-
Drug Delivery Dec 2024Pain management remains among the most common and largely unmet clinical problems today. Local anesthetics play an indispensable role in pain management. The main... (Review)
Review
Pain management remains among the most common and largely unmet clinical problems today. Local anesthetics play an indispensable role in pain management. The main limitation of traditional local anesthetics is the limited duration of a single injection. To address this problem, catheters are often placed or combined with other drugs in clinical practice to increase the time that local anesthetics act. However, this method does not meet the needs of clinical analgesics. Therefore, many researchers have worked to develop local anesthetic extended-release types that can be administered in a single dose. In recent years, drug extended-release systems have emerged dramatically due to their long duration and efficacy, providing more possibilities for the application of local anesthetics. This paper summarizes the types of local anesthetic drug delivery systems and their clinical applications, discusses them in the context of relevant studies on local anesthetics, and provides a summary and outlook on the development of local anesthetic extended-release agents.
Topics: Anesthetics, Local; Pain Management; Anesthesia, Local; Analgesics; Drug Delivery Systems
PubMed: 38130151
DOI: 10.1080/10717544.2023.2296349 -
Current Urology Sep 2023Ureteroscopy during pregnancy has become increasingly recognized as a safe intervention. Performing it under local anesthesia and light sedation reduces the risks...
Ureteroscopy during pregnancy has become increasingly recognized as a safe intervention. Performing it under local anesthesia and light sedation reduces the risks associated with general or regional anesthesia, such as difficult airway scenarios, hypothermia, and hypotension. In addition, this approach reduces the total amount of fetal exposure to medications and anesthetic agents. Performing ureteroscopy in this manner requires a number of adjustments and modifications to the standard technique. This article provides a summary in a step-by-step format, as well as an accompanying video demonstration.
PubMed: 37448618
DOI: 10.1097/CU9.0000000000000180 -
World Journal of Otorhinolaryngology -... Sep 2023To provide an overview of the various treatment options available in the clinic to achieve periorbital rejuvenation. (Review)
Review
OBJECTIVE
To provide an overview of the various treatment options available in the clinic to achieve periorbital rejuvenation.
DATA SOURCES
Literature review and expert opinion.
CONCLUSIONS
Periorbital rejuvenation in the clinic can be accomplished through a variety of treatment modalities, including topical therapies, skin resurfacing, and fillers and injectables. Furthermore, some surgical approaches, such as upper blepharoplasties, ptosis, and brow lifts, can be performed in the clinic under local anesthesia with only mild oral sedation. However, the successful execution of such procedures depends on proper patient selection and maximizing patient comfort.
PubMed: 37780673
DOI: 10.1002/wjo2.124 -
Indian Journal of Ophthalmology Jul 2023Cataract surgery ranks among the commonest procedures performed worldwide. Approximately 51% of blindness worldwide is related to cataracts, affecting about 65.2 million... (Review)
Review
Cataract surgery ranks among the commonest procedures performed worldwide. Approximately 51% of blindness worldwide is related to cataracts, affecting about 65.2 million people worldwide and more so in developing countries. Over the years, there has been a significant evolution in the surgical techniques of cataract extraction. The advancement in phacoemulsification machines, phaco-tips, and the availability of ophthalmic viscoelastic devices have played a substantial role in cataract surgery such that they are faster and more controlled than before. Similarly, anesthetic techniques in cataract surgery have advanced significantly from retrobulbar, peribulbar, and sub-Tenon's blocks to topical anesthesia. Though topical anesthesia eliminates the possible complications of injectable anesthesia, it is not suitable for use in uncooperative, anxious patients, pediatric age groups, and patients with cognitive disabilities. Hyaluronidase is an enzyme that breaks down hyaluronic acid in the retrobulbar tissue, facilitating uniform diffusion of the anesthetic drug and hastening the onset of anesthesia and akinesia. Hyaluronidase has been used in the last 80 years successfully as an adjuvant in retrobulbar, peribulbar, and sub-Tenon's blocks. Initially, the hyaluronidase enzyme was animal-derived and of bovine and ovine sources. Recombinant human-derived hyaluronidase, which has lesser allergic reactions, impurities, and toxicity, is now available. There is conflicting evidence regarding the efficacy of hyaluronidase as an adjuvant in retrobulbar and peribulbar blocks. This article summarizes a brief review of the literature on the role of hyaluronidase as an adjuvant in local anesthetic blocks in ophthalmic surgeries.
Topics: Humans; Animals; Cattle; Sheep; Child; Anesthesia, Local; Hyaluronoglucosaminidase; Anesthetics, Local; Cataract Extraction; Cataract; Lidocaine
PubMed: 37417102
DOI: 10.4103/IJO.IJO_2515_22 -
Journal of Anaesthesiology, Clinical... 2023Effective and safe ophthalmic anesthesia is essential for the delivery of ophthalmic perioperative care both for children and adults. Recent years have seen a major... (Review)
Review
Effective and safe ophthalmic anesthesia is essential for the delivery of ophthalmic perioperative care both for children and adults. Recent years have seen a major change in form of smaller incisions for most ophthalmic surgical techniques, thus making them less invasive. Additionally, most ophthalmic surgeries are now day-care surgeries at ambulatory surgical centers. The parallel advancements in the field of anesthesiology have boosted the standard of perioperative care. The purpose of this narrative review was to evaluate current trends in anesthetic agents and techniques for ophthalmic anesthesia primarily centered around deep sedation and general anesthesia as per the concerns of practicing anesthesiologists while briefly acquainting with local anesthesia advances.
PubMed: 38025549
DOI: 10.4103/joacp.joacp_555_21 -
The Japanese Dental Science Review Dec 2023Acute dental pain is a common issue leading to dental consultation. Besides causal therapy, patients are treated with acupuncture, but efficacy in acute dental pain is... (Review)
Review
Acute dental pain is a common issue leading to dental consultation. Besides causal therapy, patients are treated with acupuncture, but efficacy in acute dental pain is still not clarified. We aimed to evaluate results of recent research to estimate the efficacy of acupuncture compared to pain-relieving approaches in treatment of acute dental pain. A systematic review of controlled trials being published between database inception and 2020 were conducted to evaluate the efficacy of acupuncture (alone or as complementary therapy) compared to local anesthesia or conventional analgesic medications in acute dental pain (intraoperatively and postoperatively) and to clarify whether acupuncture reduces the use of postoperative analgesic medications. Of 1672 publications, 23 publications met the inclusion criteria. From these, 11 randomized controlled trials (n = 668) reported on the efficacy of acupuncture on postoperative acute dental pain. Patients, who received acupuncture, showed lower pain scores postoperatively compared to sham acupuncture (Relative Risk -0.77, 95% Confidence interval -1.52 to -0.03). Overall, the results suggest a potential role of acupuncture in improving acute dental pain intraoperatively and postoperatively as well as improving the efficacy of local anesthesia, but the results are limited due to methodological shortcomings emphasizing the necessity for future high-quality research.
PubMed: 36950225
DOI: 10.1016/j.jdsr.2023.02.005 -
World Journal of Otorhinolaryngology -... Sep 2023Office-based procedures can be a fulfilling part of the facial plastic practice with the right tools, personnel, and preparation. Equipping the clinic for office-based... (Review)
Review
Office-based procedures can be a fulfilling part of the facial plastic practice with the right tools, personnel, and preparation. Equipping the clinic for office-based procedures has several unique considerations that ultimately impact its success. It is important to strategize preemptively regarding what treatments will be offered and the respective equipment that will allow the safe, cost-effective, and high-quality delivery of those treatments. Most procedures in the office-based setting are cosmetic in nature and there are often overlapping treatment modalities that target similar outcomes. Patient selection and counseling is a crucial step in preparing for office-based procedures in the effort to maximize patient satisfaction. Nearly all the most common facial plastic procedures can be delivered in the office-based based setting under local anesthesia and moderate sedation, depending on the expertise of the surgeon. To enable these and other categories of treatments, there are certain expensive pieces of technology that one might consider for their office-based practice and other fundamental supplies that are necessary for almost all practices. Though the initial investment in equipment can be costly, this article also discusses more affordable alternatives or third-party sales of devices and equipment. The field of facial plastic surgery is very dynamic and having both peer and mentorship networks is invaluable in navigating some of the financial decisions discussed herein. This article also briefly covers personnel, training, and accreditation considerations.
PubMed: 37780671
DOI: 10.1002/wjo2.120 -
Medical Science Monitor : International... Jun 2023BACKGROUND Ablation has been developed as a radical surgical procedure for liver tumors. Local anesthesia in combination with general anesthesia or intravenous sedation... (Review)
Review
BACKGROUND Ablation has been developed as a radical surgical procedure for liver tumors. Local anesthesia in combination with general anesthesia or intravenous sedation is needed in ablative procedures. Although many studies have been published, a related bibliometric study is lacking. The present bibliometric analysis aimed to further understand the current situation of anesthesia for liver tumor ablation and discover candidate novel research directions. MATERIAL AND METHODS Web of Science Core Collection (WoSCC) was searched to identify studies associated with anesthesia for liver tumor ablation. Also, countries, journals, authors, and institutes contribution together with co-occurrence relations were analyzed by R, VOSviewer, and CiteSpace software; meanwhile, relevant research hotspots together with potential future trends were identified. RESULTS This work obtained 183 English-language documents during 1999-2022, and the annual growth rate was 8.83%. Most studies were conducted in the United States (24.04%, 44/183). The Oslo Univ Hosp contributed the most publications (n=11, 6.01%). Livraghi T (n=6), De Baere T (n=5), and Goldberg SN (n=4) ranked top in terms of cited authors and top authors. Keywords from that co-cited network were aggregated and identified, which revealed a shift in the liver tumor ablation anesthesia field. Initially, hotspots were predominantly "alcohol injection", "radiofrequency tissue ablation", and "metastases", but hotspots shifted to "efficacy", "ablation", "pain", "microwave ablation", "management", "analgesia", "safety", "irreversible electroporation", and "anesthesia" recently. CONCLUSIONS Anesthesia has received increased attention as liver tumor ablation advances. Bibliometric study findings provide insight into the current state and trends of anesthesia in liver tumor ablation research.
Topics: Humans; Anesthesia, General; Anesthesiology; Bibliometrics; Liver Neoplasms; Pain
PubMed: 37277976
DOI: 10.12659/MSM.939607