Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
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Comparative Study
Clonidine premedication decreases propofol consumption during bispectral index (BIS) monitored propofol-ketamine technique for office-based surgery.
Propofol-ketamine anesthesia is a room air, spontaneous ventilation (RASV), dissociative intravenous (IV) sedation technique reported to have a near-zero postoperative nausea and vomiting (PONV) rate. Clonidine premedication has been reported to control blood pressure intra- and postoperatively, as well as to reduce the requirements for hypnotic agents. The bispectral index (BIS) monitor is a reproducible, objective, observer independent, quantitative measurement of the hypnotic state. ⋯ A statistically significant reduction in propofol consumption was observed in the clonidine premedicated female elective rhytidectomy patients compared with those not receiving the clonidine. Other than modestly increased requirements for IV fluids, there were no adverse effects observed with clonidine premedication.
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Atrophic scars of the forehead can result from various pathologic processes including morphea en coup de sabre as well as trauma. A variety of surgical techniques can be used to correct these atrophic scars. ⋯ En bloc autologous dermal fat grafting appears to be a safe technique that provides excellent cosmetic results for the correction of small to medium depressed scars of the forehead.
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Digital photography is emerging as a standard method of documenting preoperative, intraoperative, and postoperative results in the clinical setting. While hard copies of these electronic images can be quickly and easily generated on color laser or inkjet printers, there are times when it is necessary to generate a true photographic print of an image, either for insurance documentation or to meet the publication requirements of a peer-reviewed journal. Standard inkjet and laser printers are unable to generate true photographic prints. ⋯ While color laser or inkjet printers allow physicians to generate their own hard copies of electronic patient images, photographic quality images are at times needed to satisfy requirements for insurance documentation or publication in peer-reviewed journals. Use of on-line service bureaus is the most cost-effective way that we have found to obtain high-quality photographic color or black-and-white prints from electronically stored patient images.
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Comparative Study Clinical Trial Controlled Clinical Trial
Topical anesthesia for laser hair removal: comparison of spot sizes and 755 nm versus 800 nm wavelengths.
The Candela alexandrite and the Coherent diode laser systems come equipped with built-in skin cooling systems that are designed to both protect the epidermis, allowing higher fluences, and to alleviate discomfort. Nevertheless, pain can be a significant problem especially with treatment of larger areas. Scatter of the laser beam is reportedly affected by the spot size. It is claimed that larger spot sizes are more effective at identical fluences. ⋯ Topical 5% lidocaine cream is a simple and effective method for reducing patient discomfort during laser hair removal procedures, even when a skin cooling device is being used. A larger spot size causes more pain than a smaller spot size at identical fluences. The 800 nm diode laser causes greater discomfort than the 755 nm alexandrite laser.
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The purpose of this study was to quantitatively evaluate venous reflux in limbs with isolated superficial venous insufficiency using color duplex ultrasound. In addition, air plethysmography (APG) was used to investigate possible correlations of duplex-derived peak velocity, duration of reflux, and CEAP classification. ⋯ Severe chronic venous insufficiency is found in limbs with high reflux velocity (greater than 30 cm/second) and the duration of reflux does not correlate with severe chronic insufficiency.