-
The Western Journal of Medicine Sep 2001
Review
Topics: Adolescent; Anesthetics, Local; Child; Child, Preschool; Evidence-Based Medicine; Glucosephosphate Dehydrogenase; Humans; Infant; Infant, Newborn; Male; Methemoglobinemia; Methylene Blue; Oxidants; Prilocaine
PubMed: 11527852
DOI: 10.1136/ewjm.175.3.193 -
Gels (Basel, Switzerland) Jan 2023This study aimed to formulate semisolid niosomal encapsulated lidocaine and prilocaine using the patented palm oil base Hamin-C for further characterization and in vivo...
This study aimed to formulate semisolid niosomal encapsulated lidocaine and prilocaine using the patented palm oil base Hamin-C for further characterization and in vivo pain assessment. Seven formulations were initially studied with various chemical compositions. A thin-layer film hydration method was used to produce niosome using a mixture of surfactant (Span 40 or Span 60) and cholesterol (CHOL) at a 1:1 ratio, with/without a charge-inducing agent (diacetyl phosphate) (DCP) and with/without labrasol. Niosome F1 formulation had been identified as the highest %EE achieved, at 53.74 and 55.63% for prilocaine and lidocaine, respectively. Furthermore, NIO-HAMIN F1 emulgel indicated the best formulation with higher permeability of prilocaine and lidocaine compared to the rest of the formulations. The reformulation of optimization of NIO-HAMIN F1 emulgel using a cold process to NIO-HAMIN F1-C emulgel to improve the viscosity resulted in higher diffusion of prilocaine and lidocaine by 5.71 and 33.38%, respectively. In vivo pain perception studies by verbal rating score (VRS) and visual analogue score (VAS) on healthy subjects show a comparable local anesthetic effect between NIO-HAMIN F1-C emulgel and EMLA cream.
PubMed: 36826266
DOI: 10.3390/gels9020096 -
BMC Pediatrics Jun 2023To characterize clinical profile of pediatric local anesthetic (LA) systemic toxicity (LAST) and to identify determinants of life-threatening outcomes.
PURPOSE
To characterize clinical profile of pediatric local anesthetic (LA) systemic toxicity (LAST) and to identify determinants of life-threatening outcomes.
METHODS
Spontaneous reports notified to the French Pharmacovigilance Network were retrieved and followed by a case-by-case review, according to the following criteria: LA as suspected drug, age < 18 years, adverse drug reactions related to nervous system, cardiac, respiratory, psychiatric or general disorders. Multivariate logistic regression analysis was performed to identify factors leading to life-threatening reaction (i.e. continuous seizures or cardiorespiratory arrest).
RESULTS
Among 512 cases retrieved, 64 LAST cases were included (neonates 11%, infants 30%, children 36%, adolescents 23%) mainly involving lidocaine (47%), lidocaine + prilocaine (22%) and ropivacaine (14%). Toxicity profiles were neurological (58%), cardiac (11%) or mixed (20%) and 7 patients (11%) developed methemoglobinemia. LAST was life-threatening for 23 patients (36%) and 2 patients died. Doses were above recommendations in 26 patients (41%) and were not different between life-threatening and non-life-threatening cases. The context of use (general and orthopedic surgery, p = 0.006) and the type of LA agent (lidocaine, p = 0.016) were independently associated with a life-threatening outcome.
CONCLUSION
In this national retrospective analysis, LAST in children appear to be a rare event. Neurological and cardiac signs were the most frequently reported reactions. LAST in children can be life-threatening, even at therapeutic doses. Although a fatal outcome may anecdotally occur, the vast majority of patients recovered after appropriate medical care.
Topics: Infant; Infant, Newborn; Adolescent; Humans; Child; Anesthetics, Local; Pharmacovigilance; Retrospective Studies; Lidocaine; Ropivacaine; Lidocaine, Prilocaine Drug Combination
PubMed: 37355586
DOI: 10.1186/s12887-023-04126-7 -
Saudi Journal of Anaesthesia 2018To investigate the speed of action and injection discomfort of 2% lidocaine and 3% prilocaine for upper teeth extractions.
OBJECTIVE
To investigate the speed of action and injection discomfort of 2% lidocaine and 3% prilocaine for upper teeth extractions.
MATERIALS AND METHODS
Forty-six patients were included in the prilocaine 3% group, and 46 in the lidocaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Moreover, the pain of the injections was recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with "no pain" (0 mm) and "unbearable pain" (100 mm).
RESULTS
There were no significant differences in the meantime of first numbness to associated buccal, palatal mucosa, and tooth of patients in the lidocaine and prilocaine buccal infiltration groups ( = 0.56, 0.37, and 0.33). However, clinically, the patients in prilocaine group recorded earlier buccal, palatal mucosa, and teeth numbness than those in lidocaine group. With regards to the discomfort of the needle injections, there was a significant difference for lidocaine and prilocaine groups when comparing the post buccal scores with the post palatal injection scores (-test: < 0.001). Lidocaine and prilocaine buccal injections were significantly more comfortable than palatal injections.
CONCLUSIONS
Using 2% lidocaine and 3% prilocaine for extractions of upper maxillary teeth produces similarly successful anesthesia. Clinically, prilocaine has slightly rapid onset of action, earlier buccal mucosa, hard palate, and teeth numbness. Prilocaine and lidocaine buccal injection was significantly more comfortable than palatal injection.
PubMed: 30429739
DOI: 10.4103/sja.SJA_259_18 -
The Israel Medical Association Journal... Apr 2014With growing awareness of the importance of pain control in all procedures, the use of lidocaine-prilocaine cream (EMLA) for all ages is increasing. Lidocaine-prilocaine... (Review)
Review
With growing awareness of the importance of pain control in all procedures, the use of lidocaine-prilocaine cream (EMLA) for all ages is increasing. Lidocaine-prilocaine cream has been implicated as a cause of methemoglobinemia. Diagnostic clues may be oxygen-resistant cyanosis and an oxygen "saturation gap" between arterial blood saturation and pulse oximetry. Treatment with intravenous methylene blue is often effective. Since EMLA is often mistakenly considered risk-free it is routinely applied by medical staff in the emergency room. Subsequent to the case of EMLA-induced methemoglobinemia in an 8 year old girl we wish to alert the medical community to this phenomenon, and in this work review the relevant literature.
Topics: Anesthetics, Combined; Anesthetics, Local; Child; Cyanosis; Enzyme Inhibitors; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Methemoglobinemia; Methylene Blue; Oximetry; Oxygen; Prilocaine
PubMed: 24834764
DOI: No ID Found -
Anesthesia Progress 1993The development of new local anesthetics has not been an area of particularly active research for a number of years. However, as the use of regional anesthesia has... (Review)
Review
The development of new local anesthetics has not been an area of particularly active research for a number of years. However, as the use of regional anesthesia has expanded, additional anesthetic requirements and techniques have stimulated the search for newer drugs and ways of modifying existing ones. This article reviews some of the more recent developments in this field.
Topics: Anesthesia, Dental; Anesthesia, Local; Anesthetics, Local; Animals; Carticaine; Dose-Response Relationship, Drug; Drug Combinations; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Prilocaine
PubMed: 8185087
DOI: No ID Found -
BMJ (Clinical Research Ed.) Nov 1988
Review
Topics: Administration, Cutaneous; Drug Combinations; Humans; Lidocaine; Prilocaine
PubMed: 3145057
DOI: 10.1136/bmj.297.6658.1215 -
European Journal of Pediatrics Jan 2021Male circumcision (MC) is one of the most common surgical procedures performed on neonates. In the last decades, there have been consistent advances in the understanding... (Review)
Review
Male circumcision (MC) is one of the most common surgical procedures performed on neonates. In the last decades, there have been consistent advances in the understanding of pain mechanisms in newborns, and analgesia has become a fundamental part of neonatal care. MC is still often performed with inappropriate analgesic methods, and there is still great variability among the various centers about surgical and anesthethic techniques to do it. The purpose of this review is to summarize the findings in the literature about pain management and analgesia during newborn MC. We performed a systematic review of neonatal MC studies published in the last 20 years. The most effective technique appeared to be the combination of pharmacological and non-pharmacological methods of analgesia.Conclusion: Combining local anesthesia with non-pharmacological analgesic strategies appears to be effective preventing procedural pain during MC. However, a standardized protocol for analgesia during MC is yet to be determined. Sensorial saturation appeared to help when used in conjunction with the local anesthesia techniques. What is Known: • Male circumcision is a painful procedure and it is frequently performed with inappropriate analgesic methods. • A gold standard practice in analgesia during male circumcision is still lacking and there is a great variability in the modus operandi between centers. What is New: • The combination of RB + EMLA + sucrose appears to be an analgesic strategy superior to other approaches. • We advocate for the integration of sensorial saturation during male circumcision in order to improve the efficacy of current analgesic practices.
Topics: Anesthetics, Local; Circumcision, Male; Humans; Infant, Newborn; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Pain; Prilocaine
PubMed: 32748017
DOI: 10.1007/s00431-020-03758-6 -
Asian Journal of Andrology Jan 2008Premature ejaculation (PE) is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is... (Review)
Review
Premature ejaculation (PE) is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition nor a medication approved by the Food and Drug Administration (FDA). Despite these shortcomings, physicians continue to diagnose their patients with PE according to major guidelines and treat them with either behavioral therapies or off-label medications. This review focuses on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.
Topics: Anesthetics, Local; Behavior Therapy; Clomipramine; Ejaculation; Humans; Lidocaine; Male; Prilocaine; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological
PubMed: 18087649
DOI: 10.1111/j.1745-7262.2008.00369.x -
Journal of Pediatric Hematology/oncology Jan 2022Deep sedation/general anesthesia is commonly used in pediatric oncology patients undergoing lumbar puncture (LP). Propofol is often used for sedation, with or without a... (Randomized Controlled Trial)
Randomized Controlled Trial
Eutectic Mixture of Lidocaine and Prilocaine Decreases Movement and Propofol Requirements for Pediatric Lumbar Puncture During Deep Sedation: A Randomized, Placebo-Controlled, Double Blind Trial.
Deep sedation/general anesthesia is commonly used in pediatric oncology patients undergoing lumbar puncture (LP). Propofol is often used for sedation, with or without a narcotic. We hypothesized that eutectic mixture of lidocaine and prilocaine (EMLA) would allow for lower cumulative doses of propofol and less movement. We performed a prospective, randomized, double blind, placebo-controlled trial in children undergoing sedation for LP. Standard initial weight-based doses of propofol and fentanyl were administered, with either EMLA cream or a placebo cream applied topically. The primary outcome was the total dose of propofol administered to each patient. We also tracked patient movement and complications. Twenty-seven patients underwent 152 LPs. Patients randomized to EMLA cream (n=75) were significantly more likely to receive a lower dose of propofol (2.94 mg/kg, SE=0.25, vs. 3.22 mg/kg, SE=0.19; P=0.036) and to not require additional propofol doses (probability 0.49, SE=0.08 vs. 0.69, SE=0.06; P=0.001) compared with patients randomized to placebo cream (n=77). In addition, patients with EMLA cream were significantly less likely to demonstrate minor or major movement. EMLA cream results in less movement and less propofol administration in pediatric oncology patients undergoing sedation for LP.
Topics: Adolescent; Child; Deep Sedation; Double-Blind Method; Female; Humans; Lidocaine; Male; Prilocaine; Propofol; Prospective Studies; Spinal Puncture
PubMed: 33885035
DOI: 10.1097/MPH.0000000000002169