Search Our Scientific Publications & Authors

Ann Ital Chir 2018 ;89:552-555

Introduction: Accordingly with the new physiopathologic insights of the 70s and 80s, hemorrhoidal disease appears to originate not much from venous hyperplasia but rather from a progressive deterioration of connective and support tissues with subsequent venous and mucosal prolapse. In the late 90s a new surgical technique for a more physiological treatment of hemorrhoids was introduced: stapled prolassectomy.

Materials And Methods: Between October 2017 and June 2018 we performed 50 hemorrhoidal stapled prolassectomies under local-regional anesthesia. Read More

Ophthalmic Plast Reconstr Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.

Purpose: Various factors help minimize pain during the injection of local anesthetic. The majority of current evidence involves nonspecific injection sites. The objective of this review was to provide a comprehensive summary of all existing evidence for methods used to reduce injection pain specifically in the context of periocular procedures. Read More

Int J Lang Commun Disord 2019 Jan 21. Epub 2019 Jan 21.

Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand.

Background: The Test of Masticating and Swallowing Solids (TOMASS) has been developed to provide clinicians with objective data regarding the efficiency of oral phase function and solid bolus ingestion.

Aims: To determine if the TOMASS will detect changes in the oral phase of swallowing imposed by topical anaesthesia, thus providing validation of its clinical utility.

Methods & Procedures: Per the standard protocol, 10 healthy participants ate one-quarter of an Arnotts Salada biscuit. Read More

Clin Ther 2019 Jan 16. Epub 2019 Jan 16.

Stephen A. Cooper DMD, PhD, LLC, Palm Beach Gardens, FL, USA.

Purpose: CTY-5339A is an investigational topical anesthetic spray containing 14% benzocaine/2% tetracaine in a metered canister. Each spray delivers ∼0.2 mL of solution. Read More

Int Forum Allergy Rhinol 2019 Jan 15. Epub 2019 Jan 15.

Lyra Therapeutics, Inc, Watertown, MA.

Background: Chronic rhinosinusitis (CRS) patients who fail medical management have few treatment options other than endoscopic sinus surgery (ESS). A novel biodegradable mometasone furoate drug delivery system (LYR-210) providing continuous topical steroid therapy to sinonasal mucosa over 24 weeks was developed to treat unoperated CRS patients who have failed medical management prior to ESS. LYR-210 was designed to slowly expand in the middle meatus, ensuring efficient drug delivery as mucosal swelling reduces. Read More

Medicine (Baltimore) 2019 Jan;98(2):e14098

Department of Anesthesiology, Sichuan University West China Hospital.

Fast-track anesthesia (FTA) is difficult to achieve in neonates due to immature organ function and high rates of perioperative events. As a high-risk population, neonates require prolonged postoperative mechanical ventilation, which may lead to contradictions in cases where neonatal intensive care unit resources and ventilator facilities are limited. The choice of anesthesia strategy and anesthetic can help achieve rapid postoperative rehabilitation and save hospitalization costs. Read More

AAPS PharmSciTech 2019 Jan 9;20(2):63. Epub 2019 Jan 9.

College of Pharmacy, Taishan Medical University, Taian, 271016, People's Republic of China.

Topical administration is a preferable choice for local anesthetic delivery. Microemulsions have shown great effectiveness for transdermal transport of lidocaine. However, fabrication of microemulsions containing highly concentrated lidocaine (10%) to provide an extended local anesthetic effect is still a challenge. Read More

Anaesthesist 2019 Jan 9. Epub 2019 Jan 9.

Department of Anesthesiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background: Peribulbar block is considered a safe option for patients undergoing cataract surgery. The limited duration of regional eye blocks was shown to be the main problem. The objective of this study was to evaluate the effects of adjuvant midazolam (in two concentrations) to lidocaine in the peribulbar block. Read More

Int Urogynecol J 2019 Jan 7. Epub 2019 Jan 7.

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 31; Room B2 B32, 9000 Rockville Pike, Bethesda, MD, USA.

Introduction And Hypothesis: Botulinum toxin (BoNT) is increasingly used for pain, especially with muscle spasm. We describe our methodology for BoNT treatment of chronic pelvic pain (CPP) in women and place it in the context of the literature on techniques for this use.

Methods: Databases were searched using terms "botulinum toxin," "pelvic pain," and "vaginismus. Read More

J Res Med Sci 2018 28;23:102. Epub 2018 Nov 28.

Department of Gastroenterology and Hepatology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Advantage of using local sedation during upper gastrointestinal endoscopy (UGE) is still challenging. In the current study, the effect of lidocaine spray versus lidocaine viscous solution for pharyngeal local anesthesia during UGE has been compared.

Materials And Methods: This is a randomized clinical trial conducted on 130 patients conducting UGE in 2013. Read More

Int J Ophthalmol 2018 18;11(12):1932-1935. Epub 2018 Dec 18.

S. Maria Goretti Hospital, via Guido Reni 1, Latina 04100, Italy.

Aim: To evaluate safety, efficacy, and patient adherence of intracameral lidocaine as supplement of classic topical anesthetic drops in cataract surgery.

Methods: A prospective and controlled trial including a large cohort of 1650 individuals suffering with bilateral cataract not complicated, in program by phacoemulsification surgery, were randomly assigned to 2 different groups for the type of anesthesia received, 0.4% oxybuprocaine hydrochloride (INN) drops, and INN drops associated to intracameral 1% lidocaine hydrochloride monohydrate. Read More

Drug Des Devel Ther 2018 13;12:4231-4240. Epub 2018 Dec 13.

Department of Anesthesiology, Affiliated Hospital of Jining Medical University, Jining, Shandong 272000, People's Republic of China,

Purpose: Transdermal drug delivery of local anesthetics using lipid nanoparticles could enhance lipophilic drugs permeation through the stratum corneum, improve drug diffusion to deeper skin, and exert good therapeutic effects. The purpose of this study was to engineer a Tocopheryl Polyethylene Glycol 1000 Succinate (TPGS)-modified cationic nanostructured lipid carriers (NLC) for the delivery of lidocaine (LID; TPGS/LID-NLC).

Materials And Methods: TPGS/LID-NLC was prepared by solvent diffusion method. Read More

Acta Stomatol Croat 2018 Jun;52(2):156-159

Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.

Hematoma is among less frequent complications which occur following local anesthesia. The posterior superior alveolar nerve block and inferior alveolar nerve block are known to be accompanied with a higher incidence of positive aspiration compared to all infiltration and block anesthesia techniques in oral surgery. We present the case of an otherwise healthy 8-year-old boy who experienced a large cheek hematoma after a routine infiltration anesthesia in the maxilla. Read More

Indian J Ophthalmol 2019 Jan;67(1):182-183

Centro de Retina Médica y Quirurgica, S.C., Centro Médico Puerta de Hierro; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan, Jalisco, México.

Indian J Ophthalmol 2019 Jan;67(1):181-182

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Sci Rep 2018 Dec 19;8(1):17972. Epub 2018 Dec 19.

Department of Physiological Sciences, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil.

This study reports the development of nanostructured hydrogels for the sustained release of the eutectic mixture of lidocaine and prilocaine (both at 2.5%) for intraoral topical use. The local anesthetics, free or encapsulated in poly(ε-caprolactone) nanocapsules, were incorporated into CARBOPOL hydrogel. Read More

Ophthalmic Surg Lasers Imaging Retina 2018 Dec;49(12):e233-e239

Background And Objective: To compare large spot versus standard spot laser for treatment of retinopathy of prematurity (ROP).

Patients And Methods: Eighty eyes of 40 infants with bilateral type 1 ROP were randomized for laser photocoagulation using laser indirect ophthalmoscope with either standard spot or large spot size laser. During the procedure, total time taken and Premature Infant Pain Profile (PIPP) scores were noted. Read More

Respirol Case Rep 2019 Feb 10;7(2):e00396. Epub 2018 Dec 10.

Department of Respiratory Medicine Uji-Tokushukai Medical Center Kyoto Japan.

Central airway obstruction caused by cancer requires urgent interventional pulmonology. Malignant main carinal involvement is one of the most challenging situations, usually treated by rigid bronchoscopic intervention under general anaesthesia. However, these patients tend to be in poor condition due to underlying malignancy. Read More

Eur J Pharm Sci 2019 Feb 12;128:270-278. Epub 2018 Dec 12.

Human and Natural Sciences Center, Federal University of ABC, Santo André, SP, Brazil. Electronic address:

The aim of this study was to synthesize a novel drug delivery system using organogels (ORGs) and characterize its physicochemical properties, in vitro and ex vivo permeation abilities, cytotoxicity and in vivo local anesthetic effects. The ORG formulations contained a mixture of oleic acid-lanolin (OA-LAN), poloxamer (PL407), and the commonly used local anesthetic lidocaine (LDC). The main focus was to evaluate the impact of LAN and PL407 concentrations on the ORG structural features and their biopharmaceutical performance. Read More

Eur Arch Otorhinolaryngol 2018 Dec 13. Epub 2018 Dec 13.

Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.

Purpose: This systematic review appraises and summaries methodology documented in studies using high resolution pharyngeal manometry (HRM) with and without impedance technology (HRIM) in adult populations.

Methods: Four electronic databases CINAHL, EMBASE, MEDLINE, and Cochrane Library were searched up to, and including March 2017. Studies reporting pharyngeal HRM/HRIM for swallowing and/or phonatory assessment, published in peer-reviewed journals in English, German, or Spanish were assessed for the inclusion criteria. Read More

J Int Adv Otol 2018 Dec 12. Epub 2018 Dec 12.

Department of Otorhinolaryngology, Health Sciences University, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.

Objectives: Topical treatment is first choice in the treatment of uncomplicated chronic otitis media. It was intended to assess auditory and histopathological safety of ototopical use of mercurochrome solution in rats with induced tympanic membrane perforation.

Materials And Methods: The study was conducted on 21 female Wistar-Albino rats which were randomly assigned into 3 groups. Read More

Pain Physician 2018 Nov;21(6):571-592

University of Texas, MD Anderson Cancer Center, Houston, TX.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a commonly encountered disease entity following chemotherapy for cancer treatment. Although only duloxetine is recommended by the American Society of Clinical Oncology (ASCO) for the treatment of CIPN in 2014, the evidence of the clinical outcome for new pharmaceutic therapies and non-pharmaceutic treatments has not been clearly determined.

Objective: To provide a comprehensive review and evidence-based recommendations on the treatment of CIPN. Read More

Int Urogynecol J 2018 Nov 28. Epub 2018 Nov 28.

Department of Urogynaecology, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore.

Labial adhesion is defined as complete or partial fusion of the labia minora in the midline through flimsy or dense adhesions. It may be congenital or acquired. Acquired cases are mainly seen in oestrogen deficiency states in prepubertal girls and postmenopausal women. Read More

Paediatr Drugs 2018 Nov 27. Epub 2018 Nov 27.

Mother and Child Health, and Radiology Department, Cádiz University, Cadiz, Spain.

Background: Upper gastrointestinal endoscopies (UGEs) performed under ketamine sedation may increase the risk of respiratory adverse events (RAEs) due to pharyngeal stimulation. Topical lidocaine prevents general anesthesia-induced laryngospasm.

Objective: Our objective was to determine whether topical lidocaine may reduce the incidence of RAEs induced by pharyngeal stimulation in UGEs performed on children sedated with ketamine. Read More

J Curr Glaucoma Pract 2018 May-Aug;12(2):64-66. Epub 2018 Aug 1.

Consultant and Surgeon, Aintree University Hospitals NHS Foundation Trust, Longmoor Lane, Liverpool, UK.

Aim: Concerns regarding 5-Fluorouracil (5-FU) corneal toxicity have resulted in various ways of reducing its corneal exposure during post-operative trabeculectomy bleb manipulation. This study investigates the properties of various topical agents used to induce the precipitation of this compound.

Materials And Methods: This is a double-blind, descriptive, laboratory study comparing five different potential precipitants of 5-FU (proxymetacaine (proxy), oxybuprocaine (oxy), ametho-caine (ameth), fluorescein (flor), proxymetacaine + fluorescein (proxy-flor) to a control group (normal saline). Read More

Respir Res 2018 Nov 21;19(1):227. Epub 2018 Nov 21.

Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

Background: Endobronchial administration of lidocaine is commonly used for cough suppression during diagnostic bronchoscopy. Recently, nebulization of lidocaine during bronchoscopies under deep sedation with fiberoptic intubation using a distinct spray catheter has been shown to have several advantages over conventional lidocaine administration via syringe. However, there are no data about this approach in bronchoscopies performed under moderate sedation. Read More

Turk J Gastroenterol 2018 Nov 16. Epub 2018 Nov 16.

Department of Statistics, Ege University School of Science, İzmir, Turkey.

Background/aims: The management of patients with cirrhosis requiring dental extractions is complicated due to an increased risk of post-operative bleeding. Topical hemostatic agents are usually required to control bleeding in these cases, as an adjunct to systemic measures of hemostasis. The aims of this randomized, prospective, single-blind clinical study are twofold. Read More

J Fr Ophtalmol 2018 Dec 16;41(10):e491-e492. Epub 2018 Nov 16.

Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, 768828 Singapore.

Int J Nanomedicine 2018 15;13:6453-6463. Epub 2018 Oct 15.

Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (Unicamp), Campinas, São Paulo, Brazil,

Background: Local anesthesia in dentistry is by far the most terrifying procedure for patients, causing treatment interruption. None of the commercially available topical formulations is effective in eliminating the pain and phobia associated to the needle insertion and injection.

Materials And Methods: In this work we prepared a nanostructured lipid-biopolymer hydrogel for the sustained delivery of lidocaine-prilocaine (LDC-PLC) for transbuccal pre-anesthesia. Read More

J Int Med Res 2018 Nov 9:300060518809251. Epub 2018 Nov 9.

1 Department of Anesthesiology, Second Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: This study was performed to investigate the management of general anesthesia in an unusual case involving a patient with a broken tracheostomy tube presenting as an airway foreign body.

Methods: We herein describe the anesthetic management of a patient with a broken tracheostomy tube. A 77-year-old Chinese man who had been involved in a car accident underwent a tracheostomy. Read More

J Dent Anesth Pain Med 2018 Oct 31;18(5):301-304. Epub 2018 Oct 31.

Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.

Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. Read More

World Neurosurg 2018 Nov 3. Epub 2018 Nov 3.

Department of Neurosurgery, Fatih Sultan Mehmet Education and Research Hospital, University of Health Sciences, Turkish Ministry of Health, Istanbul, Turkey.

Background: Epidural fibrosis is a major problem after spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. We used a rat laminectomy model to determine if topical application of boric acid could be helpful in the prevention of epidural fibrosis.

Methods: Rats were randomly assigned to 2 control and 2 experimental groups (n = 8 for each group). Read More

Geriatr Orthop Surg Rehabil 2018 30;9:2151459318803851. Epub 2018 Oct 30.

Department of Orthopaedics, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA).

Material And Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016. Read More

Int J Clin Pediatr Dent 2018 Jul-Aug;11(4):261-265. Epub 2018 Aug 1.

Postgraduate Student, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India.

Introduction: Usually discomfort and pain are associated with dental work, especially for young patients. Pain control can be achieved by using anesthesia. Sight of injection can terrify any patient and if the patient is a child it is really difficult to convince them for injections. Read More

World Neurosurg 2018 Nov 2. Epub 2018 Nov 2.

Department of Neurology and Neurosurgery, McGill University-Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada.

Background: Applying vancomycin into the surgical site has been well-described in spinal neurosurgery, with extensive institutional experience and systematic reviews describing its effectiveness in reducing surgical site infections (SSIs). Its use in nonspinal neurosurgical procedures is a logical extension of those findings; however, recent studies have described varying degrees of success. We have summarized the effect of local vancomycin application on SSIs in nonspinal neurosurgical procedures and describe the quality of the supporting evidence. Read More

J Clin Anesth 2018 Nov 1;54:25-32. Epub 2018 Nov 1.

Department of Emergency Medicine, Obamar Municipal Hospital, 2-2 Otemachi, Obama, Fukui 917-8567, Japan.

Study Objective: Postoperative sore throat negatively affects patient satisfaction and recovery. It may be related to inflammation of the mucosa caused by injury during intubation. Licorice, derived from the root of Glycyrrhiza glabra, contains active anti-inflammatory ingredients. Read More

BJU Int 2018 Nov 1. Epub 2018 Nov 1.

Division of Urology, Frimley Health, London, UK.

Objectives: To report the clinical experience with a second-generation of temporary implantable nitinol device (iTIND; Medi-Tate Ltd, Or-Akiva, Israel) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) after 1 year of follow-up.

Patients And Methods: In all, 81 patients with LUTS, International Prostate Symptom Score (IPSS) ≥10, maximum urinary flow rate (Q ) ≤12 mL/s, and prostate volume <75 mL, were enrolled in this prospective Research Ethics Committee-approved multicentre study. The main exclusion criteria were: haemostatic disorders, post-void residual urine volume (PVR) >250 mL, obstructive median lobe, and previous prostate surgery. Read More

Lung India 2018 Nov-Dec;35(6):467-471

Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Background And Objectives: No previous study has compared different concentrations of lignocaine for topical anesthesia during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In this pilot study, we compared 1% versus 2% lignocaine for topical airway anesthesia during EBUS-TBNA.

Methods: In this double-blind, randomized trial, subjects were randomized to receive either 1% or 2% lignocaine for "spray-as-you-go" administration. Read More

Photochem Photobiol Sci 2018 Oct 31. Epub 2018 Oct 31.

Department of Dermatology, Medical University of Vienna, Austria.

Background And Objective: Pyogenic granuloma is a common benign vascular lesion of the skin and mucosa prone to ulceration and bleeding. Current therapeutic approaches include surgical excision, removal by means of electro caustic therapy, cryotherapy, and ablation with CO2 or vascular lasers. The purpose of this study was to investigate the efficacy of a 532 nm potassium-titanyl-phosphate laser (KTP-laser) for the treatment of pyogenic granulomas in terms of efficacy, advantages in clinical outcome, technique and associated side effects. Read More

Int J Ophthalmol 2018 18;11(10):1685-1690. Epub 2018 Oct 18.

Clinical Research Centre, Hospital Kuala Lumpur, Kuala Lumpur 53000, Malaysia.

Aim: To report the incidence, risk factors and visual outcomes for postoperative endophthalmitis (POE) based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR).

Methods: Data was collected from the web-based MOH CSR. All consecutive cataract surgery patients from 1 June 2008 to 31 December 2014 were identified. Read More

J Binocul Vis Ocul Motil 2018 Oct-Dec;68(4):154-155. Epub 2018 Oct 26.

a Jules Stein Eye Institute and Department of Ophthalmology , University of California , Los Angeles , California.

Background: Recently, the superior rectus transposition has been widely adopted for the treatment of complete abducens palsy and Duane syndrome. This procedure is useful in that there is a decreased risk of anterior segment ischemia compared to complete vertical rectus transposition, possibly decreased incidence of postoperative-induced vertical deviations than complete vertical rectus transposition, and improvement in abduction compared to simple medial rectus recession. One difficulty with this procedure is the lack of adjustability in most patients. Read More

J Vis Exp 2018 Oct 5(140). Epub 2018 Oct 5.

Department of Optometry and Vision Sciences, University of Melbourne;

The circumlimbal suture is a technique for inducing experimental glaucoma in rodents by chronically elevating intraocular pressure (IOP), a well-known risk factor for glaucoma. This protocol demonstrates a step-by-step guide on this technique in Long Evans rats and C57BL/6 mice. Under general anesthesia, a "purse-string" suture is applied on the conjunctiva, around the equator and behind the limbus of the eye. Read More

Cornea 2019 Jan;38(1):127-133

Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.

Purpose: To describe an impression cytology (IC) technique using a purpose-built, sterile, EYEPRIM IC device that can be coupled with a TRIzol reagent-based RNA extraction protocol to yield sufficient RNA for gene expression analysis.

Methods: IC samples using the EYEPRIM device were collected from the bulbar conjunctiva, with and without topical anesthesia, and evaluated for RNA yield, the absence of polymerase chain reaction (PCR) inhibitors, and the ability to detect biomarkers by quantitative real-time PCR and droplet digital PCR. A technique for collecting IC samples in the clinic, while preserving RNA, and a protocol for subsequent laboratory analysis of RNA were developed. Read More

Acta Cir Bras 2018 Sep;33(9):799-805

Full Professor, Chairman, Nucleus of Experimental Surgery, UFRN, Natal-RN, Brazil. Conception, design, intellectual and scientific content of the study; critical revision.

Purpose: To evaluate if Moringa oleifera leaf aqueous extract (ME) influences the healing of skin wounds of diabetic rats.

Methods: Wistar rats were used (6 rats/group). Group 1 received normal saline (NS) v. Read More

J Vet Intern Med 2018 Nov 16;32(6):2069-2073. Epub 2018 Oct 16.

Hospital for Small Animals, University of Edinburgh, Edinburgh, EH25 9RG, United Kingdom.

Background: Sino-nasal aspergillosis is a common nasal disease in dogs. Recommended treatment protocols typically involve trephination of the frontal sinuses or the use of an antifungal solution instilled into the frontal sinus under anesthesia, both of which have associated morbidity and complications.

Objectives: To assess a minimally-invasive topical treatment protocol for sino-nasal aspergillosis in dogs. Read More

Pain Rep 2018 Sep 11;3(Suppl 1):e671. Epub 2018 Sep 11.

Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA.

Introduction: Pain remains common, underrecognized, and undertreated in children's hospitals and pediatric clinics. Over 200,000 patients experience needle pain annually in our institution, caused by blood draws, intravenous access, vaccinations, and injections on all inpatient units, emergency departments, outpatient laboratories, and ambulatory clinics.

Objectives: We implemented a hospital-based, system-wide initiative called the "Children's Comfort Promise," and created a new standard of care for needle procedures that required staff to consistently offer 4 strategies: (1) topical anesthetics, (2) sucrose or breastfeeding for infants 0 to 12 months, (3) comfort positioning (including swaddling, skin-to-skin, or facilitated tucking for infants; sitting upright for children), and (4) age-appropriate distraction. Read More

Best Pract Res Clin Anaesthesiol 2018 Jun 3;32(2):179-185. Epub 2018 Jul 3.

Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland.

Local anesthetics are used for performing various regional anesthesia techniques to provide intraoperative anesthesia and analgesia, as well as for the treatment of acute and chronic pain. Older medications such as lidocaine and bupivacaine as well as newer ones such as mepivacaine and ropivacaine are being used successfully for decades. Routes of administration include neuraxial, perineural, intravenous, various infiltrative approaches, topical, and transdermal. Read More

Acta Anaesthesiol Scand 2019 Feb 14;63(2):270-273. Epub 2018 Oct 14.

Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Background: Thrombocytopenia is a common condition in critically ill patients in the intensive care unit (ICU). It is associated with prolonged stay in the ICU, increased transfusion requirements, risk of bleeding and mortality. The evidence regarding the use of prophylactic platelet transfusion and thrombosis prophylaxis in patients with thrombocytopenia in the ICU is unknown. Read More