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Navrazhina K, Shah K, Rigo R, Shochat T, Minkis K. Anatomic Location Influences Duration of Local Lidocaine Anesthesia in Dermatologic Surgery. Dermatol Surg 2024; 50:155-159. [PMID: 38048284 DOI: 10.1097/dss.0000000000004012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND Although the onset and duration of local anesthetics are well-defined, how the anatomic site influences the duration of local anesthetics has not been well characterized in dermatology. OBJECTIVE To define the duration of local anesthesia by anatomic site. MATERIALS AND METHODS This was a prospective study. Adult healthy volunteers and patients undergoing Mohs micrographic surgery were invited to participate. The nose and the shin were chosen to represent highly and poorly vascularized anatomic sites, respectively. A total of 0.5 mL of buffered 1% lidocaine hydrochloride with 1:100,000 epinephrine was injected subcutaneously into each anatomic site of each participant. A pinprick test was used to assess adequate anesthesia until return of baseline sensation or visit completion. RESULTS This study enrolled 25 participants. Time to return of sensation was significantly shorter on the nose compared with the shin ( p < .0001). On the nose, there was an association between male sex and shorter time to return of sensation. CONCLUSION Time to return of sensation is significantly shorter on the nasal ala compared with the shin, suggesting that patients may regain sensation sooner on highly vascularized sites. Defining the duration of local anesthetics based on anatomic regions is important for treatment planning in dermatologic procedures.
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Affiliation(s)
- Kristina Navrazhina
- Department of Dermatology, Weill Cornell/New York Presbyterian, New York, New York
- Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional M.D.-Ph.D. Program, New York, New York
| | - Kalee Shah
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Rachel Rigo
- Department of Dermatology, Weill Cornell/New York Presbyterian, New York, New York
| | | | - Kira Minkis
- Department of Dermatology, Weill Cornell/New York Presbyterian, New York, New York
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Qiao Z, Wang X, Deng Y, Li Q, Zan T, Sun Y, Xiong X, Meng X, Li W, Yi Z, Li X, Fang B. Clinical Application of Pre-Expanded Perforator Flaps. Facial Plast Surg Aesthet Med 2023; 25:68-73. [PMID: 34619036 DOI: 10.1089/fpsam.2021.0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Challenging large soft tissue defects are typically treated with microvascular free tissue transfer; however, success has been noted with pre-expanded perforator flaps. Objective: To report outcomes and complications from pre-expanded perforator flaps. Methods: A retrospective chart review of patients undergoing tissue reconstruction with pre-expanded perforator flaps between 2014 and 2020. Data collection included flap type, defect characteristics, and complications. Results: All 29 patients had successful flap reconstruction without major complication. The median area of tissue defect was 17 × 13 cm2 (range 7 × 4 to 27 × 24 cm2). Mean tissue expansion period was 15.2 weeks (range 9-26 weeks). The most common flap was the pre-expanded internal mammary artery perforator flaps. Conclusion: The findings of this study suggest that combining tissue expansion with a perforator flap for large tissue reconstruction can be successful with limited complications. This technique may allow a larger pliable skin flap that deserves further investigation.
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Affiliation(s)
- Zhihua Qiao
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiancheng Wang
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yiwen Deng
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, The Ninth Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Tao Zan
- Department of Plastic and Reconstructive Surgery, The Ninth Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Yang Sun
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Xiong
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xianxi Meng
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenbo Li
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhongjie Yi
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaofang Li
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
| | - Borong Fang
- Department of Plastic and Burns, Second Xiangya Hospital, Central South University, Changsha, China
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Local anesthesia in oral and maxillofacial surgery: A review of current opinion. J Dent Sci 2021; 16:1055-1065. [PMID: 34484571 PMCID: PMC8403808 DOI: 10.1016/j.jds.2020.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
Local anesthesia (LA) is the most important pain management process in oral and maxillofacial surgery. Safe and effective LA not only enable patients to obtain high-quality treatment, but also relieve the anxiety of patients when they come to the clinic. The choices of local anesthetic and injection methods determine the success of LA to a great extent. At present, in most countries or regions, common local anesthetics used in oral and maxillofacial surgery belong to amides and they are injected into patients' body mainly through block or infiltration anesthesia. In addition, the operators' technique level, patient's subjective psychology and anatomical variation of maxillofacial structure also have a strong influence on LA in dental clinic. Due to the existence of above factors, the worldwide success rates of LA in oral and maxillofacial surgery is very different. There are no specific LA methods that ensure 100% successful LA rates. Fortunately, the development of new local anesthetic and injection technology are providing us with new ideas to solve this problem. This review mainly report the new research progress on LA in oral and maxillofacial surgery in recent decades and help clinicians with dental LA operation.
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Riff C, Diaz A, Blin O, Leone M, Guilhaumou R, Bourgoin A. Tumescent local anaesthesia for breast cancer surgery in elderly women: about 6 cases. Anaesth Crit Care Pain Med 2018; 38:387-389. [PMID: 29864551 DOI: 10.1016/j.accpm.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 10/14/2022]
Affiliation(s)
- C Riff
- Department of clinical pharmacology et Pharmacovigilance, AP-HM, 13385 Marseille, France; Integrated pharmacology and industrial clinical platform, Institut des Neurosciences Timone-AMU-CNRS 7289, Aix-Marseille Université, 13385 Marseille, France.
| | - A Diaz
- Department of anaesthesia and intensive care, Aix Marseille University, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, APHM, 13015 Marseille, France
| | - O Blin
- Department of clinical pharmacology et Pharmacovigilance, AP-HM, 13385 Marseille, France; Integrated pharmacology and industrial clinical platform, Institut des Neurosciences Timone-AMU-CNRS 7289, Aix-Marseille Université, 13385 Marseille, France
| | - M Leone
- Department of anaesthesia and intensive care, Aix Marseille University, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, APHM, 13015 Marseille, France
| | - R Guilhaumou
- Department of clinical pharmacology et Pharmacovigilance, AP-HM, 13385 Marseille, France
| | - A Bourgoin
- Department of anaesthesia and intensive care, Aix Marseille University, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, APHM, 13015 Marseille, France
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5
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Chen Y, Zeng Y, Zhang Y. A study on reducing the absorption of lidocaine from the airway in cats. Acta Cir Bras 2017; 32:662-672. [PMID: 28902942 DOI: 10.1590/s0102-865020170080000008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/18/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose: To determine if the combination of lidocaine with epinephrine or gamma globulin would decrease the rate or reduce the amount of local absorption of lidocaine through the airway. Methods: Twenty adult male cats were randomly and evenly distributed into four groups: 1) Group LG: lidocaine administered with gamma globulin; 2) Group LS: lidocaine administered with physiological saline); 3) Group LE: lidocaine administered with epinephrine; 4) Group C: control group. Invasive blood pressure, heart rate, and concentration of lidocaine were recorded before and after administration. Results: The peak of plasma concentrations appeared difference (Group LG: 1.39 ± 0.23 mg/L; Group LS: 1.47 ± 0.29 mg/L and Group LE: 0.99 ± 0.08 mg/L). Compared to Group C, there were significant differences in the average heart rate of Groups LG, LS, and LE (P < 0.05). The average systolic blood pressures were significantly different when each group was compared to Group C (P < 0.05). The biological half-life, AUC0-120, peak time, and half-life of absorption among the three groups have not presented statistically significant differences (P > 0.05). Conclusion: Administering lidocaine in combination with gamma globulin through airway causes significant decrease the rate and reduce the amount of local absorption of lidocaine in cats.
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Affiliation(s)
- Yunfeng Chen
- Master of Medicine, Department of Pulmonary Medicine, The Second Affiliated Hospital, Fujian Medical University, China. Acquisition and analysis of data, conception of the study, manuscript writing, final approved
| | - Yiming Zeng
- Master of Medicine, Department of Pulmonary Medicine, The Second Affiliated Hospital, Fujian Medical University, China. Acquisition and analysis of data, conception of the study, manuscript writing, final approved
| | - Yin Zhang
- Doctor of Pharmacy, Department of Pharmacy, The Second Affiliated Hospital, Fujian Medical University, China. Measured the lidocaine concentration, calculate pharmacokinetics, final approved
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6
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Roh J, Han M, Kim KN, Kim KM. The in vitro and in vivo effects of a fast-dissolving mucoadhesive bi-layered strip as topical anesthetics. Dent Mater J 2017; 35:601-5. [PMID: 27477225 DOI: 10.4012/dmj.2015-369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To overcome pain on injection, the dentist can apply a topical anesthetic spray. Despite the convenience, it is not easy to apply it locally. So, we developed an oral mucoadhesive bi-layer film containing an anesthetic. We used polyvinylpyrrolidone (PVP)/hydroxypropyl methylcellulose (HPMC) and HPMC-only layer as the drug-containing layer and ethyl cellulose (EC) as the backing layer. The lidocaine released was tested in vitro together with the adhesion time and cytotoxicity of the film. Mucosa permeability was tested in vivo. Statistical analysis was performed, with p at 0.05 taken to be significant. The lidocaine was released significantly faster in the PVP/HPMC than HPMC-only group and 80% of the drug was released within 1 min (p<0.05) and they attached at least 3 h. The test groups showed no toxicity and the drug effectively permeated the mucosa (p<0.05). We suggest this new mucoadhesive anesthetic may reduce dental phobia.
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Affiliation(s)
- Jiyeon Roh
- BK 21 PLUS Project, Yonsei University College of Dentistry
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7
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Preparation and evaluation of oral dissolving film containing local anesthetic agent, lidocaine. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2016. [DOI: 10.1007/s40005-016-0298-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Abstract
Hidradenitis suppurativa is difficult to treat owing to its complex pathomechanism; beside the extensive inflammation with abscesses and inflammatory nodules, there is also an architectural loss with sinus tract formation and in severe cases with extensive scarring. Therefore, surgery is mandatory in moderate and severe HS.
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Affiliation(s)
- Ineke Janse
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
| | - Andrzej Bieniek
- Department of Dermatology, Wroclaw Medical University, University of Wrocław, Chalubinskiego 1, 50-368 Wrocław, Poland
| | - Barbara Horváth
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands
| | - Łukasz Matusiak
- Department of Dermatology, Wroclaw Medical University, University of Wrocław, Chalubinskiego 1, 50-368 Wrocław, Poland
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Kouba DJ, LoPiccolo MC, Alam M, Bordeaux JS, Cohen B, Hanke CW, Jellinek N, Maibach HI, Tanner JW, Vashi N, Gross KG, Adamson T, Begolka WS, Moyano JV. Guidelines for the use of local anesthesia in office-based dermatologic surgery. J Am Acad Dermatol 2016; 74:1201-19. [PMID: 26951939 DOI: 10.1016/j.jaad.2016.01.022] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/19/2015] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
There are an increasing number and variety of dermatologic surgical procedures performed safely in the office setting. This evidence-based guideline addresses important clinical questions that arise regarding the use and safety of local anesthesia for dermatologic office-based procedures. In addition to recommendations for dermatologists, this guideline also takes into account patient preferences while optimizing their safety and quality of care. The clinical recommendations presented here are based on the best evidence available as well as expert opinion.
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Affiliation(s)
- David J Kouba
- Toledo Clinic Facial Plastics and Dermatology, Toledo, Ohio
| | - Matteo C LoPiccolo
- Toledo Clinic Facial Plastics and Dermatology, Toledo, Ohio; Department of Dermatology, Henry Ford Health System, Detroit, Michigan; Dermatology Specialists of Shelby, Shelby, Michigan
| | - Murad Alam
- Department of Dermatology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Bernard Cohen
- Department of Dermatology-Pediatrics, Johns Hopkins Children's Center, Baltimore, Maryland
| | - C William Hanke
- Laser and Skin Surgery Center of Indiana PC, Carmel, Indiana
| | - Nathaniel Jellinek
- Department of Dermatology, Brown University, East Greenwich, Rhode Island
| | - Howard I Maibach
- Department of Dermatology, UCSF School of Medicine, San Francisco, California
| | - Jonathan W Tanner
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neelam Vashi
- Department of Dermatology and Center for Ethnic Skin, Boston University School of Medicine, Boston, Massachusetts
| | | | - Trudy Adamson
- Department of Nursing, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Wendy Smith Begolka
- Department of Science, Quality and Practice, American Academy of Dermatology, Schaumburg, Illinois
| | - Jose V Moyano
- Department of Science, Quality and Practice, American Academy of Dermatology, Schaumburg, Illinois.
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Endovenous Laser Ablation of Great Saphenous Veins Performed Using Tumescent Cold Saline Solution without Local Anesthesia. Ann Vasc Surg 2014; 28:951-6. [DOI: 10.1016/j.avsg.2013.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 10/13/2013] [Accepted: 11/19/2013] [Indexed: 11/21/2022]
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11
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Dumantepe M, Uyar I. Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser. Phlebology 2013; 30:45-51. [DOI: 10.1177/0268355513512827] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this study was to compare the pain perception and side effects during and after endovenous laser ablation with a 1470 nm diode laser using cold or room temperature tumescence anesthesia. Methods: One hundred and one patients were randomly assigned in two groups. Group A received room temperature (+24℃) and Group B received cold (+4℃) tumescence fluid, which was used for local anesthesia in the track of great saphenous vein. A visual analog score was recorded immediately after the procedure. Patients were asked to register pain scores and the amount of pain medication consumed during the week. Results: There was no significant difference concerning gender, age, Clinical Etiological Anatomical Pathological Classification, body mass index, or diameter of the treated vein. In Group A, the mean linear endovenous energy density was 59.5 J/cm and in Group B, it was 60.4 J/cm. The average visual analog score after the endovenous laser ablation procedure in Group A was 5 and in Group B was 2. Third day after the procedure, the average visual analog score in Group A was 3 and in Group B was 1. Patients in Group B needed significantly less analgesics compared with patients in Group A ( p<0.05). The most frequent side effects in both groups were ecchymosis, induration, and minor paraesthesia, all of which were more common in Group A ( p < 0.001). Conclusions: To date, most published endovenous laser ablation series describe the use of room temperature tumescence fluid infiltration of the perivenous stroma for tumescent analgesia and protection against thermal injury to the nearby structures. We describe an alternative technique using cold tumescence fluid infiltration, which is equally effective as, but safer than, room temperature tumescence fluid infiltration, and which yields better visual analog scores.
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Affiliation(s)
- Mert Dumantepe
- Department of Cardiovascular Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ibrahim Uyar
- Department of Cardiovascular Surgery, Akut Kalp Hospital, Izmir, Turkey
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Hernández Osma E, Mordon SR, Marqa MF, Vokurka J, Trelles MA. A comparative study of the efficacy of endovenous laser treatment of the incompetent great saphenous under general anesthesia with external air cooling with and without tumescent anesthesia. Dermatol Surg 2012; 39:255-62. [PMID: 23227920 DOI: 10.1111/dsu.12063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This clinical study reports our experience with endovenous laser treatment (ELT) in which external air cooling is used without classic tumescent anesthesia. METHODS Two hundred thirty-two patients underwent ELT under general sedation. In group A (n = 192), ELT was performed with air cooling but without the concurrent use of tumescent anesthesia. In group B (n = 40), patients were treated using the traditional tumescent technique. The parameters were similar for both groups: 980-nm diode laser, power of 15 W, and pulse duration of 1 second. The laser fiber and catheter were manually withdrawn in 3-mm increments. Ultrasound was performed to reevaluate vein closure at the end of surgery and 2 and 8 weeks and 1 year after. During follow-up, complications such as burns, dyschromia, pain, and dysesthesia, as well as time used for surgery were recorded. RESULTS A 96% closure rate was obtained in groups A and B at 2 and 8 weeks. This rate remained stable 1 year after the ELT procedure. Except for a higher percentage of ecchymoses in group B (55%) than in group A (0%) (p < 0.001), no significant differences were observed for complications. With external air cooling, ELT took 17.5 minutes to perform for the whole leg, compared with 38.5 minutes when using tumescent anesthesia (p < 0.05). CONCLUSION ELT surgery for the great saphenous vein can be safely performed using the air cooling method and is as efficacious as ELT done with tumescent anesthesia but takes significantly less time to perform.
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13
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Numerical simulation of endovenous laser treatment of the incompetent great saphenous vein with external air cooling. Lasers Med Sci 2012; 28:833-44. [PMID: 22836189 DOI: 10.1007/s10103-012-1141-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 06/08/2012] [Indexed: 10/28/2022]
Abstract
Endovenous laser treatment (ELT) has been proposed as an alternative in the treatment of reflux of the great saphenous vein. Before the procedure, peri-saphenous subcutaneous tumescent saline solution infiltration is usually performed. However, diffusion of this tumescent fluid is rapidly observed and can potentially reduce the efficacy as a heat sink. External skin cooling with cold air was proposed as an alternative solution. The objective of this study is to compare endovenous laser treatment without and with air cooling by realistic numerical simulations. An optical-thermal damage model was formulated and implemented using finite element modeling. The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation, and laser-induced injury using the Arrhenius damage model. Parameters, used in clinical procedures, were considered: power, 15 W; pulse duration, 1 s; fiber pull back, 3-mm increments every second; cold air applied in continuous mode during ELT; and no tumescent anesthesia. Simulations were performed for vein locations at 5, 10, and 15 mm in depth, with and without air cooling. For a vein located at 15 mm in depth, no significant difference was observed with and without cooling. For a vein located at 10 mm in depth, surface temperature increase up to 45 °C is observed without cooling. For a vein located at 5 mm, without cooling, temperature increase leads to irreversible damage of dermis and epidermis. Conversely, with air cooling, surface temperature reaches a maximum of 38 °C in accordance with recordings performed on patients. ELT of the incompetent great saphenous vein with external air cooling system is a promising therapy technique. Use of cold air on the skin continuously flowing in the area of laser shot decreased significantly the heat extent and the thermal damage in the perivenous tissues and the skin.
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Creton D, RÉA B, Pittaluga P, Chastanet S, Allaert FA. Evaluation of the pain in varicose vein surgery under tumescent local anaesthesia using sodium bicarbonate as excipient without any intravenous sedation. Phlebology 2011; 27:368-73. [DOI: 10.1258/phleb.2011.011026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective In order to simplify varicose vein surgery, we studied the possibility of tumescent local anaesthesia (TLA) using sodium bicarbonate 1.4% as excipient without any intravenous sedation. Methods For three months, 215 patients were included in two centres for ambulatory varicose vein surgery performed without any intravenous sedation. Clinical results and pain were evaluated according to the type and duration of surgery. Results Mean perioperative pain was evaluated at 2.7 on a visual scale (0–10). In 91% of the cases, surgery was deemed to be slightly painful. Preoperative pain was not linked to the technical means of surgery but to the psychological and organizational environment of the centre. Conclusions In many of the cases, varicose vein surgery could be performed under TLA without any intravenous sedation. Ambulatory varicose vein surgery without any intravenous sedation could be highly cost-effective.
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Affiliation(s)
- D Creton
- Vascular Surgery Center, EC. A. Paré, Rue A. Paré, Nancy 54000, France
| | - B RÉA
- Vascular Surgery Center, EC. A. Paré, Rue A. Paré, Nancy 54000, France
| | - P Pittaluga
- Vascular Surgery Center, EC. A. Paré, Rue A. Paré, Nancy 54000, France
| | - S Chastanet
- Vascular Surgery Center, EC. A. Paré, Rue A. Paré, Nancy 54000, France
| | - F A Allaert
- Vascular Surgery Center, EC. A. Paré, Rue A. Paré, Nancy 54000, France
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Pomerantz RG, Lee DA, Siegel DM. Risk assessment in surgical patients: balancing iatrogenic risks and benefits. Clin Dermatol 2011; 29:669-77. [DOI: 10.1016/j.clindermatol.2011.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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