After prenatal diagnosis of bilateral fetal hydrothorax, ascites, and polyhydramnios, bilateral thoracoamniotic shunts were placed at 29 weeks gestation using an ultrasound-guided, minimally invasive technique. Anesthetic care was managed using intravenous sedation and local anesthesia infiltration. The anesthetic considerations for such procedures are discussed.

OBJECTIVES Local anesthetic infiltration is also a process of a painful process itself. INJEX™ technology, known as "Needle-free" drug delivery system, was designed for reducing the pain associated with cutaneous procedures. We conducted a prospective, randomized trial to evaluate the application of lidocaine with INJEX™ system and 27-gauge needle. METHODS A total of 60 consecutive patients w...

Although local anesthetics have an acceptable safety profile, significant morbidity and mortality have been associated with their use. Inadvertent intravascular injection of local anesthetics and/or the use of excessive doses have been the most frequent causes of local anesthetic systemic toxicity (LAST). Furthermore, excessive doses of local anesthetics injected locally into the tissues may le...

BACKGROUND AND PURPOSE To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postoperative analgesia after PAO. PATIENTS AND METHODS We performed a randomized, double-blind, placebo-...

BACKGROUND The authors evaluated published evidence from controlled clinical trials regarding the efficacy of two local anesthetic solutions in providing successful pulpal anesthesia. METHODS The authors searched MEDLINE and Embase databases to identify peer-reviewed randomized controlled trials in which researchers directly compared articaine and lidocaine local anesthetic solutions in adult...

Whether preemptive analgesic interventions are more effective than conventional regimens in managing acute postoperative pain remains controversial. We systematically searched for randomized controlled trials that specifically compared preoperative analgesic interventions with similar postoperative analgesic interventions via the same route. The retrieved reports were stratified according to fi...

Dermatologic surgeons have long been trying to find ways to eliminate patient discomfort associated with dermatologic procedures. Although some dermatologic procedures, such as facial resurfacing and extensive procedures performed on children, require intravenous or general anesthesia, dermatologic surgical procedures usually require only local anesthesia, which is frequently administered via i...