• Journal of Trauma and Injury
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• 제20권2호
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• pp.115-118
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• 2007

Purpose: A eutectic mixture of local anesthetics (EMLA$^{(R)}$) cream has been used as a topical anesthetic to reduce the pain of procedures penetrating the skin. It is generally applied for 40 to 60 minutes before the painful procedure. Because of the long application period, EMLA$^{(R)}$ is not useful in the emergency department (ED). The purpose of this study was to determine whether a 20-minute application of 9.6% lidocaine would be useful in reducing the pain of routine peripheral intravenous cannulation in the ED. Methods: We examined 27 male and 19 female patients ages over 18 years of age who required intravenous cannula insertion. Intravenous insertion was performed on 46 patients: 24 patients in the placebo group (mean age: 40.0 years) and 22 in the 9.6% lidocaine group (mean age: 37.6 years). The 9.6% lidocaine or placebo gel was applied and covered with an occlusive dressing for 20 minutes. Pain was scored by the patients using a 0- to 10-cm visual analogue scale. Results: The patients in the 9.6% lidocaine group (mean pain score: 3.4) experienced less pain than those in the placebo group (mean: 5.3), and the difference was statistically significant (p=0.029). Conclusion: We concluded that a 20-minute application of 9.6% lidocaine is safe and effective for reducing pain associated with venipuncture.

• Archives of Pharmacal Research
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• 제26권4호
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• pp.317-320
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• 2003

We present two fatal cases, a 41-year-old male (case 1) and his 8-year-old daughter (case 2), resulting from acute lidocaine poisoning. Lidocaine was quantified by gas chromatography (GC) analysis using nitrogen-phosphorus detection. The lidocaine concentrations of cases 1 and 2 were: liver, 27.7 $\mu$ g/g and 24.9 $\mu$g/g; spleen, 70.1 $\mu$g/g and 29.9 $\mu$g/g; and gastric contents, 23.6 $\mu$g/g and 42.8 $\mu$g/g, respectively.

• The Korean Journal of Pain
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• 제8권1호
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• pp.93-98
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• 1995

Arthritis is one of the most common disease of mankind. Major of arthritis is osteoarthritis(OA), but the cause is not clear and the characters are chronic and often progressive. So the management and the pain control of OA are very difficult and adequate ways of controlling it have not been discovered. In the present study we investigated the effects of Knee Intra-articular Injection(KII) of lidocaine with aspirin on OA of the knee. Thirty OA patients with Visual Analogue Scale(VAS) above 8 were studied and they were divided into two groups as follows; Group I(n=15); KII with 1% lidocaine 5 ml Group II(n=15); KII with 2% lidocaine 2 ml and aspirin 2 ml(180 mg, diluted with normal saline) In two groups, KII was done 2 times a week for 4 weeks and we compared the changes of VAS between two groups. The results were as follows; 1) Before the KII, initial mean VAS of group I and II was 8.8 and 8.9. After KII 2 times, VAS of group I and II was 6.6 and 6.4. These deceases were statistically significant, but there was no significant difference of VAS between two groups. 2) After KII 4 times, VAS of group I and II was 6.3 and 5.5, significant decrease was observed in group II. 3) After KII 6 times and 8 times, VAS of group I and II was not decreased anymore, but the VAS of group II was maintained in significant decreased state that of group I. We experienced that KII of lidocaine with aspirin was more effective than that of lidocaine only. So we suggest that KII of mixed solution of lidocaine and apsirin may be one of treatments for OA of the knee.

• The Korean Journal of Pain
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• 제13권2호
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• pp.182-186
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• 2000

Background: Ropivacaine is a new amide local anesthetics, having therapeutic properties similar to those of bupivacaine but less cardiovascular toxicity and motor blockade. The aim of this study was to evaluate the effects of ropivacaine used in stellate ganglion block (SGB) compared with those of lidocaine or bupivacaine. Methods: This prospective and crossover study performed in twenty patients with sudden sensory neural hearing loss. All patients received three times SGB, in the paratracheal approach using 8 ml of 1% lidocaine, 0.2% bupivacaine, and 0.2% ropivacaine respectively without any orders. Onset time and action duration of Horner's syndrome were observed after each SGB. Results: Onset time of ropivacaine was the middle of the three agents; earlier lidocaine and slower bupivacaine. Lidocaine ($3.0{\pm}1.9$ min), bupivacaine ($4.1{\pm}2.9$ min) and ropivacaine ($3.3{\pm}1.3$ min). But there were no significant differences; Action duration of Horner's syndrome of ropivacaine (223.6?105.2 min) was longer than lidocaine ($134.6{\pm}77.3$ min) and shorter than bupivacaine ($241.2{\pm}115.8$ min). There were significant differences in the action duration of each local anesthetics (P<0.05). There was no critical side effects and temporary foreign body sensation was the most common side effect. Conclusions: We conclude that ropivacaine is a good alternative in SGB instead of lidocaine or bupivacaine. Ropivacaine is a long acting local anesthetic similar to those of bupivacaine with wide margin of safety. However, optimal concentration and volume of ropivacaine in SGB should be studied.

• 한국양식학회지
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• 제18권4호
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• pp.236-244
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• 2005

조피볼락(Sebastes schlegeli) 소형어와 중형어를 대상으로 MS-222와 lidocaine-HCl 마취농도에 따른 마취 및 회복시간과 혈액생리학적 반응, 생존율 등을 조사하여 마취효과를 비교하였다. 마취농도에 따른 마취시간은 MS-222와 lidocaule-HCl 모두에서 마취농도가 증가함에 따라 마취시간이 유의하게 감소하였다. 어체크기에 따른 마취시간은 소형어(평균전장 18.2$\pm$1.0cm, 평균체중 100.6$\pm$21.1 g)보다는 중형어(평균전장 14.2$\pm$0.9 cm, 평균체중 51.3$\pm$10.5 g)에서 길었다. 그러나 회복시간은 MS-222와 lidocaine-HCl 모두에서 농도가 증가함에 따라 회복시간이 길어졌다. 회복시간은 소형어보다는 중형어에서 더욱 짧았다. 마취농도에 바른 cortisol 농도는 MS-222 300 ppm에서 마취 6시간후 96.1$\pm$12.1 ng/ml로 가장 높은 값을 나타내었으나, 실험종료시까지 모든 실험구에서 실험 개시전 보다 높은 수준을 보였다. Lidocaine-HCl도 모든 실험구에서 실험 종료시까지 실험개시전보다 높은 값을 나타냈다. Glucose 농도는 소형어의 경우 MS-222 마취 1시간 후 $30.3{\pm}15.4{\~}69.5{\pm}23.2 mg/dl$로 다소 높았으나 마취 6시간 후에는 유의한 차이를 보이지 않았다. 중형어는 소형어 보다 다소 높은 농도를 나타내었으나 12시간 후에는 실험 개시전 수준으로 회복되었다. Lidocaine-HCl 경우는 MS-222와 비슷한 경향을 보였다. Na+ 농도는 모든 실험구에서 실험개시전과 차이를 나타내지 않았다. K+ 농도는 소형어에서 MS-222 마취 1시간후 $5.2{\pm}1.4{\~}6.7{\pm}1.2 mEq/L$의 범위로 유의하게 높았지만 마취 6시간후 실험 개시전 수준으로 회복되었다. 중형어는 유의한 차이를 보이지 않았다 Lidocaine-HCl의 경우, K+ 농도는 모든 실험구에서 실험 개시전과 차이를 나타내지 않았다. 삼투질 농도는 MS-222에서 $317.0{\pm}4.0{\~}362.0{\pm}12.9 mOsm/kg$의 범위를 보였으며, lidocaine-HCl의 경우에도 유사한 경향을 나타냈다. MS-222 마취에서는 모든 실험농도예서 lidocaine-HCl 마취에서는 300${\~}$400 ppm에서 $95\%$이상의 생존율을 나타냈다. 조피볼락의 소형어 및 중형어에 대한 마취제로서 MS-222와 lidocaine-HCl의 농도는 각각 100${\~}$200 ppm, 400 ppm이 적합할 것으로 판정된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.87-93
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• 2017

Purpose: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. Methods: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion. Results: Sedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (p=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (p=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (p=0.019) and the difference was statistically significant. Conclusion: The study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.

• 대한치과마취과학회지
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• 제3권1호
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• pp.6-9
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• 2003

Background: The use of neurolytic agents to control neuropathic pain has been described from the last century Phenol and ethyl alcohol have been widely used as neurolytic agents, however, their neurolytic effect is variable in efficacy and duration of action, and infrequently accompanied with grave complications. It has been found that 5% lidocaine causes irreversible conduction blockade in animal studies. The goal of this study was to evaluate the neurolytic effect of 5%o lidocaine on various neuropathic pain syndromes for prolonged analgesia. Methods: Twenty-five patients with a diagnosis of neuropathic pain including trigeminal neuralgia (n = 7), postherpetic neuralgia (n = 10), and postsurgical neuralgia (n = 8) were selected after failure of routine therapeutic regimens. After performing a diagnostic nerve block with 1% lidocaine and 5% lidocaine was injected. The patients were followed for 6 months. Visual analog scale (VAS) scores and side effects were recorded for each patients. Results: A significant decrease in pain scores after neurolytic blockade with 5% lidocaine was seen in all of three pain groups. All the patients reported immediate and prolonged pain relief lasting from 4 weeks to 6 months. None of patients exhibited any appreciable side effects or complications. Conclusions: We suggest that 5% lidocaine may be used safely and effectively for the purpose of prolonged analgesia in selected patients with intractable neuropathic pain syndromes.

• Journal of Oral Medicine and Pain
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• 제30권3호
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• pp.345-351
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• 2005

근막동통(myofascial pain syndrome, MPS)은 근막발통점에 의해 야기되는 지각, 운동 및 자율신경계의 증상으로 발통점이 자극되면 이환부에 동통을 발생할 뿐 아니라 연관통, 연관압통, 운동신경장애, 자율신경반응을 야기할 수 있다. 본 연구는 근막동통의 다양한 치료법 중에서 botulinum toxin type A(BTX-A)의 주사의 효과를 국소마취제인 lidocaine의 주사효과와 비교하였다. 상부 승모근에 6개월 이상 활동성 발통점을 가진 21명의 환자를 선정한 다음, 무작위로 두 군으로 나누어 한 군(BTX-A 주사군, n=12)에는 발통점에 BTX-A(15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP))를 주사하고 다른 군(lidocaine 주사군, n=9)에는 0.5% lidocaine (0.3 ml /TrP)를 주사하였다. 두 군 모두 주사는 1 회만 시행하였으며 운동요법이나 물리치료 및 약물치료는 시행하지 않았다. 주사 후 동통의 변화를 관찰하기 위하여 주사 전 및 주사 후 2 주, 4 주, 6 주, 8 주에 주관적 동통척도인 VAS와 압력통각역치(PPT)를 측정하였으며 실험은 이중맹검으로 시행되었다. 실험결과, BTX-A 주사군은 주사 후 8 주의 시간이 경과되는 동안 VAS가 지속적으로 감소하였으며 PPT는 지속적으로 증가하였으나 lidocaine 주사군에서는 VAS의 감소만이 관찰되었다. 즉, 주관적인 동통척도에 있어서는 BTX-A 주사군과 lidocaine 주사군 사이에 유의한 통계학적 차이가 나타나지 않고(p=0.347), 두 군 모두 시간경과에 따라 동통이 감소하는 양상을 보여주었다. 그러나 PPT의 경우에는 BTX-A 주사군에서만 감소하여 두 군 사이에 유의한 통계학적 차이가 관찰되었다(p=0.000). 본 연구의 결과에 따르면 상부승모근 발통점에 대한 BTX-A 주사는 효과적이고 신뢰할 만한 치료법이라고 생각된다.

• Journal of Pharmaceutical Investigation
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• 제35권6호
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• pp.417-422
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• 2005

This study was aimed to design and formulate the moisture-activated patches containing ofloxacin and lidocaine for antibacterial and local anesthetic action. The solubility of lidocaine at $32^{\circ}C$ in various vehicles decreased in the rank order of PG $759.5{\pm}44.5\;mg/mL$ > PGL > IPM > PEG 300 > PEG 400 > Ethanol > PGMC > DGME > PGML > OA > $Captex^{\circledR}\;300$ > $Captex^{\circledR}\;200$ > water $(4.0{\pm}0.1\;mg/mL)$. Ofloxacin revealed very low solubility, which the highest solubility was obtained from PEG 400 $(18.7{\pm}6.3\;mg/mL)$ among the vehicles used. The addition of lactic acid increased the solubility of ofloxacin dramatically; the solubility at 5% lactic acid was $133.7{\pm}9.7\;mg/mL$. As $2-hydroxypropyl-{\beta}-cyclodextrin$ was added at the concentrations of 40, 80, 120, 160 and 200 mM, the solubilities of lidocaine and ofloxacin were enhanced up to three and two times, respectively, with concentration-dependent pattern. Gel intermediates for filmtype patches were prepared with mucoadhesive polymer, viscosity builders, lidocaine or ofloxacin at pH values from 5 to 7. Gels were cast onto a release liner and dried at room temperature. Dried patch was attached onto an adhesive backing layer, thus forming a patch system. Patches containing a single drug component were characterized by in vitro measurement of drug release rates through a cellulose barrier membrane. The release study was carried out at $37^{\circ}C$ using a Franz-type cell. Receptor solutions were isotonic phosphate buffers (pH 7.4). Samples $(100\;{\mu}L)$ were taken over 24 hours and quantitated by a verified HPLC method. The releases from all tested were proportional to the square root of time. The release rates were 0.9, 157.3 and $281.7\;{\mu}g/cm^{2}/min^{1/2}$ for the lidocaine patches and 19.8,37.2 and $50.7\;{\mu}g/cm^{2}/min^{1/2}$ for the ofloxacin patches at the concentrations of 0.3, 0.5 and 1 %, respectively. The release rates were dose dependent in both drug patches $(R^{2}\;=\;0.9077\;for\;lidocaine;\;R^{2}\;=\;0.9949\;for\;ofloxacin)$ and those were also thickness-dependent $(R^{2}\;=\;0.9246\;for\;lidocaine;\;R^{2}\;=\;0.9512\;for\;ofloxacin)$.

• 기본간호학회지
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• 제2권1호
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• pp.37-43
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• 1995

This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as $4.56{\pm}1.38$ and $2.05{\pm}1.36$ points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%)and pallor (5 cases, 6.3%)were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27cases, 16.9%)and fear for needle insertion(6 cases, 3.8%). The most frequent problems with EMLA cream application were an inconvenience in use (11 cases, 6.9%)and tedious long pretreatment time(11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.