Humans ; Lidocaine ; Anesthesia, Local ; Radius Fractures/surgery* ; Anesthetics, Local/adverse effects* ; Bone Plates ; Fracture Fixation, Internal

An allergic reaction was occurred in a 17-years old girl who was undergoing local anesthesia before tonsillectomy. Ptosis was observed in right side of patient shortly after injection of lidocaine to right palate. Then the patient feel grasp and cough, accompanied by nausea and vomiting. The patient was placed in supine position. Dexamethasone and epinephrine was administrated intramuscularly, symptoms were relieved 10 minutes later.
Adolescent ; Anesthesia, Local ; adverse effects ; Eyelids ; drug effects ; Female ; Humans ; Lidocaine ; adverse effects ; Muscle Weakness ; chemically induced

No abstract available.
Anesthesia, Local/*adverse effects ; Anesthetics, Local/administration & dosage/*adverse effects ; Eye Movements/*drug effects ; Female ; Humans ; Middle Aged ; Ocular Motility Disorders/*chemically induced/diagnosis/physiopathology ; Oculomotor Muscles/drug effects/*physiopathology ; Phacoemulsification/*adverse effects ; *Postoperative Complications

OBJECTIVE: To conclude the correlation between the alternatives of anesthesia--general and local anesthesia--and the complications of nasal endoscopic surgeries. METHOD: Summing up the occurrence rates of the complications from 176 cases (321 sides) of patients with sinusitis(some were air crew); comparing and calculating these complications according to the ways of anesthesia which were adopted in the surgeries. RESULT: The occurrence rates of the complications from nasal endoscopic surgeries were 6.9% (22/321) and rates of major complications were 1.6% (5/321). Rates of 1.9% (4/210) occurred after surgeries with local anesthesia, 16.2% (18/111) with general anesthesia, which indicated the striking differences between them (chi2 = 21.11, P < 0.01). There were no differences between the types of diseases resulted from the choice of anesthesia (Type I and Type II, Type I and Type II, Type II and Type III chi2 = 0.06, 2.56, 3.82; P > 0.05). However, the incidences of various types of complications with local anesthesia were less than those with general anesthesia, which differed significantly within two groups (P < 0.05). No cases of obvious complications occurred to air crew. CONCLUSION The occurrence rates of complications of endoscopic surgeries with local anesthesia are lower than that of those with general anesthesia, which is worth promoting in ground crew and sing for reference to elevate rate of resuming flight in aircrew.
Adolescent ; Adult ; Aged ; Anesthesia, General ; adverse effects ; Anesthesia, Local ; adverse effects ; Child ; Chronic Disease ; Endoscopy ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sinusitis ; surgery ; Young Adult

OBJECTIVETo investigate the feasibility of continuation of aspirin before tooth extraction in the elderly.

METHODSThe patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction. 300 elderly outpatients used lidocaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group I, 100 patients with prolong use of aspirin before tooth extraction as observation group I. 300 elderly outpatients used compound articaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group II, 100 patients with prolong use of aspirin before tooth extraction as observation group II.Bleedings at 5, 10, 30 min, 24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed.

RESULTSThere was no significant difference at 5, 10, 30 min, 24 h in postoperative bleeding after extraction between control group I and observation group. The incidence of bleeding of observation group II after tooth extraction at 5 min was higher than that of control group II and there was no significant difference at 10, 30 min, 24 h between the two groups.

CONCLUSIONSContinuation of aspirin have no influence on postoperative bleeding. Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.

Aged ; Aged, 80 and over ; Anesthesia, Local ; Aspirin ; adverse effects ; Female ; Humans ; Lidocaine ; Male ; Middle Aged ; Oral Hemorrhage ; etiology ; Platelet Aggregation Inhibitors ; adverse effects ; Postoperative Hemorrhage ; etiology ; Tooth Extraction ; adverse effects

OBJECTIVETo evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis.

METHODSA total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth: the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4% articaine and 1:100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure.

RESULTSThe overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively; χ² = 34.3, P<0.01). Both the PM and SM groups showed higher success rates than that of the FM group (v=1, χ² = 16.73, P<0.01; v=1, χ² = 24.5, P<0.01). No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups.

CONCLUSIONThe computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

Adolescent ; Adult ; Anesthesia, Dental ; adverse effects ; methods ; Anesthesia, Local ; adverse effects ; methods ; Anesthetics, Local ; administration & dosage ; Carticaine ; administration & dosage ; Drug Delivery Systems ; Humans ; Injections ; Mandible ; Mandibular Nerve ; Middle Aged ; Molar ; Nerve Block ; adverse effects ; methods ; Pain Measurement ; Periodontal Ligament ; Pulpitis ; therapy ; Therapy, Computer-Assisted ; Treatment Outcome ; Young Adult

OBJECTIVETo study the significance and safety of flexible bronchoscopy and balloon dilatation in the diagnosis and treatment of respiratory diseases in children.

METHODSA total of 438 children (236 males and 202 females) with respiratory diseases who were aged from 17 days to 15 years, were examined and/or treated by bronchoscopy (including bronchoscopic intervention) under local anesthesia.

RESULTSOf the 438 children, 311 were diagnosed with pulmonary infection, 68 with atelectasis, 36 with recurrent cough and asthma, 6 with hemoptysis of unknown origin, 6 with bronchial foreign body, 5 with congenital bronchopulmonary dysplasia, 2 with bronchiectasis, 1 with ciliary dyskinesia syndrome, 1 with lung tumor, and 2 with congenital immunodeficiency disease. After bronchoscopic examination, local flushing or bronchoalveolar lavage, and foreign body extraction, marked response was seen in 379 cases and response was seen in 46 cases. High-pressure balloon dilatation under bronchoscopy was performed in 5 cases with inflammatory stricture and achieved satisfying clinical effect. No severe complications were found in bronchoscopy.

CONCLUSIONSBronchoscopy and balloon dilatation under local anesthesia is safe and effective for the diagnosis and treatment of respiratory diseases in children.

Adolescent ; Anesthesia, Local ; Bronchoscopy ; adverse effects ; methods ; Child ; Child, Preschool ; Dilatation ; methods ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Respiratory Tract Diseases ; diagnosis ; therapy

OBJECTIVETo evaluate the clinical outcomes of percutaneous kyphoplasty (PKP) in treating senile osteoporotic vertebral compression fractures under local anesthesia.

METHODSFrom May 2007 to May 2010,129 patients with osteoporotic vertebral compression fractures were treated with PKP under local anesthesia. There were 47 males and 82 females, ranging in age from 61 to 92 years old,with an average of 73.7 years old,including 88 segments of thoracic vertebrae and 101 segments of lumbar vertebrae. Visual analogue scale (VAS),height of vertebral body,Cobb's angle were evaluated before and after operation.

RESULTSOperations were performed successfully in all patients and these patients were followed up from 24 to 60 months with an average of 34.2 months. Preoperative,postoperative two weeks and at final follow-up,VAS score was 7.9+/-2.5,2.8+/-1.8,3.0+/-2.2,respectively;Cobb angle was (28.3+/-13.7)degree, (16.2+/-9.8)degree, (19.1+/-10.3)degree, respectively. There was significant difference between postoperative and preoperative, and between at final follow up and preoperative (P<0.05). The height of vertebral body obtained partial recovery. Bone cement leakage occurred in 23 vertebrae (with proportion of 17.8%) during operation,among one patient with temporary clinical symptom of radiculalgia. All lumbago obtained obviously anesis after operation, 1 case complicated with respiratory depression and recovered after resuscitation; 1 case complicated with intestinal obstruction and improved after treatment, 1 case complicated with fracture separation of vertebral body by bone cement, and 4 cases complicated with fracture of adjacent vertebral body.

CONCLUSIONPercutaneous vertebral kyphoplasty is an effective method for treatment of senile osteoporotic vertebral compression fractures,which can expeditiously relieve pain and effectively recovery height of vertebral body and Cobb angle,it has advantages of minimal invasive. The results of short and mid-term follow-up were satisfactory, long-term follow-up is still needed. Correctly choosing the operative indication and improving surgical technique may avoid complications, especially bone cement leakage which is the most frequent complication.

Aged ; Aged, 80 and over ; Anesthesia, Local ; methods ; Female ; Follow-Up Studies ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; adverse effects ; methods ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Spinal Fractures ; surgery

OBJECTIVE: This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. MATERIALS AND METHODS: A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). RESULTS: The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was administered. Four patients had an equivalent pain score for both treatments. This finding was also statistically significant (p = 0.001). CONCLUSION: In our study, patient pain scales were significantly lower when no local anesthesia was used prior to US-FNABs of thyroid nodules as compared to when local anesthesia was administered. Therefore, we believe that when one needle puncture is used, US-FNAB should be performed without administering local anesthesia.
Adult ; Aged ; Anesthesia, Local/*utilization ; Biopsy, Fine-Needle/*adverse effects ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Prospective Studies ; Punctures/adverse effects ; Statistics, Nonparametric ; Thyroid Neoplasms/*pathology/ultrasonography ; Thyroid Nodule/*pathology/ultrasonography ; *Ultrasonography, Interventional

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor , confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.
Anesthesia, Dental ; Anesthesia, Local ; Arrhythmias, Cardiac ; Cardiovascular System ; Causality ; Central Nervous System ; Dizziness ; Drug-Related Side Effects and Adverse Reactions ; Heart Arrest ; Heart Diseases ; Humans ; Incidence ; Parenteral Nutrition ; Pregnancy ; Prevalence ; Risk Factors ; Unconsciousness