Some misconceptions about diagnostic anaesthesia administered during lameness evaluation

UK-Vet Equine ◽  
2019 ◽  
Vol 3 (5) ◽  
pp. 169-174
Author(s):  
Jim Schumacher ◽  
Michael Schramme ◽  
John Schumacher
Keyword(s):  
Inflammatory Response ◽  
Local Anaesthetic ◽  
Skin Necrosis ◽  
Positive Response ◽  
Anaesthetic Agent ◽  
Local Anaesthetics ◽  
White Hair ◽  
Cutaneous Sensation ◽  
Perineural Injection

The notion that the accuracy of a nerve block correlates well with cutaneous sensation in the nerve's dermatome is false. A positive response to direct anaesthesia of a joint does not prove that the source of pain is within that joint or, conversely, that a negative response eliminates the joint as a source of pain. Local anaesthetics do appear to have the potential to cause long-term deleterious effects to joints when administered intra-articularly, in addition to the transient inflammatory response some are known to elicit. Administering epinephrine perineurally in combination with a local anaesthetic agent has been thought to have the potential to result in skin necrosis, subcutaneous swelling, and growth of white hair at the site of injection, but experience indicates that these complications are unlikely when epinephrine is administered at a concentration of 1:200 000 or less. The extent to which a local anaesthetic can migrate proximally following perineural injection can be underestimated.

scholarly journals Private Practitioners Knowledge of Local Anaesthetic Systemic Toxicity (LAST)

2021 ◽  
Vol 10 (41) ◽  
pp. 3571-3576
Author(s):  
Neha Yadav ◽  
Reshu Madan Sanan ◽  
Shefali Phogat ◽  
Nisha Yadav ◽  
Nupur Dabas ◽  
...  
Keyword(s):  
Local Anaesthetic ◽  
Anaesthetic Agent ◽  
Nerve Impulse ◽  
Local Anaesthetics ◽  
Systemic Toxicity ◽  
Blood Levels ◽  
Private Practitioners ◽  
Adequate Knowledge ◽  
Online Mode ◽  
Administration Methods

BACKGROUND Local anaesthetics (LAs) by definition are drugs that reversibly block the transmission of a nerve impulse, causing reversible absence of pain sensations without affecting consciousness. As a complication of local anaesthetic administration, a condition called as local anaesthetic systemic toxicity (LAST) can occur which affects central nervous system (CNS) and cardiovascular system (CVS). Local anaesthetic systemic toxicity is a very serious condition that can cause death. In LAST, blood levels of anaesthetic agent exceed the maximum dose, usually as a result of multiple injections or an accidental injection into a vein. The main objective of this survey was to assess the knowledge of LAST among private practitioners and to spread awareness about this common but often neglected complication of local anaesthetic administration. METHODS A survey was conducted with a questionnaire comprising of 15 questions for 251 private practitioners (registered in Indian Dental Association, Gurugram). The survey was mailed to the participants and the response was collected through online mode only. Using Excel program, the results were organized in graphs and tables, and presented as descriptive statistics. RESULTS Of the 251 surveys sent online, 151 were completed, with a survey completion rate of 60 %. On an average, only 39.9 % of the participating dentists had adequate knowledge of local anaesthetic systemic toxicity. Based on the survey, only 3.3 % of participating dentists knew how to use lipid treatment and 55.6 % had no idea about lipid treatment. CONCLUSIONS If LAST occurs, the key is to recognize it immediately and institute appropriate management. Based on the survey, there is a need to create awareness about local anaesthetic systemic toxicity and its management among dentists. KEY WORDS Local Anaesthesia, Last, Complication, Toxicity, Overdose

scholarly journals Use of Phenol as a Local Anaesthetic for Adult Grommet Insertion in Resource-Limited Settings: A Preliminary Report

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Social Sciences ◽  
Local Anaesthetic ◽  
Preliminary Report ◽  
Anaesthetic Agent ◽  
Computer Software ◽  
Local Anaesthetics ◽  
Local Anaesthetic Agent ◽  
Resource Limited ◽  
Outpatient Procedures ◽  
Tertiary Hospitals

Background. Grommet insertion is one of the most commonly performed minor surgical procedures in otolaryngological practice. For such minor procedures in the outpatient, local anaesthetics are preferred; this is even more so in adults especially for grommet insertion. This study described our experience with the use of phenol as a local anaesthetic agent for grommet insertion in adults. Methods. Phenol was used as a local anaesthetic agent that was applied topically for grommet insertion in adult patients as outpatient procedures between January and September 2018 in two tertiary hospitals. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS IBM) version 23.0 computer software. Results. Nineteen ear drums were operated in patients aged between 20 and 52 years. No pain or discomfort was reported by 89.5% and 94.7% had no bleeding. There was no vertigo in all the cases that completed the procedures. Conclusion. This preliminary result shows that the use of phenol as a topical local anesthetic is simple, safe, and effective especially in resource-limited environments.

scholarly journals ANATOMICAL MEASUREMENTS FOR THE BLOCKING SITES OF PARAVERTEBRAL REGIONAL ANAESTHESIA IN BLACK BENGAL DOE

1970 ◽  
Vol 8 (1) ◽  
pp. 81-86 ◽  
Author(s):  
S Sikder ◽  
SSU Ahmed ◽  
ASMG Kibria ◽  
MS Pallab ◽  
MB Uddin ◽  
...  
Keyword(s):  
Nerve Block ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Anaesthetic Agent ◽  
Transverse Process ◽  
Local Anaesthetics ◽  
Spinal Nerve ◽  
Dorsal Midline ◽  
Lateral Border ◽  
Lateral Angle

The study was conducted in 25 black Bengal does to determine the exact site of infiltration of local anaesthetics for the last thoracic (T13), first lumbar (L1) and second lumbar (L2) paravertebral spinal nerve block at the Dept. of Anatomy and Histology, Chittagong Veterinary and Animal Sciences University, Chittagong. The animals were anaesthetized with pentobarbital sodium @ 20 mg / kg body weight IM and bled to death by giving incision on the right common carotid artery and preserved by 10 % formalin and dissected carefully to visualize the spinal nerves for the determination of the exact site of infiltration of local anaesthetic at the perineural area for paravertebral nerve block. For the vertical or proximal approach, the T13 spinal nerve was located at 0.8 ± 0.17 cm caudally from head of the last rib, 0.7 ± 0.22 cm cranio-medially from cranio-lateral angle of L1 transverse process and 3.4 ± 0.20 cm laterally from dorsal midline; L1 spinal nerve was placed at 1.2 ± 0.40 cm medially from cranio-lateral angle of L2 transverse process and 3.5 ± 0.17 cm laterally from the dorsal midline; and L2 spinal nerve was situated at 1.6 ± 0.26 cm medially from cranio-lateral angle of L3 transverse process and 3.7 ± 0.14 cm laterally from the dorsal midline. In horizontal or distal approach, T13 spinal nerve was located at 0.5 ± 0.10 cm and 1.8 ± 0.63 cm cranially from the cranio-lateral and caudo-lateral angles of L1 transverse process respectively and 4.6 ± 0.30 cm laterally from dorsal midline at lateral border of L1 transverse process; L1 spinal nerve was placed at 0.4 ± 0.10 cm and 1.4 ± 0.28 cm caudally and cranially from the cranio-lateral and caudo-lateral angle of L2 transverse process respectively and 5.1 ± 0.20 cm laterally from dorsal midline at lateral border of L2 transverse process and L2 spinal nerve was situated at 2.5 ± 0.42 cm and 0.5 ± 0.10 cm caudally and cranially from the cranio-lateral and caudo-lateral angle of L3 transverse process respectively and 5.5 ± 0.28 cm laterally from dorsal midline at lateral border of L3 transverse process. These measurements will be helpful to determine of the exact site for the deposition of the local anaesthetic agent at the perineural area of the specific paravertebral spinal nerve during paravertebral regional anaesthesia in doe. DOI = 10.3329/bjvm.v8i1.8354 Bangl. J. Vet. Med. (2010). 8(1): 81-86

scholarly journals Long-term assessment of a modified tibial tuberosity advancement technique in dogs

2018 ◽  
Vol 70 (4) ◽  
pp. 1053-1059 ◽  
Author(s):  
R.M. Medeiros ◽  
M.A.M. Silva ◽  
P.P.M. Teixeira ◽  
D.G. Chung ◽  
M.E.B.A.M. Conceição ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Positive Response ◽  
Tibial Tuberosity ◽  
Compression Tests ◽  
Radiographic Evidence ◽  
Long Term Follow Up

ABSTRACT The purpose of study was to assess long-term clinical and radiographic aspects of dogs’ stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient’s gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner’s perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners’ perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.

Homozygous Protein C Deficiency: Description of a New Mutation and Successful Treatment with Low Molecular Weight Heparin

1998 ◽  
Vol 79 (04) ◽  
pp. 756-761 ◽  
Author(s):  
Paul Monagle ◽  
Maureen Andrew ◽  
Jacqueline Halton ◽  
Richard Marlar ◽  
Lawrence Jardine ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Bone Density ◽  
Skin Necrosis ◽  
Protein C ◽  
Low Molecular Weight Heparin ◽  
Whole Body ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
New Mutation

SummaryWe present a kindred with a new mutation of the protein C gene, in which the proband had an unusual clinical presentation. The relationship between warfarin induced skin necrosis and level of anticoagulation was investigated. The pharmacokinetics of protein C concentrate was assessed to determine frequency of replacement therapy. The clinical and biochemical efficacy of therapy with low molecular weight heparin (LMWH) was assessed. The effect of long-term LMWH on bone density in the growing child was monitored using whole body densitometry.Warfarin therapy required an INR of greater than 3.5 to avoid skin necrosis. If protein C replacement was to be used, doses of 100 U/kg/day would have been required to maintain protein C levels consistently at or above 0.20 U/ml. While receiving prophylactic therapy with LMWH for almost 3 years, there were no episodes of recurrent thrombosis, no skin necrosis and no bleeding. Biochemical markers of in vivo thrombin generation were suppressed and within the normal range. Bone density continued to increase at the normal rate throughout the treatment period.LMWH is an effective form of long-term therapy for homozygous protein C deficient patients with measurable protein C levels.

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