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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty volunteer subjects were given bilateral injections of one-half carpule of 2% Xylocaine with 1:100,000 epinephrine to anesthetize the incisive nerve. Injections were given either inside or outside the mental foramen. Success (80/80 reading) and duration of anesthesia were verified with the Analytic Technology pulp tester. Pain and preference for either injection type were evaluated via questionnaire. The mental foramen could be located in 1 min 56.6% of the time. There was a significantly greater chance of success for injections given inside the foramen for the second bicuspid (p = 0.0422) and the canine (p = 0.015). There was no statistically significant difference in success for either type injection for the first bicuspid (p = 0.184). There was no significant difference in duration of anesthesia whether given inside or outside the foramen and no difference in pain of injection with either type. Patients had no clear-cut preference for either injection type.
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PMID:Evaluation of the effectiveness and comfort of incisive nerve anesthesia given inside or outside the mental foramen. 826 44

Treatment of genital warts (HPV lesions) by Laser-surgery was performed in 90 patients and 90 male partners under topical anaesthesia with 1-3 gr EMLA cream and in 45 patients and 45 males (control groups) under 1-2 ml 2% Carbocaine infiltration. EMLA cream was applied to warts 5-18 minutes (median = 7) before operation. Pain from application of anaesthetic and Laser surgery was significantly less (p < .001) in the groups treated by EMLA. Side effects were minimal in the EMLA groups. The results suggest that EMLA cream could be the anaesthetic of choice in Laser surgery of genital warts.
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PMID:Vulvar and penile HPV lesions: laser surgery and topic anaesthesia. 839 52

This randomized clinical trial evaluated the efficacy of injections of a dextrose-glycerine-phenol connective tissue proliferant into the posterior ligaments, fascia, and joint capsules to treat chronic low back pain. Seventy-nine patients with chronic low back pain that had failed to respond to previous conservative care were randomly assigned to receive a double-blind series of six injections at weekly intervals of either Xylocaine/saline solution or Xylocaine/proliferant into the posterior sacroiliac and interspinous ligaments, fascia, and joint capsules of the low back from L4 to the sacrum. Patients were observed with a visual analog, disability, and pain grid scores, and with objective computerized triaxial tests of lumbar function for 6 months following conclusion of injections. Pretreatment imaging tests with either magnetic resonance imaging (MRI) or computed tomography (CT) scans were performed in all patients. Thirty of the 39 patients randomly assigned to the proliferant group achieved a 50% or greater diminution in pain or disability scores at 6 months compared to 21 of 40 in the group receiving lidocaine (p = 0.042). Subjective parameters measured at 6 months posttreatment improved (p < 0.001) overall in both the treatment and control group compared to baseline. Improvements in visual analog (p = 0.056), disability (p = 0.068), and pain grid scores (p = 0.025) were greater in the proliferant group. Objective testing of range of motion, isometric strength, and velocity of movement showed significant improvements in both groups following treatment but did not favor either group. The MRI and CT scans showed significant abnormalities in both groups, but these did not correlate with subjective complaints and were not predictive of response to treatment.
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PMID:A randomized double-blind trial of dextrose-glycerine-phenol injections for chronic, low back pain. 843 13

No adequate topical therapy is available for pruritus. As little is known about the local influence of antihistamines and topical anaesthetics on the pruritic effect of histamine, we studied these agents in 12 volunteers. The antipruritic effect of 15-min topical application of dimethindene maleate (Fenistil gel) and different agents (Optiderm, EMLA, Xylocaine-Salbe 5%) on subsequent focal histamine stimulus (20 mC) given by iontophoresis was evaluated. The results were compared with those of pretreatment with the corresponding placebo creams and observations on skin. Wheal and flare areas were evaluated planimetrically. Itch or pain ratings were entered on a scale every minute over a 24-min period. The examination also comprised alloknesis, i.e. elicitation of perifocal itch sensation by usually non-itch-inducing (e.g. mechanical) stimuli. Remarkably, all topically applied substances, regardless of antihistaminic or anaesthetic potential, reduced the area of alloknesis significantly. This is likely to be a result of diminished excitability of the cutaneous mechanoreceptors. Itching was significantly reduced by all active substances, including the placebo cream corresponding to Optiderm, which might be due to the presence of urea.
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PMID:[Antipruritic effect of antihistaminic and local anesthetic topical agents after iontophoretic histamine stimulation]. 870 80

A new technique was developed that combines topical and subconjunctival sub-Tenon's anesthesia, with the goal of enhancing the topical anesthesia by blocking the perilimbal nerve plexus and the long posterior ciliary nerves as they pass intrasclerally in the horizontal hemimeridians of the eye. In this technique-circumferential peribulbar anesthesia-topical 4% lidocaine hydrochloride (Xylocaine) is administered, followed by a subconjunctival injection of 0.25 cc 4% Xylocaine 3.0 to 4.0 mm superior to the limbus. Then, the anesthetic is spread 360 degrees around the limbus. Medical records and postoperative interviews of 68 consecutive patients having phacoemulsification with circumferential peribulbar anesthesia showed no reports of intraoperative pain.
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PMID:Circumferential perilimbal anesthesia. 910 94

Topical anesthetics are routinely used to reduce the pain and discomfort that patients may experience during dental injections. Just recently, however, an anesthesia (Electronic Dental Anesthesia or EDA) which works by transcutaneous electrical nerve stimulation (TENS) was introduced to the dental profession. The purpose of this study was to determine whether an electrical signal as provided by an EDA is more effective than topical anesthesia in reducing pain and discomfort caused by local anesthetic injections. Two nasopalatine block injections, one using and EDA as the adjunct, and the other using a topical anesthetic ointment of Xylocaine 5% were performed on thirty-four patients. The volunteers were asked on the spot to report the level of the pain they felt during the penetration of the needle to the mucosa, during the deposition of local anesthetic solution, and their overall evaluation of the injections. The results of this investigation showed that the EDA is the more effective adjunct for local anesthetic injections compared to the traditional topical anesthetics.
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PMID:Electronic dental anesthesia versus topical anesthesia for the control of pain caused by nasopalatine block injections. 946 76

The purpose of this study was to compare postoperative administration of bupivacaine, a long-acting local anesthetic, with lidocaine, a short-acting local anesthetic, on pain perception and analgesic use following periodontal surgery. Ten male subjects were selected on the basis of having similar bilateral mandibular quadrants with moderate to severe periodontal disease requiring osseous surgery. The study was a matched-pair, double-blind design. Carpules of 2% xylocaine with 1:100,000 epinephrine and 0.5% bupivacaine with 1:200,000 epinephrine were wrapped in opaque tape and placed in separate coded envelopes. At the time of suturing, the quadrant was injected with one Carpule from one envelope. The Carpules from the second envelope were saved for the second surgery, which took place approximately one month later. Subjects were given standardized postoperative instructions and prescriptions for Peridex and Tylenol #3. They were told not to take the analgesic unless pain or discomfort occurred. They were given a self-administered questionnaire and asked to assess pain and/or discomfort 2, 4, 6, 8, 10, and 12 hours after the procedure, the amount of analgesic taken, and time when complete sensation returned. Results showed that the quadrants which received lidocaine maintained postoperative anesthesia an average of 2.47 hours while the Marcaine quadrants had a significantly longer duration of 5.62 hours. A large intra- and intersubject variability was noted in the amount of analgesic taken. The lidocaine group reported an average of 3.70 tablets versus a significantly smaller amount for the bupivacaine group of 1.60 tablets. Throughout all time intervals, the bupivacaine group reported significantly less pain than the lidocaine group. When used at the end of a mandibular periodontal surgical procedure, bupivacaine provides a significantly greater duration of anesthesia, decreased postoperative pain, and a reduction of anesthesia, decreased postoperative pain, and a reduction in the amount of analgesics taken.
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PMID:Comparison of postoperative bupivacaine with lidocaine on pain and analgesic use following periodontal surgery. 947 66

In today's dental practice, local anesthesia is safe and effective, and injectable agents only rarely cause allergy. Ester-type agents, like procaine, which served the profession for over 50 years, have now been abandoned and are no longer available in dental cartridges in the U.S. Modern practitioners know of their disadvantages only through historical accounts of local anesthesia, and utilize daily the excellent chemical and pharmacologic characteristics of the amide local anesthetics, a tradition begun with the introduction of Xylocaine in the late 1940s and a tradition which will likely continue into the 21st century. The reader is referred to Table III for a comparison of quantities and dollar-value of sales of amide local anesthetics available in dental cartridges (17). In order to supplant Xylocaine (lidocaine) as a preferred local anesthetic in dentistry, any new agent will have to prove that it is superior in terms of short onset, appropriate duration, stability, excellent safety record, low allergenicity, and topical efficacy. As our understanding of the molecular structure of ion channels and the interactions of local anesthetics with neural sodium channels increase, new agents can be developed rationally. In the meantime, the amide local anesthetics will continue to serve dentists and their patients by providing safe and effective control of pain to facilitate ever-advancing surgical and restorative techniques.
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PMID:Xylocaine: 50 years of clinical service to dentistry. 966 95

Although the application of a topical local anaesthetic before fibreoptic nasendoscopy is routine practice in many otolaryngological outpatients, the actual benefit to the patient of this procedure remains in doubt. Eighty-two patients were recruited in this double-blind randomized control trial which compared the patients' experiences of fibreoptic nasendoscopy with nasal preparations of Xylocaine (lidocaine), normal saline, and no spray to the nose and throat. A visual analogue scoring system was used to determine scores for the overall unpleasantness of procedure, receiving a spray, and taste of the spray, and pain. This study has shown significantly worse overall experience (P = 0.001) and pain (P = 0.048) scores for Xylocaine spray versus no spray. It is concluded that the routine use of topical local anaesthetics within the nose before routine fibreoptic nasendoscopy is not only of no value, but actually makes the experience worse for the patient.
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PMID:Is local anaesthesia actually beneficial in flexible fibreoptic nasendoscopy? 966 77

This study was designed to determine if an electrical signal can effectively control the pain caused by injection of local anesthesia for mildly and moderately apprehensive patients. Five techniques were used in this study: the Mandibular Block injection, Long Buccal nerve injection, Maxillary Infiltration injection, Incisive Papilla injection, and the Great Palatine nerve injection. Two injections, using the Electronic Dental Anesthesia (EDA/EA) as the adjunct, and the other using a topical anesthetic ointment of Xylocaine 5%, were performed on 30 patients who passed the criteria we have set including the indications for use of the EDA. The volunteers were asked on the spot to report the level of pain they felt during the penetration of the needle in the mucosa, and during the deposition of the local anesthetic solution. A pool of 47 patients were gathered for this experiment. Of this number, 11 failed to pass for reasons of high-anxiety level and 2 were contraindicated for use of the EDA. Of the 34 who successfully passed the screening, only 30 patients were chosen. A total of 6 patients each, 3 males and 3 females, were used for the five techniques. The results of this study show that in all five injection techniques, the EDA is effective in blocking pain transmission. The EDA is proven to be an effective adjunct to local anesthetic injections.
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PMID:Effectivity of the Electronic Dental Anesthesia in controlling pain caused by local anesthetic injections. 1059 56


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