Lidocaine-based Topical Anesthetic With Disinfectant (LidoDin) Versus EMLA for Venipuncture: A Randomized Controlled Trial

Comparison of the Effects of Lidocaine-Prilocaine Cream and Lidocaine Injection on the Reduction of Perineal Pain While Doing and Repairing Episiotomy in Natural Vaginal Delivery: Randomized Clinical Trial

Background

Doing and repairing episiotomy in a natural vaginal delivery is a painful phenomenon and various methods have been used to reduce its pain. Nowadays, topical ointments are being increasingly used due to low systemic absorption and ease of use.

Objectives

The present study aimed to compare the effects of lidocaine-prilocaine cream (XYLA cream) and lidocaine injection on the reduction of pain while doing and repairing episiotomy.

Methods

This randomized clinical trial was conducted on 98 pregnant women with the gestational age of > 37 weeks. In the intervention group that contained 50 women, 5 gr XYLA cream was applied to the episiotomy area one hour prior to delivery. It was also applied to healthy wound edges to numb the area while repairing episiotomy. In the control group, lidocaine 2% injection was used at the time of delivery. The two groups were compared regarding demographic characteristics, delivery characteristics, pain intensity based on visual analogue scale (VAS), and satisfaction with the applied technique.

Results

The results showed no significant differences between the two groups with respect to age, occupation, mother’s weight and education level, gestational age, parity, number of deliveries, and infant’s weight and head circumference (P > 0.05). Also, no significant difference was found between the two groups concerning the length of the active, second, and third phases of labor (P > 0.05). Considering postpartum complications (episiotomy wound infection), the infection was detected in three participants in the XYLA cream group and four individuals in the lidocaine group, but the difference was not statistically significant (P = 0.376). It should be noted that the application of XYLA cream did not cause eye irritation in any of the infants. The results also revealed no significant differences between the two groups regarding pain intensity and satisfaction with the applied technique after doing and repairing episiotomy (P = 0.288).

Conclusions

The results indicated that XYLA cream had no specific complications and had an effect similar to lidocaine injection while doing the episiotomy.

Comparison of the Efficacies of Topical Anaesthetics in the Reduction of the Pain during Peripheral Intravenous Cannulation: A Randomised Trial

Objective

This study aimed to compare the efficacies of two different topical anesthetic agents and placebo in the reduction of the pain observed during intravenous (IV) cannulation.

Methods

Study enrolled a total of 129 healthy male donors and IV cannulation was performed to antecubital region. The donors were assigned into three groups. Prilocaine-lidocaine mixture cream (E), lidocaine spray (X) and Placebo cream (P) were given to patients. After the administration the donors were waited for approximately 45 minutes. The pain experienced by the donors after the insertion of 16 gauge cannula in arms was recorded as “pain experienced at minute 0, 5 and 15” on 100 mm visual analog scale (VAS).

Results

In the first group, there was no significant difference between mean VAS scores recorded after the administration of prilocainelidocaine mixture cream and lidocaine spray before IV cannulation. Mean VAS value was 9.1 mm with prilocaine-lidocaine mixture cream and 9.3 mm with lidocaine spray. In the second group, we detected significant difference between mean VAS scores recorded after the administration of lidocaine spray and placebo cream. Mean VAS value was 9.8 mm with lidocaine spray and 24.3 mm with placebo (p<0.05). In the third group, we found statistically significant difference between VAS scores recorded after the administration of prilocaine-lidocaine mixture cream and placebo cream. Mean VAS value was 8.8 mm with prilocaine-lidocaine mixture cream and 33.0 mm with placebo cream (p<0.05).

Conclusion

Although both agents administrated before IV cannulation were superior to placebo in adult patients in this study, we can state that these drugs were not superior to each other and showed similar efficacy.

Relaxation and guided imagery used with 12-year-olds during venipuncture in a school-based screening study

Needle-related procedures are reported to be problematic for children. In a school-based celiac disease screening, 12-year-olds' experiences with relaxation and guided imagery (R-GI) during venipuncture were investigated. One group tried nurse-led R-GI (n = 60) and another group received standard care (SC; n = 49). A mixed method design was applied using short written narratives, facial affective scale (FAS), and visual analog scale (VAS) for pain intensity. Qualitative content analysis highlighted that diversity and contradictions when facing blood tests. FAS scores were significantly lower in the SC group before (p = 0.01), during (p = 0.01), and after (p = 0.01) venipuncture. VAS scores did not differ between the groups. The blood test was mostly experienced as unproblematic, and GI during venipuncture did not decrease pain or affect. However, the fact that a number of children scored high FAS indicates a need for effective methods to help children cope with needle-related school-based procedures.

Conservative treatment for neck pain: medications, physical therapy, and exercise

This article offers conservative treatment strategies for patients suffering from musculoskeletal causes of neck pain. Basic pharmacology is reviewed, including that of opioids, nonsteroidal anti-inflammatory drugs, adjuvants, and topical analgesics. Moreover, indications for therapeutic exercise, manual therapy, and modalities are reviewed, along with any supporting literature. Treatment considerations with each category of medication and physical therapy are discussed. This article is meant to serve as a resource for physicians to tailor conservative treatment options to their individual patients.

The effectiveness of Oraqix versus TAC(a) for placement of orthodontic temporary anchorage devices

OBJECTIVE

To test the hypothesis that there is no difference in the actions and effectiveness of topical anesthetics TAC Alternate (TAC((a))) and Oraqix in placing temporary anchorage devices (TADs).

MATERIALS AND METHODS

Each topical anesthetic was placed on opposing sides in the maxilla or mandible using blinded applicators for 3-9 minutes followed by the TAD placement. A total of 21 patients ranging from 10-25 years old were studied. During the procedure the primary investigator (PI) used the sound, eye, and motor scale to measure the movements elicited by the patient. The PI also noted the time taken for the topical anesthetic to be effective and the amount that was applied. Following the placement of the TADs, the patients were given the Wong-Baker FACES Scale and the Visual Analog Scale to rate the degree of discomfort. The nonparametric Wilcoxon signed-rank test was used to test the effectiveness of the treatments based on the three ordinal scales, the dosage, and the onset time.

RESULTS

The time it took for the TAC((a)) to provide adequate anesthesia averaged 4.43 minutes and for Oraqix the time was 6.33 minutes (P = .00). The minimum dosage of TAC((a)) to provide adequate anesthesia averaged 0.25 mL, and for Oraqix the minimum dosage averaged 0.31 mL (P = .00).

CONCLUSIONS

The hypothesis was rejected. TAC((a)) was more effective than Oraqix in placing TADs with a recommended dose of 0.20-0.30 mL and a minimum application time of 3 minutes.