No abstract available.
Anesthesia, Local*

The Brown-Robert-Wells(BRW) stereotactic system has many advantages in the supratentorial spontaneous intracerebral hemorrhage(ICH), but is has less accessibility to the spontaneous cerebellar hemorrhage by stereotactic suboccipital approach. To overcome this disadvantage, we have tried to treat stereotactically three patients of spontaneous intracerebellar hemorrhage through tentorium using BRW stereotaxis and gradual irrigation wth urokinase(UK). This new approach has been used successfully under the local anesthesia with satisfactory postoperative neurological results. We present a detailed technique of this approach.
Anesthesia, Local ; Hemorrhage* ; Humans

This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at 16(th) postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.
Anesthesia, Local ; Fluoroscopy ; Gastrostomy*

No abstract available.
Anesthesia, Local* ; Arthroscopy* ; Knee*

No abstract available.
Anesthesia, Local* ; Arthroscopy* ; Knee*

The objective of this review was to investigate the efficacy of dental local anesthetics, as it is well known among clinicians that local anesthesia may be challenging in some circumstances. Therefore, the focus of this review was on the efficacy of the products used in dental local anesthesia. In a Pubmed database literature search conducted, a total of 8646 articles were found to be related to dental local anesthetics. After having applied the inclusion criteria (human research, performed in the last 10 years, written in English language, and focus on dental local anesthetics) and having assessed the quality of the papers, 30 were deemed eligible for inclusion in this review. The conclusion of this review is that none of the dental local anesthetic amides provide 100% anesthesia. The problem appears to be more pronounced when mandibular teeth are attempted to be anaesthetized and especially if there is irreversible pulpitis involved. The authors conclude that this finding suggest exploration of more efficient techniques to administer dental local anesthesia, especially in the mandible, to establish a 100% efficacy, is needed.
Amides ; Anesthesia ; Anesthesia, Local ; Anesthetics, Local ; Mandible ; Pulpitis ; Tooth

The authors report two cases of intractable cancer pain, which was managed by bilateral cingulotomy. The technique involved stereotaxis using magnetic resonance guidance and local anesthesia, with the introduction of a mechanical and chemical lesion(absolute alcohol). Postoperative pain relief was excellent that lasted relatively prolonged period of time until disease has far advanced. There were no complications related to procedure. Bilateral stereotactic cingulotomy is considered safe, feasible and most of all, effective in the severe, disabling pain from metastatic lesion. Also, a invasive surgery with general anesthesia can be avoided.
Anesthesia, General ; Anesthesia, Local ; Pain, Postoperative

BACKGROUND: Arterial hypotension secondary to a sympathectomy from a spinal block remains to be a major concern among anesthesiologists. Preloading and use of vasoconstrictor agents have been used to prevent this. The modification of level of blockade through position change will be explored in this study METHODS: A randomized double-blind study was done to evaluate the effects of prolonged lateral positioning on the spread of block and hemodynamic variables after spinal anesthesia with hyperbaric tetracaine. Two hundred twenty five (n=225) ASA PS I-III patients for unilateral lower limb surgery under spinal anesthesia were given tetracaine 0.6 percent heavy with volume adjusted to height. The patients were randomized into 3 groups: Group I (conventional, n=75)were placed supine immediately after spinal injection; Group 11 (n=75) were maintained for 10 minutes in the lateral position before being turned supine; and Group III (n=75) remained for 15 minutes then turned supine. Dermatomal sensory levels and degrees of motor block for both dependent and nondependent sides were recorded for all the groups as well as the incidence of hypotension and bradycardia RESULTS: The study showed that although there were few patients with complete unilateral block in the 10-(n=4) and 15-minute (n=6) groups, the maximum height of sensory level attained as well as the maximum degree of motor block effected were significantly higher on the dependent side for both experimental groups than the nondependent side (P0.001). The conventional patients all showed equal bilateral distribution of spinal block. The time to onset, two-segment regression of sensory block, and one-degree regression of motor block were significantly faster in the conventional group than the experimental groups (P0.001). The incidence of hypotension in both 10-minute (13 percent) and 15-minute groups (5 percent) were significantly lower than in the conventional group (39 percent). The conventional group also had greater mean systolic and diastolic blood pressure changes from the baseline (P0.001). No significant difference was noted in the incidence of bradycardia among the groups (P0.05). CONCLUSION: Prolonged lateral positioning with hyperbaric tetracaine produces asymmetric spinal blockade and effectively reduces the incidence of adverse hemodynamic effects such as hypotension in both the 10-minute and 15-minute groups. (Author)
Human ; HYPOTENSION ; ANESTHESIA ; SPINAL, SURGERY ; ANESTHESIA, LOCAL

Office-based procedures of laryngoesophageal region have become significantly more common in recent years. The term "office-based" refers to an awake patient in an upright position, typically with no sedation and receiving local topical anesthesia alone. The goal of this article is to introduce various recent office-based laryngological procedures, including diagnosis and treatment and to review of literatures along with our experiences. The authors hope that this document will encourage otolaryngologists to expand the role of office-based diagnosis and treatment in laryngology for the best treatment of their patients' care.
Anesthesia ; Anesthesia, Local ; Esophagus ; Humans ; Larynx ; Otolaryngology

One complication related to local anesthesia in the dental clinic is a broken needle. Although rare, a broken needle may be difficult to retrieve. Dental radiographs and 3D CT have been used in the past to confirm the location of a broken needle. We present the case of a broken needle, which was successfully removed using a careful, microscopic approach.
Anesthesia, Local ; Dental Clinics ; Needles*