The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Dec 2011
Randomized Controlled TrialEffect of alkalinisation of lignocaine for intraoral nerve block on pain during injection, and speed of onset of anaesthesia.
Injections of lignocaine as local anaesthetic for pain control in oral and maxillofacial surgery can themselves be painful. The time of onset of anaesthesia is from 3 to 5 min. Sodium bicarbonate has been used worldwide to reduce both these drawbacks to the injection, so making procedures more acceptable. ⋯ No patient given the injection with sodium bicarbonate complained of pain, compared with 39/50 (78%) not given sodium bicarbonate (p<0.0001). The mean (SD) time (seconds) to onset of local anaesthesia in the group given sodium bicarbonate was 34.4 (9.8) compared with 109.8 (31.6) in the control group (p<0.001). Our results have confirmed the efficacy of the alkalinised local anaesthetic solution in reducing pain on injection and resulting in quicker onset of anaesthesia.
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Br J Oral Maxillofac Surg · Dec 2011
ReviewFace, neck, and eye protection: adapting body armour to counter the changing patterns of injuries on the battlefield.
Recent international papers have suggested an urgent need for new methods of protecting the face, neck, and eyes in battle. We made a systematic analysis to identify all papers that reported the incidence and mortality of combat wounds to the face, eyes, or neck in the 21st century, and any papers that described methods of protecting the face, neck, or eyes. Neck wounds were found in 2-11% of injuries in battle, and associated with high mortality, but no new methods of protecting the neck were identified. ⋯ Given the need to balance protection with the functional requirements of the individual soldier, a multidisciplinary approach is required. Military surgeons are well placed to work with material scientists and biomechanical engineers to suggest modifications to the design of both personal and vehicle-mounted protection. Further research needs is needed to find out how effective current methods of protecting the neck are, and to develop innovative methods of protecting the vulnerable regions of the neck and face.