Scand J Plast Recons
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Scand J Plast Recons · Jan 2009
Randomized Controlled Trial Comparative StudyModification of the forearm tourniquet techniques of intravenous regional anaesthesia for operations on the distal forearm and hand.
Our aim was to find out if a modified intravenous regional anaesthetic block technique, used for invasive surgical procedures on the distal forearm and hand, results in a drier operative field than traditional methods. Twenty consenting adult (age > 18) patients who were to have an operation on the distal forearm or hand were randomised into two groups (n=10 in each). The first group was using a traditional bier block, with a double upper arm tourniquet. ⋯ This benefit was not sustained postoperatively (p=0.57). Plasma lignocaine concentrations were higher in the conventional group (p=0.004). The modified technique was as safe as the conventional technique but has the benefits of a drier surgical field and improved intraoperative comfort for patients.
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Scand J Plast Recons · Jan 2005
Randomized Controlled TrialIntermittent injection of bupivacaine into the margin or the cavity after reduction mammaplasty.
Twenty-seven operated women had postoperative intermittent injections of bupivacaine or saline for 24 hours after reduction mammaplasty. The injections were given five-hourly either subcutaneously along the submammary incision or deep into the wound. The patients were randomised into three groups of nine each: 5 ml bupivacaine 0.25% into the margin; 5 ml bupivacaine 0.25% into the cavity; and 5 ml physiological saline into the cavity. ⋯ Total morphine consumption was significantly (p<0.03) lower in patients given bupivacaine into the margin (2.0 (0.9) mg) or into the cavity (2.4 (0.8) mg) compared with controls (6.9 (1.5) mg). VAS pain scores and vomiting did not differ among the three groups. Postoperative intermittent infusion of bupivacaine lowered morphine consumption after reduction mammaplasty, and the analgesic effect seemed to be independent of where the infusion was given.
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Scand J Plast Recons · Sep 2001
Randomized Controlled Trial Clinical TrialRole of pre-emptive analgesia in reduction mammaplasty.
Pre-emptive analgesia is an antinociceptive treatment that prevents altered central excitability from high intensity noxious stimuli. The aim of this study was to evaluate the efficacy of pre-emptive analgesia in patients due to have elective breast reduction that usually requires drugs for postoperative pain control. ⋯ Analgesic requirements were recorded. There was a statistically significant difference between groups in the amount of additional pain control required during the early postoperative period, which suggests that pre-emptive analgesia reduces pain after reduction mammaplasty.
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Scand J Plast Recons · Mar 1999
Randomized Controlled Trial Clinical TrialBilateral infraorbital nerve block is superior to peri-incisional infiltration for analgesia after repair of cleft lip.
Cleft lip repair is a common operation in infants and requires that the child is pain-free during the postoperative period so that handling does not affect the integrity of the delicate surgical site. This study was designed to compare the efficacy and duration of effect of 0.125% bupivacaine given preoperatively as a bilateral infraorbital nerve block with peri-incisional infiltration of the same local anaesthetic for postoperative analgesia in cleft lip repair. It was a randomised, double blind, prospective study in 30 children aged 4-20 months (ASA grade 1). ⋯ The analgesic requirement in group B became significant at two hours postoperatively, while group A had significant analgesic requirements only after eight hours. The significant rise in heart rate and blood pressure that accompanied tracheal intubation in both groups suggested that while both methods of analgesia may be adequate to prevent responses to skin incision, they do not substitute for adequate systemic analgesia during the operation. We conclude that infraorbital nerve block with 0.125% bupivacaine provides better and more prolonged analgesia than peri-incisional infiltration in cleft lip repair.
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Scand J Plast Recons · Mar 1994
Randomized Controlled Trial Comparative Study Clinical TrialAlkalisation of lignocaine-adrenaline reduces the amount of pain during subcutaneous injection of local anaesthetic.
A double blind, randomised controlled trial was performed to compare the amount of pain experienced after subcutaneous infiltration of lignocaine with adrenaline, and the same anaesthetic buffered to pH 7.1-7.3, in patients undergoing liposuction (n = 8), blepharoplasty (n = 7), mammaplasty (n = 6), and in volunteers (n = 10). A linear analogue pain scale was used to access pain. In all four groups the buffered solution caused significantly less pain (p < 0.001 except for mammaplasty--p = 0.02).