The extraction of permanent maxillary tooth is possible by depositing 2 mL of lidocaine to the buccal vestibule of the tooth without the need for palatal anesthesia.

No abstract

BACKGROUND:There are always efforts to find better and safer local anaesthetics along with adjuvants for supraclavicular brachial plexus block. Levobupivacaine, has strongly emerged as a safer alternative for regional anesthesia than its racemic sibling, bupivacaine. Alpha 2 agonists are combined with local anaesthetics to improve the quality of regional anesthesia. AIMS AND OBJECTIVES: This study was conducted to evaluate and compare the onset, duration of sensory and motor blockade along with the duration of analgesia between dexmedetomidine and clonidine when administered along with 0.5% levobupivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries. MATERIALS AND METHODS: A prospective randomized study was carried out in the department of Anaesthesia at Rajarajeswari Medical College and Hospital which included 50 adult patients between the ages of 20 and 50 years (of ASA I/II grade) who underwent upper limb orthopaedic surgeries. The patients were randomly allocated into two groups; levobupivacaine + dexmedetomidine (LD) and levobupivacaine + clonidine (LC), comprising of 25 patients each. Group LD was administered 30 ml of 0.5% levobupivacaine and 1µg/kg of dexmedetomidine, while group LC received admixture of 30 ml of 0.5% levobupivacaine and 1 µg/kg of Clonidine. Onset, duration of sensory and motor blockade and duration of analgesia were observed. STATISTICAL ANALYSIS: Statistical analysis was done using student t test, chi-square test and Fisher Exact test. The Statistical Software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Sysatat 12.0 and R environment ver.2.11.1 were also used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. The value of P <0.05 was considered significant and P < 0.001 as highly significant. RESULTS: The onset of sensory and motor blockade was faster in Group LD when compared to Group LC. The duration of sensory blockade, motor blockade and analgesia was longer in Group LD when compared to Group LC (p <0.001). Sedation scores were better in LD group. (p<0.05). CONCLUSION: Dexmedetomidine is a better adjuvant than Clonidine when added to Levobupivacaine in supraclavicular brachial plexus block as it prolongs the duration of sensory and motor blockade as well as the duration of analgesia.

Background: The coronavirus-2019 (COVID-19) pandemic has increased the use of pulse oximeters worldwide. It has become an inevitable tool in the monitoring of the disease. However, the accuracy of pulse oximeters in COVID-19 has not been established. Aims and Objectives: The aims of the study were to examine the relationship between oxygen saturation as measured by pulse oximeter (SpO2) and oxygen saturation measured by arterial blood gas analysis (SaO2) measurements in COVID-19 patients admitted to the intensive care unit (ICU)/high dependency unit (HDU) and to assess the ability of SpO2 readings to detect low SaO2 and low oxygen tension in COVID-19 patients. Materials and Methods: This prospective observational study was conducted in the COVID-19 ICU and high dependency unit of a tertiary care hospital in Bengaluru, India. All patients admitted with confirmed COVID-19, meeting the eligibility criteria, were included in the study. We assessed bias and limits of agreement between paired samples of oxygen saturation from pulse oximetry (SpO2) and arterial oxygen saturation from blood gas analysis (SaO2). Results: The sample mean difference SpO2-SaO2 is −0.86% (bias) and the 95% confidence interval for the mean difference was −1.67 and −0.04. The lower limit of agreement was −7.32 with a 95% confidence interval (−8.74, −5.91). The upper limit of agreement was 5.61 with a 95% confidence interval of 4.19 and 7.02. Conclusion: SpO2 values are not completely dependable in estimating SaO2 in COVID-19 patients in ICU/HDU; therefore, arterial blood gas analysis measurement of oxygen saturation has to be done depending on the clinical scenario CTRI (CTRI/2020/11/029035).

No abstract