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Third Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alyssa R. Hersh, Jorge E. Tolosa
Compared with placebo, topical anesthetics applied to the perineum are associated with similar pain relief up to 24 hours to 72 hours postpartum, but women are more satisfied after administration of an anesthetic [63]. Epifoam (1% hydrocortisone acetate and 1% pramoxine hydrochloride in the mucoadhesive foam base) use is associated with less additional analgesia, while lignocaine/lidocaine showed no difference with regard to additional analgesia use compared with placebo [63]. A lidocaine/prilocaine cream appears to be as effective as local mepivacaine injection for pain relief during repair, with improved patient satisfaction [64]. Compared with indomethacin vaginal suppositories, topical anesthetics have similar mean pain scores.
Prilocaine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Although few cases of allergic contact dermatitis from topical prilocaine have been reported, repeated use of lidocaine-prilocaine cream not infrequently leads to sensitization, (nearly) always from the prilocaine component. Indeed, of 75 patients non-selected dialysis patients, 8 (11%) had positive patch tests reactions to the cream, in all cases caused by prilocaine sensitization (22).
Lips
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Ali Pirayesh, Raul Banegas, Per Heden, Khalid Alawadi, Jennifer Gaona, Alwyn Ray D’Souza
Various topical anesthetics are effective and include combinations of lidocaine, prilocaine, tetracaine, and phenylephrine. Topical anesthetic is applied approximately 30 minutes prior to treatment. Infraorbital and mental nerve blocks, either intraoral or transcutaneous, may also be utilized. It is critical not to distort the shape of the lips. Currently, it is easier to use a premixed HA with lidocaine as an add-on to reduce pain.
Anorectal application of 5% lidocaine cream reduces pain prior to periprostatic nerve block during transrectal ultrasound guided prostate biopsy: Randomized, prospective controlled study
Published in Scandinavian Journal of Urology, 2021
Yishai H. Rappaport, Sergey Kravchick, Amos Neheman, Ilia Beberashvili, Kobi Stav, Shmuel Roizman, Amnon Zisman
Transrectal ultrasound guided prostate biopsy (TRUS PBx) is often performed in an ambulatory setting under local anesthesia. Previous studies have demonstrated that periprostatic nerve block (PPNB) is the superior analgesic method for TRUS PBx [1–4]. However, PPNB is unable to decrease the pain associated with intrarectal probe insertion and manipulation, nor with needle puncture through the rectal wall used to deliver an anesthetic agent periprostatically [2,5]. Several studies reported the efficacy of the anesthetic combination or perianal-intrarectal local anesthesia in combination with PPNB [2,5–9], suggesting better pain control compared to PPNB alone with no increase in complication rate. The method of pre-PPNB anesthesia differed, with the use of intrarectal lidocaine gel [5] or of lidocaine-prilocaine cream perianal-intrarectaly [6,7] with subsequent massaging of the cream onto the anal canal mucosa and anterior rectal wall. Ideal exposure time is also an issue, as lidocaine cream was exposed to the perianal/intrarectal mucosa for 20–30 min [6,7], adding considerable time to an otherwise short office procedure. Efficacy of topical anesthesia exposure times on normal mucosa was demonstrated with sufficient efficacy achieved within 5–10 min [10]. We studied anesthetic effect of 5% lidocaine cream with exposure times of 5, 10 and 20 min applied to the anal ring as well as to combined exposure to the anal ring and rectal walls, followed by PPNB. These groups were compared to a control group who received PPNB alone.
Safety considerations when using drugs to treat pruritus
Published in Expert Opinion on Drug Safety, 2020
Kayla Fourzali, Gil Yosipovitch
Capsaicin, the active ingredient in hot chili peppers, activates TRPV1 receptors in skin to desensitize peripheral nociceptive and pruriceptive nerve fibers. It has been used to alleviate neuropathic forms of pruritus in cream formulation (0.075% −0.1%) as well as in concentrated 8% patches [15]. In controlled trials with the 8% patch, mild to moderate application site reactions (burning, erythema, pain, pruritus) are the most common adverse events with few serious or systemic adverse events reported [16]. Compliance may be limited by the burning sensation that initially accompanies application, as the nociceptive fibers are activated. A pre-treatment with a topical anesthetic (lidocaine/prilocaine) can reduce this effect [17]. Of note, capsaicin application must be avoided in mucocutaneous areas or near the eyes to avoid risk of burning. Additional adverse effects include dermal pain and contact dermatitis that have been reported with topical use. Also, because capsaicin leads to desensitization of the TRPV1 receptors in the skin with a long refractory period, repeated use may lead to persistent localized de-innervation, which may be of particular concern in patients with peripheral neuropathy or other sensory deficits.
Effect of platelet-rich plasma on patients after blepharoplasty surgery
Published in Orbit, 2018
Fidelina Parra, David Enrique Morales-Rome, Rafael Campos-Rodríguez, Teresita Rocío Cruz-Hernández, Maria Elisa Drago-Serrano
In plasma layer appeared three fractions: top fraction containing platelet-poor plasma, a middle fraction corresponded to a plasma with a platelet number similar to that of the peripheral blood, and a third fraction next to the red blood cells and just above the white series, highly enriched in platelets and growth factors. The latter fraction was collected with a sterile syringe and placed into a tube kept at 37°C. PRP was activated 5–10 min before its application by mixing 0.01 mL of calcium gluconate per each mL of plasma. Anesthetic cream containing 2.5% lidocaine/prilocaine was applied on the eyelids. A volume of 1.8 mL of activated PRP was divided in two equal portions for application to each eyelid and administered intradermically by using an insulin syringe (BD Ultra-Fine 31 G × 0.8 mm).