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Sedation, analgesia and patient observation in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
Jeffrey E. Quam, Michael A. Bettmann
Large doses of lidocaine can cause CNS side-effects including dizziness, paresthesias, seizures and induction of coma.27 The most lethal complications of excess doses are ventricular fibrillation and cardiac arrest.28 These complications most often occur as a result of accidental intravenous administration, and care must be taken to avoid intravascular injection. Such complications can also occur as a result of very large doses of non-vascular lidocaine, but are very rare below the maximum dose of 5 mg/kg (0.5 mL/kg of 1 per cent solution). If the formulation includes a vasoconstricting agent (e.g. epinephrine), the local anesthetic action is both potentiated and prolonged. This is due to a decrease in the rate of systemic resorption of the agent from the site of injection, and this also decreases the frequency of systemic complications. However, epinephrine should not be added when infiltrating tissues that are supplied by end-arteries (e.g. fingers, toes, nose, ears or penis). Since these regions lack sufficient collateral arteries, ischemic necrosis may result from the vasoconstriction.
Microneedles: Current Trends and Applications
Published in Tuhin S. Santra, Microfluidics and Bio-MEMS, 2020
Hima Manoj, Pallavi Gupta, Loganathan Mohan, Moeto Nagai, Syrpailyne Wankhar, Tuhin S. Santra
Microneedles can be used for needle-free delivery of anesthetics. As they are minimally invasive in nature, cause no pain, and are small in size (100 microns), they play a major role in drug delivery. Microneedle administration of anesthetics is identical to one injection of hypodermic needles. During drug delivery the sensitivity and concentration of the anesthetic given to the patient depend on the number and spacing of microneedles in the microneedle patch. Lidocaine is used as a drug for local anesthesia. Baek et al. showed consistent and higher delivery within 2 min by microneedle tips coated with lidocaine. Thus the proposed technique can be employed for painless and faster local anesthesia [165].
Lidocaine loaded nanostructured lipid carriers for prolonged local anesthesia: in vitro and in vivo studies
Published in Journal of Dispersion Science and Technology, 2022
Meng Suo, Xu Zhao, Guanling Yu, Wenjia Zhang
Lidocaine as an amino amide type local anesthetic (diethylamoinoacetyl-2-6-xylidine); is widely used in many clinical applications.[25,26] Lidocaine is a fast-acting local anesthetic with intermediate duration of action owing to its comparatively low protein binding. Lidocaine reversibly prevents the sensory neuronal conduction of noxious stimuli from reaching the central nervous system by binding to voltage-gated sodium channel of excitable membranes.[27] The effect can be enhanced by using novel drug delivery systems that sustained the release of lidocaine after topical application.
Pulsed radiofrequency for low-back pain and sciatica
Published in Expert Review of Medical Devices, 2020
Alessandro Napoli, Giulia Alfieri, Roberto Scipione, Fabrizio Andrani, Andrea Leonardi, Carlo Catalano
PRF procedure requires an imaging guidance, that is commonly represented by fluoroscopy or, in some more advanced centers, CT. A 20–22 G needle-electrode with an active tip is introduced and advanced toward target DRG. RF current should be activated only if imaging results confirmed the exact positioning of the needle on target symptomatic DRG (usually within 8 mm). Before the actual treatment, as further security step, the optimal location is confirmed delivering low-frequency electrical sensory stimulation. Treatments are generally performed without local anesthesia or after the local injection of Lidocaine 1–2%.