PURPOSE: To assess aqueous humor lidocaine concentrations in 2 common regimens of topical anesthesia and after intracameral injection of the anesthetic agent. SETTING: University hospital eye clinic. METHODS: Twenty patients having routine cataract surgery were randomized into 3 groups: 1 given 3 drops of lidocaine 4% before surgery; 1 given 6 drops; 1 given 3 drops plus an intracameral injection of 0.1 mL lidocaine 1%. Lidocaine concentration was measured in aqueous humor samples taken before surgery. RESULTS: With 3 drops, aqueous lidocaine concentration was 1.4 micrograms/mL +/- 0.5 (SD) and with 6 drops, 4.3 +/- 1.5 micrograms/mL (P = .0015). With an intracameral injection, it was 341.8 +/- 152.6 micrograms/mL. CONCLUSION: Measurable amounts of lidocaine entered the anterior chamber in topical anesthesia, and more entered when more drops were given. It is likely that concentrations in this range could anesthetize the iris, but they are far lower than concentrations after an intracameral ...
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INTRODUCTION. The narrow therapeutic index of 5% hyperbaric lidocaine on neuroaxis has been shown since the early 1990, when Cauda Equina syndrome was associated to its spinal administration via microcatheter in continuous infusion 1,2, after single pencil point needle injection 3,4 and repeated injections due to blockade failure 5.. Lidocaine concentration potentially able to determine nervous tissue injury is still not well established. Experimental studies in rats, in which the anesthetic was administered via spinal catheter, have shown neurotoxicity in concentrations varying from 2.5% 6 to 7.5% 7,8. The criticism to this model is that it does not reproduce the anesthetic technique used in the clinical practice 6.. This study aimed at investigating the effect on spinal cord and meninges of increasing spinal lidocaine concentrations in single injection through Quincke needle.. METHODS. After the Animal Experiment Ethical Committee approval, 40 adult mixed-breed dogs of both genders, weighing 7 ...
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The effectiveness of local anesthetics is reduced if inflammation is present, making it difficult to control pain during such procedures as root canals and wisdom teeth removal. This set of studies will assess the effectiveness of the opioid (synthetic narcotic) fentanyl in enhancing the local anesthetic lidocaine (delivered with epinephrine) when used on inflamed molar teeth.. In the first study, a topical anesthetic patch or a placebo will be placed on the gum tissues next to four or five lower posterior teeth. The patch will removed at either 5, 10, or 15 minutes. An electronic test that sends a light electronic impulse into the tooth, lip sensitivity testing (Is your lip numb?), and discomfort reports will be started immediately after removal of the patch and repeated every 5 minutes for 30 minutes. An oral surgeon will then remove the patients wisdom teeth (tooth).. In the second and third studies, a topical anesthetic will be placed on the gum tissue. An electronic test that sends a ...
TY - JOUR. T1 - Use of excessive lidocaine concentrations for local anesthesia. AU - Bashein, G.. AU - Zipes, D.. AU - Nattel, S.. AU - Rinkenberger, R. L.. PY - 1980. Y1 - 1980. UR - http://www.scopus.com/inward/record.url?scp=0018913417&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0018913417&partnerID=8YFLogxK. M3 - Article. C2 - 7350424. AN - SCOPUS:0018913417. VL - 302. SP - 122. JO - New England Journal of Medicine. JF - New England Journal of Medicine. SN - 0028-4793. IS - 2. ER - ...
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This prospective randomized study aims to evaluate the effectiveness of intravenous lidocaine injection on the relief of pain in patients undergoing tonsillectomy.. A total of 62 patients will be randomized into one of two groups (group C or group I) based on Excel number generation.. Patients in group C will receive received normal saline intravenous injection, and patients in group I will receive an intravenous bolus injection of 1.5 mg/kg lidocaine followed by a continuous lidocaine infusion of 2 mg/kg/hr.. Visual analogue scale pain scores, fentanyl consumption and the frequency at which patients pushed the button (FPB) of a patient-controlled analgesia system will be recorded at 4, 12, 24, 48 hours postoperatively. ...
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Lidocaine is absorbed following topical administration to mucous membranes, its rate and extent of absorption being dependent upon concentration and total dose administered, the specific site of application, and duration of exposure. In general, the rate of absorption of local anesthetic agents following topical application occurs most rapidly after intratracheal administration. Lidocaine is also well-absorbed from the gastrointestinal tract, but little intact drug appears in the circulation because of biotransformation in the liver. The plasma binding of lidocaine is dependent on drug concentration, and the fraction bound decreases with increasing concentration. At concentrations of 1 to 4 mcg of free base per mL, 60 to 80 percent of lidocaine is protein bound. Binding is also dependent on the plasma concentration of the alpha-1-acid glycoprotein.. Lidocaine crosses the blood-brain and placental barriers, presumably by passive diffusion. Lidocaine is metabolized rapidly by the liver, and ...
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Background and purpose: Lidocaine is an intermediate acting local anesthetic agents used very much in epidural anesthesia and has less risk of cardiac or CNS problems compared with bupivacaine. This study evaluated the duration of motor and sensory block of epidural anesthesia with lidocaine alone, lidocoine plus epinephrine and lidocaine ...
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In this prospective, placebo-controlled, randomized study of lidocaine during adult cardiac surgery with CPB, no neuroprotective effect of lidocaine was found. In addition, we found that diabetic subjects receiving lidocaine were more likely to suffer cognitive decline at 6 weeks. In secondary analyses, an association between higher total dose of lidocaine and increased neurocognitive decline was detected in the lidocaine treated group; a total dose of 35 mg/kg approximated the threshold for this cognitive decline. Furthermore, when the study sample was restricted to only nondiabetic subjects who received a dose of lidocaine ,42.6 mg/kg (75th percentile), a protective effect of lidocaine on cognition was seen. A marginally significant improvement in cognition was also detected at 1 year after surgery in subjects receiving lidocaine, although this finding is limited by substantial loss to follow-up. There was no diminution of the perioperative cytokine response in lidocaine treated ...
Yoo Shin Choi, MD, Hyun Gang, md. Chung-Ang University Hospital. Objective: The aim of this randomized, double-blind study trial was to evaluate the effect of intraperitoneal (IP) lidocaine instillation and intravenous (IV) lidocaine infusion on postoperative pain control after laparoscopic cholecystectomy (LC). Methods: Seventy-two patients who underwent LC were randomly assigned to 3 groups: Group IV (intravenous lidocaine infusion, n = 26), Group IP (intraperitoneal lidocaine instillation, n = 22), and Group C (control group, IP and IV saline, n = 24). Patients in each group were evaluated with regard to postoperative pain severity (TPPS) (using the VAS), total fentanyl consumption (TFC), frequency of pushing the button for a bolus of PCA (FPB), pain control satisfaction score (PCSS) (using the NRS). Results: Reduced TPPS, TFC, and FPB scores were observed in groups IP and IV as compared to group C (P , 0.05). PCSS was also higher in groups IP and IV than in group C (P , 0.05). TPPS was lower ...
TY - JOUR. T1 - Isoform-specific lidocaine block of sodium channels explained by differences in gating. AU - Nuss, H. Bradley. AU - Kambouris, Nicholas. AU - Marbán, Eduardo. AU - Tomaselli, Gordon F.. AU - Balser, Jeffrey R.. PY - 2000/1/1. Y1 - 2000/1/1. N2 - When depolarized from typical resting membrane potentials (V(rest) ~ - 90 mV), cardiac sodium (Na) currents are more sensitive to local anesthetics than brain or skeletal muscle Na currents. When expressed in Xenopus oocytes, lidocaine block of hH1 (human cardiac) Na current greatly exceeded that of μ1 (rat skeletal muscle) at membrane potentials near V(rest), whereas hyperpolarization to -140 mV equalized block of the two isoforms. Because the isoform-specific tonic block roughly parallels the drug-free voltage dependence of channel availability, isoform differences in the voltage dependence of fast inactivation could underlie the differences in block. However, after a brief (50 ms) depolarizing pulse, recovery from lidocaine block is ...
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Reproduction studies for lidocaine have been performed in both rats and rabbits. There was no evidence of harm to the fetus at subcutaneous doses of up to 50 mg/kg lidocaine (300 mg/m2 on a body surface area basis) in the rat model. In the rabbit model, there was no evidence of harm to the fetus at a dose of 5 mg/kg, s.c. (60 mg/m2 on a body surface area basis). Treatment of rabbits with 25 mg/kg (300 mg/m2) produced evidence of maternal toxicity and evidence of delayed fetal development, including a non-significant decrease in fetal weight (7%) and an increase in minor skeletal anomalies (skull and sternebral defect, reduced ossification of the phalanges). The effect of lidocaine on post-natal development was examined in rats by treating pregnant female rats daily subcutaneously at doses of 2, 10, and 50 mg/kg (12, 60, and 300 mg/m2) from day 15 of pregnancy and up to 20 days post partum. No signs of adverse effects were seen either in dams or in the pups up to and including the dose of 10 ...
membranes. For example, when using lidocaine for dental procedures, applying it using a cotton swab with just the right amount on a tooth or in gum area is the best way.. What Is Lidocaine: Its Uncommon Uses. • Helps Relieve The Squeeze of a Mammogram. Lidocaine is found useful for women ages 40+ who delay or skip getting annual mammogram. By just applying 5% Lidocaine cream to their breast and on surrounding chest skin, they may find some relief from the pain of compression. A study conducted at St. Lukes Mountain States Tumor Institute in Boise, Idaho tested 418 women who had delayed mammograms due to anticipated pain by giving them a couple of premedications. The 418 women were separated into groups that took acetaminophen, ibuprofen, a topical 5% Lidocaine gel, or an oral or topical placebo. The group of women who took the Lidocaine treatment said that they have significantly less pain than they had anticipated, and agreed that because of the experience, it led them to consider following ...
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