Effectiveness of tramadol compared to lignocaine as local anesthesia in the extraction of firm teeth: a randomized controlled trial

BackgroundRegional anesthesia improves short-term blood flow through arteriovenous fistulas (AVFs). We previously demonstrated that, compared with local anesthesia, regional anesthesia improves primary AVF patency at 3 months.MethodsTo study the effects of regional versus local anesthesia on longer-term AVF patency, we performed an observer-blinded randomized controlled trial at three university hospitals in Glasgow, United Kingdom. We randomly assigned 126 patients undergoing primary radiocephalic or brachiocephalic AVF creation to receive regional anesthesia (brachial plexus block; 0.5% L-bupivacaine and 1.5% lidocaine with epinephrine) or local anesthesia (0.5% L-bupivacaine and 1% lidocaine). This report includes findings on primary, functional, and secondary patency at 12 months; reinterventions; and additional access procedures (primary outcome measures were previously reported). We analyzed data by intention to treat, and also performed cost-effectiveness analyses.ResultsAt 12 months, we found higher primary patency among patients receiving regional versus local anesthesia (50 of 63 [79%] versus 37 of 63 [59%] patients; odds ratio [OR], 2.7; 95% confidence interval [95% CI], 1.6 to 3.8; P=0.02) as well as higher functional patency (43 of 63 [68%] versus 31 of 63 [49%] patients; OR, 2.1; 95% CI, 1.5 to 2.7; P=0.008). In 12 months, 21 revisional procedures, 53 new AVFs, and 50 temporary dialysis catheters were required. Regional anesthesia resulted in net savings of £195.10 (US$237.36) per patient at 1 year, and an incremental cost-effectiveness ratio of approximately £12,900 (US$15,694.20) per quality-adjusted life years over a 5-year time horizon. Results were robust after extensive sensitivity and scenario analyses.ConclusionsCompared with local anesthesia, regional anesthesia significantly improved both primary and functional AVF patency at 1 year and is cost-effective.Clinical Trial registry name and registration numberLocal Anaesthesia versus Regional Block for Arteriovenous Fistulae, NCT01706354

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A randomized controlled trial of minor hand surgeries comparing wide awake local anesthesia no tourniquet and local anesthesia with tourniquet

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2020.03.013 ◽

2020 ◽

Vol 106 (8) ◽

pp. 1645-1651

Author(s):

Sang Ki Lee ◽

Sung Gul Kim ◽

Won Sik Choy

Keyword(s):

Randomized Controlled Trial ◽

Local Anesthesia ◽

Controlled Trial ◽

Randomized Controlled ◽

Wide Awake ◽

No Tourniquet

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Alkalinized lidocaine solution as a first‐line local anesthesia protocol for intradetrusor injection of onabotulinum toxin A: Results from a double‐blinded randomized controlled trial

Neurourology and Urodynamics ◽

10.1002/nau.24519 ◽

2020 ◽

Vol 39 (8) ◽

pp. 2471-2479

Author(s):

Ricardo Pereira e Silva ◽

Carolina Ponte ◽

Filipe Lopes ◽

José Palma dos Reis

Keyword(s):

Randomized Controlled Trial ◽

Local Anesthesia ◽

Controlled Trial ◽

First Line ◽

Toxin A ◽

Randomized Controlled ◽

Lidocaine Solution ◽

Onabotulinum Toxin A ◽

Double Blinded

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Randomized controlled trial to evaluate intraocular pressure following sub-Tenon′s local anesthesia for cataract surgery: With and without hyaluronidase added to anesthetic solution

Saudi Journal of Anaesthesia ◽

10.4103/1658-354x.144080 ◽

2014 ◽

Vol 8 (5) ◽

pp. 63

Author(s):

RizwanA Cheema ◽

MedhatA Abdelaziz ◽

AshbalaKhattak Khattak ◽

Naif Al-Ali

Keyword(s):

Randomized Controlled Trial ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Local Anesthesia ◽

Controlled Trial ◽

Randomized Controlled ◽

Anesthetic Solution

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A Phase 1, Dose-escalation, Double-blind, Block-randomized, Controlled Trial of Safety and Efficacy of Neosaxitoxin Alone and in Combination with 0.2% Bupivacaine, with and without Epinephrine, for Cutaneous Anesthesia

Anesthesiology ◽

10.1097/aln.0000000000000831 ◽

2015 ◽

Vol 123 (4) ◽

pp. 873-885 ◽

Cited By ~ 33

Author(s):

Kimberly Lobo ◽

Carolina Donado ◽

Laura Cornelissen ◽

Joseph Kim ◽

Rebeca Ortiz ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Adverse Events ◽

Local Anesthesia ◽

Active Sites ◽

Peak Plasma ◽

Controlled Trial ◽

Phase 1 ◽

Double Blind ◽

Safety And Efficacy ◽

Randomized Controlled

Abstract Background: Neosaxitoxin (NeoSTX) is a site-1 sodium channel blocker that produces prolonged local anesthesia in animals and humans. Under a Food and Drug Administration–approved phase 1 Investigational New Drug trial, the authors evaluated safety and efficacy of NeoSTX alone and combined with 0.2% bupivacaine (Bup) with and without epinephrine. Methods: The authors conducted a double-blind, randomized, controlled trial involving healthy male volunteers aged 18 to 35 yr receiving two 10-ml subcutaneous injections. Control sites received Bup. In part 1, active sites received (1) 5 to 40 μg NeoSTX+Saline (NeoSTX-Saline), (2) 5 to 40 μg NeoSTX+Bup (NeoSTX-Bup), or (3) placebo (Saline). In part 2, active sites received 10 or 30 μg NeoSTX+Bup+Epinephrine (NeoSTX-Bup-Epi) or placebo. Primary outcome measures were safety and adverse events associated with NeoSTX. Secondary outcomes included clinical biochemistry, NeoSTX pharmacokinetics, and cutaneous hypoesthesia. Results: A total of 84 subjects were randomized and completed the two-part trial with no serious adverse events or clinically significant physiologic impairments. Perioral numbness and tingling increased with NeoSTX dose for NeoSTX-Saline and NeoSTX-Bup. All symptoms resolved without intervention. NeoSTX-Bup-Epi dramatically reduced symptoms compared with other NeoSTX combinations (tingling: 0 vs. 70%, P = 0.004; numbness: 0 vs. 60%, P = 0.013) at the same dose. Mean peak plasma NeoSTX concentration for NeoSTX-Bup-Epi was reduced at least two-fold compared with NeoSTX-Saline and NeoSTX-Bup (67 ± 14, 134 ± 63, and 164 ± 81 pg/ml, respectively; P = 0.016). NeoSTX-Bup showed prolonged cutaneous block duration compared with Bup, NeoSTX-Saline, or placebo, at all doses. Median time to near-complete recovery for 10 μg NeoSTX-Bup-Epi was almost five-fold longer compared with Bup (50 vs. 10 h, P = 0.007). Conclusion: NeoSTX combinations have a tolerable side effect profile and appear promising for prolonged local anesthesia.

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