scholarly journals 05 / Topical lidocaine 2% gel for analgesia and patient comfort during interscalene brachial plexus and axillary blocks: A noninferiority randomized controlled trial

2018 ◽  
Author(s):  
Cédric Bouts
Keyword(s):  
Randomized Controlled Trial ◽  
Brachial Plexus ◽  
Controlled Trial ◽  
Patient Comfort ◽  
Randomized Controlled ◽  
Topical Lidocaine

scholarly journals The impact of topical lidocaine and timing of LMA removal on the incidence of airway events during the recovery period in children: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruiqiang Sun ◽  
Xiaoyun Bao ◽  
Xuesong Gao ◽  
Tong Li ◽  
Quan Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Recovery Period ◽  
Awake State ◽  
Randomized Controlled ◽  
Laryngeal Spasm ◽  
Topical Lidocaine ◽  
Lubricant Application ◽  
Pacu Stay ◽  
The Impact

Abstract Background The timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events. Methods This randomized controlled trial assessed one-to-six-year-old children with ASA I-II scheduled for squint correction surgery under general anesthesia. The children were randomized into the LA (lidocaine cream smeared to the cuff of the LMA before insertion, with mask removal in the awake state), LD (lidocaine application and LMA removal under deep anesthesia), NLA (hydrosoluble lubricant application and LMA removal in the awake state) and NLD (hydrosoluble lubricant application and LMA removal in deep anesthesia) groups. The primary endpoint was a composite of irritating cough, laryngeal spasm, SpO2 < 96%, and glossocoma in the recovery period in the PACU. The secondary endpoints included the incidence of pharyngalgia and hoarseness within 24 h after the operation, duration of PACU stay, and incidence of agitation in the recovery period. The assessor was unblinded. Results Each group included 98 children. The overall incidence of adverse airway events was significantly lower in the LA group (9.4%) compared with the LD (23.7%), NLA (32.6%), and NLD (28.7%) groups (P=0.001). Cough and laryngeal spasm rates were significantly higher in the NLA group (20.0 and 9.5%, respectively) than the LA (5.2 and 0%, respectively), LD (4.1 and 1.0%, respectively), and NLD (9.6 and 2.1%, respectively) groups (P=0.001). Glossocoma incidence was significantly lower in the LA and NLA groups (0%) than in the LD (19.6%) and NLD (20.2%) groups (P< 0.001). At 24 h post-operation, pharyngalgia incidence was significantly higher in the NLA group (15.8%) than the LA (3.1%), LD (1.0%), and NLD (3.2%) groups (P< 0.001). Conclusions LMA removal in the awake state after topical lidocaine anesthesia reduces the incidence of postoperative airway events. Trial registration ChiCTR, ChiCTR-IPR-17012347. Registered August 12, 2017.

scholarly journals Gastroscopy Should Come Before Colonoscopy Using CO2 Insufflation in Same Day Bidirectional Endoscopies: A Randomized Controlled Trial

2019 ◽  
Vol 3 (3) ◽  
pp. 120-126
Author(s):  
Fahd Jowhari ◽  
Lawrence Hookey
Keyword(s):  
Carbon Dioxide ◽  
Randomized Controlled Trial ◽  
Primary Outcome ◽  
Conscious Sedation ◽  
Controlled Trial ◽  
Patient Comfort ◽  
Clinical Indication ◽  
Randomized Controlled ◽  
Co2 Insufflation ◽  
Carbon Dioxide Co2

Abstract Background and Aims Same day bidirectional endoscopies (esophagogastroduodenoscopies [EGD]s and colonoscopies) are routinely performed. However, the best sequence of procedures is unknown, as is whether the use of carbon dioxide (CO2) affects the preferred sequence of procedures. This study aims to determine the preferred sequence of procedures and choice of insufflation gas (air or CO2) in patients undergoing same day bidirectional endoscopies. Methods Two hundred adults with a clinical indication for same day bidirectional endoscopies were randomized equally into four groups: A1 (EGD first, CO2 as insufflator); A2 (EGD first, air as insufflator); B1 (colonoscopy first, CO2 as insufflator); and B2 (colonoscopy first, air as insufflator). All procedures were performed with conscious sedation (Midazolam/Fentanyl). The primary outcome was patients’ overall comfort/satisfaction with the procedures and sedation received, as assessed by questionnaires and validated scoring scales (Nurse-Assessed Patient Comfort Score [NAPCOMS], La Crosse [WI]) collected during the procedures, before discharge, and on day 7 postprocedure. Results Two hundred patients were randomized, with data available for 186. Mean Midazolam dose between groups was significantly less in the EGD first groups (P=0.01). During the procedures, no differences were found in patients’ comfort as per the nurse reported NAPCOMS scores (P=0.19) or the Lacrosse (WI) endoscopy scores (P=0.05). On postprocedure days 0 and 7, no differences were found in the patients’ reported Lacrosse (WI) scores, nausea, sore throat, dizziness, satisfaction with sedation or overall level of procedural satisfaction (P&gt;0.05 for each). However, bloating and discomfort were significantly lower in the CO2 arms (P&lt;0.001). Conclusions This randomized controlled trial using validated patient comfort scoring assessments for same day bidirectional endoscopies demonstrated that the sequence of procedures affects the sedation used but does not affect overall patient comfort or satisfaction. Lesser sedation is needed in the EGD first group, and less postprocedural abdominal pain/discomfort and bloating is seen with CO2 insufflation.

Sign in / Sign up

Export Citation Format

Share Document