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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A procedure for the outpatient management of acute hemorrhoidal disease is presented. Treatment, using local anesthesia with hyaluronidase, is directed to (1) relieve pain, (2) decrease edema, (3) treat appropriately the internal hemorrhoidal disease, and (4) treat the external thrombosis if present. Adequate treatment of the acute disease will, in a significant proportion of patients, avoid further surgical intervention. Eperience with results of this modality of treatment in patients is presented.
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PMID:The outpatient management of acute hemorrhoidal disease. 46 96

Intra-muscular ketamine with hyaluronidase was used on nineteen occasions to provide anaesthesia for daily radiotherapy in a 22-month-old boy with a rhabdomysarcoma of the bladder. The technique produced a sharper, reliable recovery and allowed the child his normal fluid and caloric intake within 90 minutes.
Anaesthesia
PMID:Intramuscular ketamine with hyaluronidase. Nineteen daily anaesthetics administered to a child for radiotherapy. 90 Apr 37

The authors describe 5 patients who developed an orbital pseudotumor as a complication of retrobulbar anesthesia. Allergy tests revealed a hypersensitivity to hyaluronidase, suggesting an immunoallergic etiology of the pseudotumor, which needed to be differentiated from other causes of proptosis after retrobulbar injection.
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PMID:Hyaluronidase induced orbital pseudotumor as complication of retrobulbar anesthesia. 130 46

In a prospective, randomised, masked trial, 91 patients undergoing intraocular surgery received an anaesthetic mixture containing lignocaine hydrochloride 2% and bupivacaine hydrochloride 0.5%. In addition group 1 had hyaluronidase (50 i.u./ml) and adrenaline (1:200,000), group 2 had hyaluronidase alone, group 3 had adrenaline alone and group 4 had neither. The groups were compared regarding the quality of operating conditions. Hyaluronidase had a substantial beneficial effect though there was no significant difference related to the use of adrenaline. Anaesthesia was less effective in patients under the age of 65 years.
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PMID:The effects of adrenaline, hyaluronidase and age on peribulbar anaesthesia. 144 62

The effect of adding hyaluronidase to regional ophthalmic anaesthesia with etidocaine 1.5% was examined. Two studies were performed in a double-blind fashion. In Study #1, 70 patients were given peribulbar anaesthesia with etidocaine either with or without hyaluronidase (7.5 IU.ml-1) using a standard intraorbital injection and separate lid injections. The block was supplemented as needed. Lower intraorbital volumes (6.4 +/- 2.2 ml vs 8.2 +/- 2.3 ml, P < 0.01) and improved scores for globe akinesia (P < 0.01), lid akinesia (P < 0.01) and analgesia (P < 0.05) were recorded in the hyaluronidase group than in the plain etidocaine group. In Study #2, 80 patients were randomized to receive etidocaine and hyaluronidase either at a concentration of 7.5 IU.ml-1 or 15 IU.ml-1 using a two-injection-site technique. No differences were noted in the volumes of local anaesthetics required or in the success rates between the two groups. It was concluded that the addition of hyaluronidase to etidocaine decreases the volume needed and improves the quality of block compared with plain etidocaine. Doubling the dose of hyaluronidase does not improve the effectiveness of block.
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PMID:Hyaluronidase improves regional ophthalmic anaesthesia with etidocaine. 145 Dec 20

Regional anaesthesia by retrobulbar injection by the anaesthetist is recommended for day care ophthalmic surgery. Patient management and anaesthetic technique are detailed. The preferred anaesthetic is 2% lidocaine with hyaluronidase and adrenaline added. Fine, sharp pointed needles are recommended.
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PMID:Technique of ocular regional anesthesia. 147 66

The effect of needle length on the efficacy of regional ophthalmic anesthesia in conjunction with cataract surgery was studied in 97 patients using a two-site injection technique. The local anesthetic used was etidocaine 1.5% with hyaluronidase. In 48 patients, the anesthetic was administered inferolaterally with a 22-millimeter needle, and in the other 49 patients, with a 31-millimeter needle. Every patient had a medial injection with a 12-millimeter needle to achieve lid akinesia and to complete the globe akinesia. At 5 minutes, lid akinesia was considered better in the 22-millimeter needle group (P < .005). After one supplemental dose, when necessary, complete globe akinesia was achieved at 15 minutes significantly more often (94% vs 79%) in the 31-millimeter needle group (P < .05). Lid akinesia in the two groups was identical at that time. Eight patients in the short-needle group and three in the long-needle group experienced some pain during surgery. Throughout the study, the required intraorbital anesthetic volumes were smaller in the 31-millimeter needle group. We recommend the use of a 31-millimeter needle inferolaterally in combination with a 12-millimeter needle medially to achieve satisfactory regional anesthesia for cataract surgery.
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PMID:Comparison of two needle lengths in regional ophthalmic anesthesia with etidocaine and hyaluronidase. 148 66

Ninety patients scheduled for elective cataract extraction under local anesthesia received an inferolateral intraconal injection of 4 mL of etidocaine mixed with hyaluronidase. They were divided into three groups of 30 patients each according to the method used to provide orbicular akinesia. Those in group I had a nasal, intraorbital injection; those in group II underwent electrostimulation to locate branches of the facial nerve in the eyelids; and those in group III had the anesthetic agent injected subcutaneously into the lids. Ten minutes after the regional blockade, orbicular muscle activity of the upper eyelid, as measured by electromyography, was found to be higher in group I than in the other two groups. The muscular activity of the lower lid at 10 minutes, or of either of the lids at 20 minutes, was similar in all three groups. The use of electrostimulation did not yield better orbicular akinesia than the infiltration technique alone. Nasal injection improved globe akinesia.
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PMID:Orbicular muscle akinesia: a comparison, using electromyography, of three techniques. 151 39

Limited data exist on the recovery of ocular motility after adjustable suture strabismus surgery performed under local anesthesia. The timing of adjustment has been chosen empirically and has varied widely. We sought to more precisely quantify the recovery of motility by measuring ductions before and after surgery with a modified arc perimeter. Twenty-one eyes of 20 patients were studied. All patients underwent adjustable suture strabismus surgery under retrobulbar or peribulbar anesthesia using 2% lidocaine with hyaluronidase. Mean ductions orthogonal to the field of action of the operated muscle(s) returned to 90% of preoperative levels between 5 and 6 hours after injection. We recommend adjustment 6 or more hours after injection, or at least 5 to 6 hours postoperatively, when 2% lidocaine with hyaluronidase is used for local anesthesia.
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PMID:Recovery of extraocular muscle function after adjustable suture strabismus surgery under local anesthesia. 158 75

Peribulbar anaesthesia was used in 40 patients undergoing vitreoretinal surgery; two injections of a mixture of bupivacaine 0.5% and hyaluronidase were performed in the lower and the upper eyelid. Results were judged very satisfactory in 38 of these 40 cases, for anaesthesia as well as for akinesia; no local or systemic complications were observed. Peribulbar anaesthesia is one of the methods of choice, because of its safety; it seems well appropriate for vitreoretinal surgery, provided that its indications are judicious.
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PMID:[Peribulbar anesthesia in surgery of the vitreous body and retina]. 159 27


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