword(s):  
Heart Rate ◽  
Local Anesthesia ◽  
Study Design ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Computerized Method ◽  
Local Anesthetic Injection ◽  
Computerized System ◽  
Buccal Infiltration

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups

scholarly journals Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Mukesh Kumar Prasad ◽  
Payal Jain ◽  
Rohit Kumar Varshney ◽  
Aditi Khare ◽  
Gurdeep Singh Jheetay
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Blood Loss ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Skin Graft ◽  
Tumescent Local Anesthesia ◽  
Graft Harvest ◽  
Contracture Release ◽  
Split Skin

Background: Anesthetic management of severe post burn neck contracture is difficult, demanding due to fixed flexion deformity of neck, incomplete oral occlusion and insufficient mouth opening leading to difficulty in intubation. Patients undergoing contracture release, skin graft harvest under general anesthesia (GA) were compared with patients undergoing the same surgery under tumescent local anesthesia (TLA) technique. Methodology: Twenty-one patients with post burn neck contracture undergoing contracture release with split skin grafting under GA were compared with twenty-one patients undergoing the same surgery under TLA. Post-operative pain and satisfaction were assessed using 10 cm VAS (Visual Analogue Scale).  Results: Demographic profile was comparable in both groups. Changes in intra-operative vital parameters remained insignificant. The average volume of tumescent solution used was 254.76 + 49.05ml. Blood loss was significantly decreased, postoperative pain relief was more than sixteen hours in thirteen patients and extended beyond twenty-four hours in six patients in the TLA group. Time for the first rescue analgesia was significantly lesser in the GA group and the average dose of injection tramadol used in the GA group was significantly higher within the first 24 h. Overall satisfaction in the TLA group was significantly higher than in the GA group. Conclusion: TLA can be used as sole technique for release of post burn neck contracture and harvest of split skin grafts with less blood loss and significantly better postoperative pain relief avoiding complications of general anesthesia. Key words: Tumescent local anesthesia; Post burn neck contracture; Skin graft harvest; General anesthesia Citation: Prasad MK, Jain P, Varshney RK, Khare A, Jheetay GS. Tumescent local anesthesia as an alternative to general anesthesia in the release of post-burn neck contracture and skin graft harvesting: A comparative study. Anaesth. Pain intensive care 2021;25(1):34–39. DOI: 10.35975/apic.v25i1.1434 Received: 18 February 2020, Reviewed: 16 March 2020, Accepted: 30 April 2020

Method of surgical treatment of the saddle nose deformity

2021 ◽  
Vol 20 (4) ◽  
pp. 43-47
Author(s):  
D. S. Pshennikov ◽  
◽  
Z. M. Abdulaev ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Local Anesthesia ◽  
Nasal Septum ◽  
Soft Tissues ◽  
Operation Time ◽  
Functional Results ◽  
Nasal Dorsum ◽  
Superficial Musculoaponeurotic System ◽  
Saddle Nose Deformity ◽  
External Nose

Saddle deformity of the external nose, which is a consequence of trauma, is usually combined with a nasal septal deviation and is quite widespread in the population. The problem of surgical treatment of this group of patients lies not only in the technical complexity, trauma of the proposed methods but also in the need to carry out significant interventions under general anesthesia, which limits the use of available techniques by a wide number of ENT surgeons, increases the duration of the operation, recovery time and temporary disability of the patient. The invention aims to improve surgical treatment of patients with saddle nasal deformity by providing stable cosmetic and functional results. Materials and methods: The proposed method of surgical treatment of saddle deformity of nasal dorsum includes several stages. Cartilage autograft taken from nasal septum during septoplasty is milled to 0,5–1,0 mm, mixed with 0,5 ml of latex tissue glue (LTG) having hemostatic and antiseptic properties due to aminocaproic acid and dioxidine content, respectively. This mixture is kept for 5 minutes and delivered to the pocket formed under the SMAS (superficial musculoaponeurotic system) layer in the soft tissues of the dorsum of the external nose, after which the final shape of the nose is simulated and fixed with a plaster splint for a week. Results: Based on the department of otolaryngology of Semashko Ryazan Regional Clinical Hospital, for the period from 2012 to 2019, 17 patients were treated with a diagnosis: saddle deformity of the external nose and nasal septum deviation. All patients underwent rhinoseptoplasty under local anesthesia using LTG as described above. No complications were observed in the postoperative period. During follow-up from 7 to 24 months, patients retain constant functional and cosmetic results. Conclusions. This method is a simple, low-traumatic one of surgical treatment of saddle deformity of the nasal dorsum, which allows reducing the operation time, performing it under local anesthesia and obtaining good cosmetic and functional results. The technical simplicity and accessibility of the method make it possible to use it in hospitals engaged in the surgical treatment of nasal diseases.

Sign in / Sign up

Export Citation Format

Share Document