Serum Lidocaine Levels and Cutaneous Side Effects After Application of 23% Lidocaine 7% Tetracaine Ointment to the Face

McCleskey, Patrick E.; Patel, Seema; Mansalis, Katherine; Elam, Amanda L.; Kinsley, Tina R.

doi:10.1111/dsu.12064

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…risk of adverse events. 13,34,35 However, caution must be taken when occlusion is used or large surface areas are treated because there are no data supporting standard practice. This is particularly true with compounded mixtures and nonstandard doses, which although rarely used by dermatologists may increase the risk of adverse events and even death.…”

Section: Topical Anesthesiamentioning

confidence: 99%

Guidelines for the use of local anesthesia in office-based dermatologic surgery

Kouba

LoPiccolo

Alam

et al. 2016

Journal of the American Academy of Dermatology

112

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There are an increasing number and variety of dermatologic surgical procedures performed safely in the office setting. This evidence-based guideline addresses important clinical questions that arise regarding the use and safety of local anesthesia for dermatologic office-based procedures. In addition to recommendations for dermatologists, this guideline also takes into account patient preferences while optimizing their safety and quality of care. The clinical recommendations presented here are based on the best evidence available as well as expert opinion.

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Section: Topical Anesthesiamentioning

confidence: 99%

Guidelines for the use of local anesthesia in office-based dermatologic surgery

Kouba

LoPiccolo

Alam

et al. 2016

Journal of the American Academy of Dermatology

112

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“…Many topical agents reduce pain and have a low risk of adverse events. 40,41 Two of the most commonly used topical anesthetics in dermatology are BLT 20%/8%/4% cream and lidocaine/prilocaine 2.5%/2.5% cream. 42 These esters and amides produce anesthesia by binding inotropic receptors and preventing action potential generation.…”

Section: Discussionmentioning

confidence: 99%

Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections

2019

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Background Local anesthetic injections can be painful and distressing. Objective The aim of this study was to determine whether nitrous oxide, ice, vibration, or topical anesthetic improves analgesia for local anesthetic injections. Method A cohort study of 400 patients undergoing Mohs micrographic surgery with local anesthetic was conducted. Patients received no intervention ( n = 200), ice ( n = 50), topical anesthetic cream ( n = 50), vibration device ( n = 50), or nitrous oxide ( n = 50). Pain was rated using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale. Results Without intervention, mean VAS was 4.2 and FACES was 4.6. Nitrous oxide was the most successful in reducing pain (mean VAS 1.6 vs. 4.2, P < .01, FACES 1.2 vs. 4.6, P < .01). Topical ice reduced pain (mean VAS 3.0 vs. 4.2, P < .01, FACES 3.0 vs. 4.6, P < .01). Vibration reduced pain (mean VAS 3.5 vs. 4.2, P < .01, FACES 3.6 vs. 4.6, P < .01). Higher pain scores were associated with age <50 ( P = .02), male sex ( P = .05), and surgery on the nose, lip, ear, or eyelid ( P = .02). Conclusion Nitrous oxide, ice, and vibration reduce injection pain. These interventions are especially useful for younger males undergoing surgery on the nose, lip, ear, or eyelid.

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“…Lidocaine pretreatment or mixed with propofol has also been used successfully for preventing propofol-induced pain [9]. Although the effectiveness is obvious, the side effects of the medicine are also palpable [10,11]. …”

Section: Introductionmentioning

confidence: 99%

Chitosan Oligosaccharide Reduces Propofol Requirements and Propofol-Related Side Effects

Yang

Song

et al. 2016

Marine Drugs

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Propofol is one of the main sedatives but its negative side effects limit its clinical application. Chitosan oligosaccharide (COS), a kind of natural product with anti-pain and anti-inflammatory activities, may be a potential adjuvant to propofol use. A total of 94 patients receiving surgeries were evenly and randomly assigned to two groups: 10 mg/kg COS oral administration and/or placebo oral administration before being injected with propofol. The target-controlled infusion of propofol was adjusted to maintain the values of the bispectral index at 50. All patients’ pain was evaluated on a four-point scale and side effects were investigated. To explore the molecular mechanism for the functions of COS in propofol use, a mouse pain model was established. The activities of Nav1.7 were analyzed in dorsal root ganglia (DRG) cells. The results showed that the patients receiving COS pretreatment were likely to require less propofol than the patients pretreated with placebo for maintaining an anesthetic situation (p < 0.05). The degrees of injection pain were lower in a COS-pretreated group than in a propofol-pretreated group. The side effects were also more reduced in a COS-treated group than in a placebo-pretreated group. COS reduced the activity of Nav1.7 and its inhibitory function was lost when Nav1.7 was silenced (p > 0.05). COS improved propofol performance by affecting Nav1.7 activity. Thus, COS is a potential adjuvant to propofol use in surgical anesthesia.

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Serum Lidocaine Levels and Cutaneous Side Effects After Application of 23% Lidocaine 7% Tetracaine Ointment to the Face

Abstract: Facial surface area, male sex, and nonwhite ethnicity were associated with higher serum lidocaine levels after topical application of lidocaine. Compounded anesthetics containing lidocaine should be used with caution under the direct supervision of a physician.

Cited by 11 publications

References 20 publications

Guidelines for the use of local anesthesia in office-based dermatologic surgery

Guidelines for the use of local anesthesia in office-based dermatologic surgery

Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections

Chitosan Oligosaccharide Reduces Propofol Requirements and Propofol-Related Side Effects

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