The Experts below are selected from a list of 85053 Experts worldwide ranked by ideXlab platform
Daniel I Sessler - One of the best experts on this subject based on the ideXlab platform.
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Lidocaine tetracaine patch rapydan for topical anaesthesia before arterial access a double blind randomized trial
BJA: British Journal of Anaesthesia, 2012Co-Authors: Kurt Ruetzler, B Sima, L Mayer, A Golescu, Walter Jaeger, Martina Hoeferl, Daniel I Sessler, Daniela Dunkler, Georg GrubhoferAbstract:Background Arterial catheterization is painful and is associated with patient stress and anxiety. Analgesia is usually provided by subcutaneous injection of local anaesthetic. An alternative is topical anaesthesia, such as Rapydan which is a novel topical anaesthetic patch containing 70 mg each of Lidocaine and tetracaine. We therefore tested the hypothesis that Rapydan patch analgesia is non-inferior to subcutaneous local anaesthetic. Methods Ninety patients undergoing elective major cardiac surgery were included in this prospective, double-blind clinical trial. Patients were randomly assigned to receive either a Lidocaine/tetracaine patch, followed by subcutaneous injection 0.5 ml of normal saline solution, or placebo patch with subsequent subcutaneous injection of 0.5 ml of Lidocaine 1%. Pain during arterial catheterization using 100-mm-long visual analogue scale (VAS) was the primary outcome. Other outcomes were pain during anaesthetic/saline injection and plasma tetracaine concentrations. Results VAS pain scores during arterial puncture were comparable in both groups and Rapydan was non-inferior to subcutaneous Lidocaine. Pain scores at the time of subcutaneous injection were significantly lower (better) in patients assigned to the Lidocaine/tetracaine patch than to Lidocaine ( P =0.001). Plasma tetracaine concentrations never exceeded the detection limit of 25 ng ml −1 at any time in any patient. Conclusions Both the Lidocaine/tetracaine patch and subcutaneous injection of Lidocaine provided comparable pain control during arterial catheter insertion. Subcutaneous Lidocaine caused discomfort during injection, whereas the Lidocaine/tetracaine patch required placement 20 min before the procedure. Given adequate time, the patch provided better overall analgesia by obviating the need for subcutaneous infiltration.
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identification of the epidural space loss of resistance with air Lidocaine or the combination of air and Lidocaine
Anesthesia & Analgesia, 2004Co-Authors: Samuel Evron, Daniel I Sessler, Oscar Sadan, Mona Boaz, Marek Glezerman, Tiberiu EzriAbstract:The ideal technique for identifying the epidural space remains unclear. Five-hundred-forty-seven women in labor who requested epidural analgesia were randomly allocated to three groups according to the technique by which the epidural space was identified: 1) loss-of-resistance with air (air; n = 180), 2) loss-of-resistance with Lidocaine (Lidocaine; n = 185), and 3) loss-of-resistance with both air and Lidocaine (air-plus-Lidocaine; n = 182). We assessed ease of epidural catheter insertion, characteristics of the blockade, quality of analgesia, and complications. The inability to thread the epidural catheter occurred in 16% of the air, 4% of the Lidocaine, and 3% of the air-plus-Lidocaine patients (P < 0.001). More patients from the air group had unblocked segments (6.6% versus 3.2% and 2.2%, respectively; P < 0.02). The incidence of accidental dural puncture was greater in the air group (1.7% versus 0% in the other two groups; P < 0.02). Pain scores, time to onset of analgesia, upper sensory level, motor blockade, and the incidence of hypotension, transient neurological deficits, postpartum urinary retention, and postdural puncture headache were comparable. Identification of the epidural space with air was more difficult and caused more dural punctures than with Lidocaine or air plus Lidocaine. Additionally, sequential use of air and Lidocaine had no advantage over Lidocaine alone.
Georg Grubhofer - One of the best experts on this subject based on the ideXlab platform.
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Lidocaine tetracaine patch rapydan for topical anaesthesia before arterial access a double blind randomized trial
BJA: British Journal of Anaesthesia, 2012Co-Authors: Kurt Ruetzler, B Sima, L Mayer, A Golescu, Walter Jaeger, Martina Hoeferl, Daniel I Sessler, Daniela Dunkler, Georg GrubhoferAbstract:Background Arterial catheterization is painful and is associated with patient stress and anxiety. Analgesia is usually provided by subcutaneous injection of local anaesthetic. An alternative is topical anaesthesia, such as Rapydan which is a novel topical anaesthetic patch containing 70 mg each of Lidocaine and tetracaine. We therefore tested the hypothesis that Rapydan patch analgesia is non-inferior to subcutaneous local anaesthetic. Methods Ninety patients undergoing elective major cardiac surgery were included in this prospective, double-blind clinical trial. Patients were randomly assigned to receive either a Lidocaine/tetracaine patch, followed by subcutaneous injection 0.5 ml of normal saline solution, or placebo patch with subsequent subcutaneous injection of 0.5 ml of Lidocaine 1%. Pain during arterial catheterization using 100-mm-long visual analogue scale (VAS) was the primary outcome. Other outcomes were pain during anaesthetic/saline injection and plasma tetracaine concentrations. Results VAS pain scores during arterial puncture were comparable in both groups and Rapydan was non-inferior to subcutaneous Lidocaine. Pain scores at the time of subcutaneous injection were significantly lower (better) in patients assigned to the Lidocaine/tetracaine patch than to Lidocaine ( P =0.001). Plasma tetracaine concentrations never exceeded the detection limit of 25 ng ml −1 at any time in any patient. Conclusions Both the Lidocaine/tetracaine patch and subcutaneous injection of Lidocaine provided comparable pain control during arterial catheter insertion. Subcutaneous Lidocaine caused discomfort during injection, whereas the Lidocaine/tetracaine patch required placement 20 min before the procedure. Given adequate time, the patch provided better overall analgesia by obviating the need for subcutaneous infiltration.
Kurt Ruetzler - One of the best experts on this subject based on the ideXlab platform.
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Lidocaine tetracaine patch rapydan for topical anaesthesia before arterial access a double blind randomized trial
BJA: British Journal of Anaesthesia, 2012Co-Authors: Kurt Ruetzler, B Sima, L Mayer, A Golescu, Walter Jaeger, Martina Hoeferl, Daniel I Sessler, Daniela Dunkler, Georg GrubhoferAbstract:Background Arterial catheterization is painful and is associated with patient stress and anxiety. Analgesia is usually provided by subcutaneous injection of local anaesthetic. An alternative is topical anaesthesia, such as Rapydan which is a novel topical anaesthetic patch containing 70 mg each of Lidocaine and tetracaine. We therefore tested the hypothesis that Rapydan patch analgesia is non-inferior to subcutaneous local anaesthetic. Methods Ninety patients undergoing elective major cardiac surgery were included in this prospective, double-blind clinical trial. Patients were randomly assigned to receive either a Lidocaine/tetracaine patch, followed by subcutaneous injection 0.5 ml of normal saline solution, or placebo patch with subsequent subcutaneous injection of 0.5 ml of Lidocaine 1%. Pain during arterial catheterization using 100-mm-long visual analogue scale (VAS) was the primary outcome. Other outcomes were pain during anaesthetic/saline injection and plasma tetracaine concentrations. Results VAS pain scores during arterial puncture were comparable in both groups and Rapydan was non-inferior to subcutaneous Lidocaine. Pain scores at the time of subcutaneous injection were significantly lower (better) in patients assigned to the Lidocaine/tetracaine patch than to Lidocaine ( P =0.001). Plasma tetracaine concentrations never exceeded the detection limit of 25 ng ml −1 at any time in any patient. Conclusions Both the Lidocaine/tetracaine patch and subcutaneous injection of Lidocaine provided comparable pain control during arterial catheter insertion. Subcutaneous Lidocaine caused discomfort during injection, whereas the Lidocaine/tetracaine patch required placement 20 min before the procedure. Given adequate time, the patch provided better overall analgesia by obviating the need for subcutaneous infiltration.
John C Campbell - One of the best experts on this subject based on the ideXlab platform.
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heated Lidocaine tetracaine patch synera rapydan compared with Lidocaine prilocaine cream emla for topical anaesthesia before vascular access
BJA: British Journal of Anaesthesia, 2009Co-Authors: J Sawyer, Syed Masud, S Febbraro, Michael A Ashburn, John C CampbellAbstract:Background We compared the Lidocaine/tetracaine patch [Synera™ (USA), Rapydan™ (Europe)], a novel heat-aided patch using a eutectic mixture of Lidocaine 70 mg and tetracaine 70 mg, with a eutectic mixture of Lidocaine 25 mg ml−1 and prilocaine 25 mg ml−1 (EMLA® Cream). The agents were administered at different time periods for local topical anaesthesia before a vascular access procedure. Methods In this double-blind, paired study, 82 adult volunteers were randomized to receive the Lidocaine/tetracaine patch on one anticubital surface and Lidocaine/prilocaine cream on the other concurrently for 10, 20, 30, or 60 min before a vascular access procedure. Subjects rated pain intensity using a 100 mm visual analogue scale (VAS). Skin reactions and adverse events were also evaluated. Results Median VAS scores were significantly lower for the Lidocaine/tetracaine patch than for Lidocaine/prilocaine cream in the 10 min (P=0.010), 20 min (P=0.042), and 30 min (P=0.001) application groups. The Lidocaine/tetracaine patch was associated with significantly more erythema than Lidocaine/prilocaine cream at 20, 30, and 60 min, whereas Lidocaine/prilocaine cream produced more blanching than the Lidocaine/tetracaine patch at 30 and 60 min. Two subjects reported nausea and faintness associated with the vascular access procedure; one was withdrawn from the study. Conclusions The Lidocaine/tetracaine patch provided effective anaesthesia with an application time as short as 10 min and was better than Lidocaine/prilocaine cream at all application times shorter than 60 min, demonstrating a substantial improvement in time to onset of anaesthesia. The Lidocaine/tetracaine patch provided an important alternative to Lidocaine/prilocaine cream for topical local anaesthesia.
Syed Masud - One of the best experts on this subject based on the ideXlab platform.
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heated Lidocaine tetracaine patch synera rapydan compared with Lidocaine prilocaine cream emla for topical anaesthesia before vascular access
BJA: British Journal of Anaesthesia, 2009Co-Authors: J Sawyer, Syed Masud, S Febbraro, Michael A Ashburn, John C CampbellAbstract:Background We compared the Lidocaine/tetracaine patch [Synera™ (USA), Rapydan™ (Europe)], a novel heat-aided patch using a eutectic mixture of Lidocaine 70 mg and tetracaine 70 mg, with a eutectic mixture of Lidocaine 25 mg ml−1 and prilocaine 25 mg ml−1 (EMLA® Cream). The agents were administered at different time periods for local topical anaesthesia before a vascular access procedure. Methods In this double-blind, paired study, 82 adult volunteers were randomized to receive the Lidocaine/tetracaine patch on one anticubital surface and Lidocaine/prilocaine cream on the other concurrently for 10, 20, 30, or 60 min before a vascular access procedure. Subjects rated pain intensity using a 100 mm visual analogue scale (VAS). Skin reactions and adverse events were also evaluated. Results Median VAS scores were significantly lower for the Lidocaine/tetracaine patch than for Lidocaine/prilocaine cream in the 10 min (P=0.010), 20 min (P=0.042), and 30 min (P=0.001) application groups. The Lidocaine/tetracaine patch was associated with significantly more erythema than Lidocaine/prilocaine cream at 20, 30, and 60 min, whereas Lidocaine/prilocaine cream produced more blanching than the Lidocaine/tetracaine patch at 30 and 60 min. Two subjects reported nausea and faintness associated with the vascular access procedure; one was withdrawn from the study. Conclusions The Lidocaine/tetracaine patch provided effective anaesthesia with an application time as short as 10 min and was better than Lidocaine/prilocaine cream at all application times shorter than 60 min, demonstrating a substantial improvement in time to onset of anaesthesia. The Lidocaine/tetracaine patch provided an important alternative to Lidocaine/prilocaine cream for topical local anaesthesia.
