Regional anesthesia with epinephrine-containing lidocaine reduces pericatheter bleeding after tunneled hemodialysis catheter placement

Mini-percutaneous Nephrolithotomy Under mixture of Local Anesthesia: A Randomized-Controlled Study

OBJECTIVE

to evaluate the safety, efficacy, and feasibility of mini-percutaneous nephrolithotomy (MPCNL) under mixture of local anesthetics (MLA) versus spinal anesthesia (SA) for management of large renal stones.

PATIENTS AND METHODS

the current study was a prospective randomized controlled study. A total of 120 consecutive patients who met the inclusion criteria of the study and agreed to sign the informed consent form were randomized to undergo MPCNL under MLA (60 patients) or SA (60 patients). Intra- and post-operative findings included visual pain analogue scale (VAS), operative time, hospital stay, adverse events, stone-free rate and related data were recorded.

RESULTS

Baseline characteristics and demography included age, sex; stone's site, size and density were comparable for both groups (p> 0.05). The average VAS scores in MLA group at 0, 2, 6, 12; and 24 hours were 2.5; 0;1; 1 and 0, respectively. The corresponding values in the SA group were 2; 1; 2; 2; and 1, respectively, (p< 0.05). The average operation time was about an hour for both groups and the length of hospital stay was 1.5 days for both groups (p> 0.05). While the mean hemoglobin deficit was 1.04±0.54 % vs 1.27±0.46 (p=0.013), and the primary postoperative stone clearance was 93.4%, vs 88.3% (p > 0.05), for MLA and SA groups, respectively. Post-operative analgesic consumption and Complications were similar in the MLA and SA groups.

CONCLUSION

Single tract MPCNL is feasible under either mixture of Local or Spinal anesthesia with comparable stone clearance & adverse events. Perioperative VAS was similar and acceptable for both modalities.

Delivery of Local Anesthesia: Current Strategies, Safety, and Future Prospects

BACKGROUND

The systemic administration of anesthesia is associated with severe and undesirable side effects such as sedation, vomiting, nausea, allergies, respiratory problems, and neutrophil dysfunction. With the increase in the procedures of limb surgery, cosmetics, facial, skin, and cancer reconstruction, the demand for local anesthesia has increased multifold during the last one decade. Therefore, novel, safe, and cost-effective methods are being developed to deliver local anesthetics by the surgeons.

METHOD

To prepare a comprehensive research report on anesthesia, we performed a structured literature search of bibliographic databases for peer-reviewed articles published recently. The studies of different articles were summarized and a deductive qualitative and quantitative data analysis was applied. Subsequently, a comprehensive summary of the analysis was used to frame this review article with ample examples.

RESULTS

A thorough analysis of the reports suggested that there have been tremendous developments of synthesizing nanoparticle-based local anesthesia drugs. The active targeting ability of nanoparticle-based drug delivery strategy can further help to deliver the desired anesthetic drug locally. It was also found that different local anesthetic drugs are developed into liposome form and show better efficacy in patients receiving anesthesia.

CONCLUSION

The findings of this review article endorse that safe delivery of anesthesia drugs are essential for the safety of patients. Further, nanotechnology-based strategies are extremely useful for targeted delivery of anesthetic drugs at the required dose without affecting the neighboring tissues.