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Anaesthesiology Intensive Therapy 2021Respiratory complications are one of the main problems in paediatric anaesthesia. Cherubism is a rare fami-lial disease causing enlargement of the mandible that may be...
Respiratory complications are one of the main problems in paediatric anaesthesia. Cherubism is a rare fami-lial disease causing enlargement of the mandible that may be associated with difficult intubation [1, 2]. A 5-year-old, 20 kg, ASA 1, healthy girl was evaluated for anaesthesia requested for the removal of mandibular lesions (Figure 1). She had a positive family history of cherubism; her father and cousins were affected. Radiogra-phically, the lesions demonstrated multilocular, expansile radiolucencies with mandibular enlargement. The preoperative examination was unremarkable: normal neck flexion, no trismus, and a Mallampati score of 1. A venous catheter was inserted peripherally under N2O inhalation and transdermic lidocaine and prilocaine patch. The general anaesthesia combined sevoflurane and IV sufentanil. Nasotracheal intubation under direct laryngoscopy was uneventful. After the surgery, which lasted 120 minutes, she was admitted to the post anaesthesia care unit for 1 night and discharged the next day without any sequelae.
Topics: Anesthesia, General; Anesthesiology; Cherubism; Child; Child, Preschool; Female; Humans; Intubation, Intratracheal; Laryngoscopy
PubMed: 34006057
DOI: 10.5114/ait.2021.105980 -
Journal of Dental Anesthesia and Pain... Apr 2020Dental local anesthesia is performed daily on a global scale. Adverse effects are rare, but the topic of neurotoxicity of local anesthetics deserves to be explored, as... (Review)
Review
Dental local anesthesia is performed daily on a global scale. Adverse effects are rare, but the topic of neurotoxicity of local anesthetics deserves to be explored, as publications can be controversial and confusing. Therefore, a need was felt to address and question the evidence for potential neurotoxicity of dental local anesthetics. This review aimed to assess the studies published on the neurotoxicity of dental local anesthetics. A Pubmed® search was conducted between January 2019 and August 2019. This revealed 2802 hits on the topic of neurotoxicity or cytotoxicity of the following anesthetics: lidocaine, prilocaine, mepivacaine, articaine, ropivacaine, and bupivacaine. Only 23 papers were deemed eligible for this review: 17 studies, 3 reviews and 3 audits of national inquiries. The heterogeneous literature on this topic showed that all dental local anesthetics are potentially neurotoxic in a concentration and/or exposure time fashion. There seems no consensus about what cell lines are to be used to investigate the neurotoxicity of local anesthetics, which makes the comparison between studies difficult and ambiguous. However, the bottom line is that all dental local anesthetics have a neurotoxic potential, but that there is no unanimity in the publications about which local anesthetic is the least or the most neurotoxic.
PubMed: 32395611
DOI: 10.17245/jdapm.2020.20.2.63 -
International Journal of Pharmaceutics Jun 2021Lipid nanocapsules (LNC) are special drug delivery system (DDS) carriers obtained by the phase-inversion temperature method (PIT). This study describes the encapsulation...
Lipid nanocapsules (LNC) are special drug delivery system (DDS) carriers obtained by the phase-inversion temperature method (PIT). This study describes the encapsulation of the local anesthetics (LA) prilocaine (PLC) and lidocaine (LDC) in lipid nanocapsules (LNC) optimized by 2 factorial design, characterized through DLS, NTA, CRYO-EM and release kinetics and incorporated in carbopol gel (Gel) prior to in vivo anesthetic effect (in mice) evaluation. A very homogeneous population of small (50 nm; polydispersity index = 0.05) spherical nanocapsules with negative zeta potentials (-21 mV) and ca. 2.3 × 10 particles/mL was obtained. The encapsulation efficiency was high (81% and 89% for prilocaine and lidocaine, respectively). The release rate profile was free PLC = free LDC > LNC > Gel. The hybrid system increased (4x) the anesthesia time in comparison to an equipotent gel formulation prepared without LNC. No tissue damage was detected on the tail skin of mice that received the formulations. This study shows that lipid nanocapsules are suitable carriers for PLC and LDC, promoting longer and safer topical anesthesia. Gel is mucoadhesive and suitable for application in the mouth, where it could be used as a pre-anesthetic, to reduce pain of needle stick (infiltrative anesthesia).
Topics: Anesthetics, Local; Animals; Lidocaine; Lipids; Mice; Nanocapsules; Prilocaine
PubMed: 33961954
DOI: 10.1016/j.ijpharm.2021.120675 -
Daru : Journal of Faculty of Pharmacy,... Jun 2021This study investigated whether thymoquinone (TQ) could alleviate central nervous system (CNS) and cardiovascular toxicity of prilocaine, a commonly used local...
PURPOSE
This study investigated whether thymoquinone (TQ) could alleviate central nervous system (CNS) and cardiovascular toxicity of prilocaine, a commonly used local anesthetic.
METHODS
Rats were randomized to the following groups: control, prilocaine treated, TQ treated and prilocaine + TQ treated. Electroencephalography and electrocardiography electrodes were placed and trachea was intubated. Mechanical ventilation was initiated, right femoral artery was cannulated for continuous blood pressure measurements and blood-gas sampling while the left femoral vein was cannulated for prilocaine infusion. Markers of myocardial injury, reactive oxygen/nitrogen species (ROS/RNS) generation and total antioxidant capacity (TAC) were assayed by standard kits. Aquaporin-4 (AQP4), nuclear factor(NF)κB-p65 and -p50 subunit in brain tissue were evaluated by histological scoring.
RESULTS
Blood pH and partial oxygen pressure, was significantly decreased after prilocaine infusion. The decrease in blood pH was alleviated in the prilocaine + TQ treated group. Prilocaine produced seizure activity, cardiac arrhythmia and asystole at significantly lower doses compared to prilocaine + TQ treated rats. Thymoquinone administration attenuated levels of myocardial injury induced by prilocaine. Prilocaine treatment caused increased ROS/RNS formation and decreased TAC in heart and brain tissue. Thymoquinone increased heart and brain TAC and decreased ROS/RNS formation in prilocaine treated rats. AQP4, NFκB-p65 and NFκB-p50 expressions were increased in cerebellum, cerebral cortex, choroid plexus and thalamic nucleus in prilocaine treated rats. Thymoquinone, decreased the expression of AQP4, NFκB-p65 and NFκB-p50 in brain tissue in prilocaine + TQ treated rats.
CONCLUSION
Results indicate that TQ could ameliorate prilocaine-induced CNS and cardiovascular toxicity.
Topics: Animals; Anticonvulsants; Aquaporin 4; Benzoquinones; Blood Pressure; Brain; Cardiotonic Agents; Cardiotoxicity; Epilepsy; Heart; Heart Rate; Male; Myocardium; NF-kappa B p50 Subunit; Neuroprotective Agents; Prilocaine; Rats, Wistar; Reactive Nitrogen Species; Reactive Oxygen Species; Transcription Factor RelA; Rats
PubMed: 33469802
DOI: 10.1007/s40199-020-00385-2 -
International Wound Journal Oct 2019This study aimed to demonstrate the antibacterial effects of bupivacaine and prilocaine on Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. In our... (Comparative Study)
Comparative Study
This study aimed to demonstrate the antibacterial effects of bupivacaine and prilocaine on Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. In our study, the in vitro antimicrobial effects of 20 mg/mL prilocaine and 5 mg/mL bupivacaine were tested against a S. aureus American-type culture collection (ATCC) 29213, P. aeruginosa ATCC 27853, and E. coli ATCC 25922, divided into Group P (Prilocaine) and Group B (Bupivacaine), respectively. S. aureus ATCC 29213, P. aeruginosa ATCC 27853, and E. coli ATCC 25922 were cultured on Mueller Hinton agar (Oxoid, Basingstoke, UK) plates for 18 to 24 hours at 37°C. In terms of inhibition zone diameters, inhibition of S. aureus ATCC 29213 was observed in both groups at the 12th and 24th hours. The 12th- and 24th-hour S. aureus ATCC 29213 value was significantly higher in Group P compared with Group B (P = .008). At the 12th and 24th hours, inhibition of E. coli ATCC 25922 was observed in both groups. The 12th- and 24th-hour E. coli ATCC 25922 value was significantly higher in Group P compared with Group B (P = .008). In our study, it was seen that prilocaine and bupivacaine had an antimicrobial effect on S. aureus and E. coli. In the comparison between these two local anesthetics (LAs), this effect was found to be significantly higher in prilocaine than bupivacaine. Therefore, we are of the opinion that antimicrobial effect potentials should also be taken into account in the selection of an LA agent in order to prevent the complications of an infection that might develop during LA infiltration and might lead to serious morbidity.
Topics: Bupivacaine; Escherichia coli; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Prilocaine; Pseudomonas aeruginosa; Sensitivity and Specificity; Staphylococcus aureus; Statistics, Nonparametric
PubMed: 31407480
DOI: 10.1111/iwj.13180 -
Anaesthesia Jun 2021
Topics: Anesthesia, Obstetrical; Anesthesia, Spinal; Anesthetics, Local; Bupivacaine; Cesarean Section; Double-Blind Method; Female; Humans; Pregnancy; Prilocaine
PubMed: 33428235
DOI: 10.1111/anae.15341 -
Swiss Dental Journal Sep 2022When choosing local anesthetics, risk factors such as underlying diseases, use of other medications and allergies have to be taken into consideration. Systematic...
When choosing local anesthetics, risk factors such as underlying diseases, use of other medications and allergies have to be taken into consideration. Systematic complications might occur if a specific limit in the plasma concentration is exceeded. Articaine and prilocaine are metabolized extrahepatically. In case of an absolute contraindication for vasoconstrictors, the use of mepivacaine, bupivacaine or articaine is recommended.
Topics: Aged; Anesthetics, Local; Bupivacaine; Carticaine; Humans; Mepivacaine; Prilocaine
PubMed: 36052970
DOI: No ID Found -
Turk Gogus Kalp Damar Cerrahisi Dergisi Apr 2021In this study, we present our experiences with local injections of triamcinolone and prilocaine in patients diagnosed with Tietze syndrome.
BACKGROUND
In this study, we present our experiences with local injections of triamcinolone and prilocaine in patients diagnosed with Tietze syndrome.
METHODS
Between January 2016 and January 2019, a total of 28 patients (12 males, 16 females; median age: 33 years; range, 21 to 51 years) who were diagnosed with TS in our clinic were retrospectively analyzed. Triamcinolone hexacetonide and prilocaine hydrochloride were injected into painful joints. At first week, pain sensation of the patients was recorded using the Pain Rating Scale developed by the British Pain Society. Pain was also assessed at one, two, and three weeks after injections qualitatively and based on physical examination.
RESULTS
At one week, the pain severity before the local injection treatment was above average the pain-related discomfort rates, and the response was quite favorable after the treatment (p=0.005 and p=0.001, respectively). A statistically significant rating was observed for treatment response and success (p=0.003). Totally 75% of the patients experienced more than 70% reduction in pain level after the injection.
CONCLUSION
Our treatment approach involving injection of a mixture of steroid and a local anesthetic provides a rapid relief from pain, irrespective of age, sex, or employment status in patients diagnosed with Tietze syndrome.
PubMed: 34104518
DOI: 10.5606/tgkdc.dergisi.2021.21120