NEWS HIGHLIGHTSMedia Articles Related to Novocain (Procaine Infiltration)
Abdominal Surgery Without General Anesthesia
Source: GastroIntestinal / Gastroenterology News From Medical News Today [2009.11.04]
A recent review in Faculty of 1000 Medicine Reports, a publication in which clinicians highlight advances in medical practice, suggests regional pain relief could be used during abdominal surgery. In this review, Michael Schaefer recommends a new approach that can be performed without the need for general anaesthetics.
Anesthesia, Exertional Heat Deaths May Be Linked
Source: MedicineNet Hyperthermia Specialty [2009.10.26]
Title: Anesthesia, Exertional Heat Deaths May Be Linked
Category: Health News
Created: 10/23/2009 4:10:00 PM
Last Editorial Review: 10/26/2009
Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Source: MedicineNet Hernia Specialty [2009.03.25]
Title: Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Category: Health News
Created: 3/25/2009 2:00:00 AM
Last Editorial Review: 3/25/2009
Need For Emergency Airway Surgery For Hard-to-Intubate Patients Reduced
Source: Respiratory / Asthma News From Medical News Today [2009.11.18]
Be prepared, that old Boy Scout motto, is being applied with great success to operating room patients whose anatomy may make it difficult for physicians to help them breathe during surgery, Johns Hopkins researchers report in a new study. When patients undergo general anesthesia, they stop breathing on their own and anesthesiologists must quickly insert a tube into the airway as a first step in machine-assisted breathing.
New Technique For Injectable Facial Fillers Improves Comfort, Recovery
Source: Cosmetic Medicine / Plastic Surgery News From Medical News Today [2009.10.29]
Less pain during injections for wrinkle-fighting facial fillers. Less swelling afterward. Less time in the office waiting for anesthesia to take effect. These and other benefits of a new injection technique that UT Southwestern Medical Center plastic surgeons are helping pioneer are outlined in the October issue of Plastic and Reconstructive Surgery.
Published Studies Related to Novocain (Procaine Infiltration)
The interaction between epidural 2-chloroprocaine and morphine: a randomized controlled trial of the effect of drug administration timing on the efficacy of morphine analgesia. [2009.07]
BACKGROUND: The efficacy and duration of epidural morphine analgesia is diminished when administered after 2-chloroprocaine compared with lidocaine. The mechanism of the interaction between 2-chloroprocaine and morphine is unknown... This suggests that the observed interaction between epidural morphine and 2-chloroprocaine is a result of differences in latency and duration of action of the two drugs, or that the administration of morphine before 2-chloroprocaine effectively blocks a receptor site antagonism.
A controlled clinical interventional trial comparing 2% chloroprocaine-bupivicaine versus 2% lidocaine-bupivicaine for retrobulbar anesthesia in scleral buckling surgery. [2009.02]
OBJECTIVE: We undertook this prospective study to compare the relative effectiveness of a bupivicaine mixture with either lidocaine or chloroprocaine for retrobulbar anesthesia in scleral buckling surgery, since chloroprocaine, in some types of nonocular nerve block anesthesia, has been demonstrated to be a more effective nerve block anesthetic. DESIGN: This prospective, randomized, double-blind, controlled, clinical, unicentre, interventional trial compared mixtures of lidocaine-bupivacaine with chloroprocaine-bupivacaine in scleral buckling surgery performed by 1 surgeon during a 12-month period.Participants: A total of 136 patients who underwent scleral buckling surgery constituted the cases studied... CONCLUSIONS: We found no difference in effectiveness for bupivicaine mixed with either lidocaine or chloroprocaine for retrobulbar anesthesia in scleral buckling surgery. Surgeon, anesthetist, and patient-centered data showed no differences in any of the measures studied.
A randomized, prospective, double-blind trial comparing 3% chloroprocaine followed by 0.5% bupivacaine to 2% lidocaine followed by 0.5% bupivacaine for interscalene brachial plexus block. [2008.11]
BACKGROUND: The combination of 2-chloroprocaine and bupivacaine (C/B) for regional anesthesia has been described, but its use was largely abandoned due to equivocal results in efficacy. In this prospective, double-blind, randomized study, we compared the onset of an interscalene block using C/B versus a combination of lidocaine and bupivacaine (L/B)... CONCLUSIONS: This study demonstrates that a successful block was more rapid using C/B than L/B for interscalene blocks.
Spinal 2-chloroprocaine: effective dose for ambulatory surgery. [2008.05]
Background: There is an interest in finding a safe, short-acting spinal anaesthetic, suitable for ambulatory surgery. In this prospective study, we evaluated the effective dose of plain 2-chloroprocaine (2-CP) for lower limb surgery, including knee arthroscopy and saphenectomy.Conclusion: Spinal 2-CP, 10 mg/ml 35, 40, 45 and 50 mg provide reliable sensory and motor block for ambulatory surgery, while reducing the dose of 2-CP to 35 and 40 mg resulted in a spinal block of faster ambulation.
Combined spinal and epidural anaesthesia with chloroprocaine for hysterectomy. [2008.01]
1. The aim of the present study was to determine the clinical efficacy and safety of chloroprocaine (CP) for gynaecological surgery... The combination of spinal and epidural anaesthesia with 2.5% CP can achieve 100% satisfactory anaesthesia for this type of surgery.
Clinical Trials Related to Novocain (Procaine Infiltration)
Efficacy of the Combination Bismuth + Neomycin + Procaine in the Treatment of Recurrent Aphthous Ulceration [Not yet recruiting]
To evaluate the efficacy of the product Bismu-Jet ® (bismuth tartrate and sodium, neomycin
sulfate and procaine hydrochloride) produced by EMS S / A compared to placebo in reducing
the signs and symptoms resulting from UAR in patients of both sexes, with age over 12 years.
Efficacy Study of Community-Based Treatment of Serious Bacterial Infections in Young Infants [Active, not recruiting]
Approximately one-third of neonatal deaths in developing countries are due to infections
acquired through the birth canal and/or exposure to an unclean environment soon after birth.
Current World Health Organization recommendations for the management of infants younger than
2 months of age who have serious bacterial infections involve hospitalization and parenteral
therapy for at least 10 days with antibiotic regimens containing penicillin or ampicillin
combined with an aminoglycoside. However, in many settings throughout the developing world,
this is not currently possible, nor is this standard of care likely to be feasible in the
near future. Several studies have reported that for a variety of sociocultural reasons many
families are unable or unwilling to access hospital-based care and their sick young infants
do not get hospitalized, and instead, receive a variety of home-based antibiotic therapies,
or none at all. In our community field sites, approximately 70% of families refuse hospital
referral for a sick newborn, despite provision of transport.
Thus, there is an urgent need to define the role of community/first-level facility-based care
versus hospitalization for the management of young infants with serious bacterial infections,
and the potential for community-based parenteral antibiotics as an alternative strategy in
resource poor areas with high neonatal mortality rates. Bang and colleagues have demonstrated
significant reductions in neonatal mortality from infections in an underdeveloped rural
district in Maharashtra, India by a field-based case management approach which used oral
cotrimoxazole and intramuscular gentamicin given for 7 days as treatment for neonates with
sepsis.
This study is an equivalence randomized controlled trial (RCT) comparing once daily IM
ceftriaxone injection to once daily IM procaine penicillin and gentamicin injection, to once
daily intramuscular gentamicin injection and twice daily oral cotrimoxazole, given for 7 days
in babies with clinically-diagnosed possible serious bacterial infection (pneumonia, or
sepsis with or without local infections such as skin or umbilical infections) whose families
refused referral to a hospital. After supplementary informed consent, patients meeting
specific inclusion and exclusion criteria are randomly allocated to one of the three regimens
being tested. The study hypothesis is that all 3 regimens will perform equally well in the
treatment of sepsis in a first-level facility setting.
A Dose Response and Safety Study of Procaine HCl in HIV-Infected Patients [Completed]
This a Phase I/II non-randomized, open-label clinical study of 8 weeks duration using SP01A
in HIV positive patients on a stable antiretroviral regimen. Dose response and safety
associated with oral administration of four doses (200 mg, 400 mg, 600 mg, and 800 mg daily)
of SP01A will be studied in a total of 24 study subjects. In addition, six HIV-negative
subjects will be recruited as a control for cortisol secretion only and will not receive
study medication.
Simplified Antibiotic Regimens for Outpatient Treatment of Suspected Sepsis in Neonates and Young Infants in Bangladesh [Recruiting]
The primary aim is to establish the non-inferiority of several simplified, home-based
antibiotic regimens compared to the standard course of parenteral antibiotics for the
empiric treatment of suspected sepsis in Bangladeshi young infants whose parents refuse
hospitalization. Three alternative regimens will be compared with a standard (reference)
regimen of injectable procaine-benzyl penicillin and gentamicin once daily each for seven
days. Alternative regimens are (1) injectable gentamicin once daily and oral amoxicillin
twice daily for seven days; (2) injectable penicillin and gentamicin once daily for two days
followed by oral amoxicillin twice daily for five days; and (3) injectable gentamicin once
daily and oral amoxicillin twice daily for two days followed by oral amoxicillin twice daily
for five days.
Hypothesis
The proportion who fails treatment will be 10 percent in the reference group and the
alternative treatment groups. An alternative therapy will be considered non-inferior to the
standard therapy if the failure rate in the alternative therapy exceeds the failure rate in
the injectable therapy by less than 5 absolute percentage points.
Secondary Objectives:
- To identify baseline clinical predictors of treatment failure in severe infections in
young infants.
- To determine the proportion of relapse (young infants who were considered cured by day
7 but developed any of the signs of suspected severe infection by day 14).
Effect of Timing on Efficacy of Morphine Analgesia After 2-Chloroprocaine Anesthesia [Recruiting]
pidural chloroprocaine is often used in obstetrical anesthesia because of its fast onset and
short duration. These properties make it an ideal drug to use for epidural anesthesia in
patients undergoing postpartum tubal ligation. When epidural morphine is given after
chloroprocaine, there is a decreased efficacy of analgesia as compared to lidocaine (1).
Several studies have hypothesized a specific opioid receptor mediated antagonism of
chloroprocaine (2,3). Karambelkar raised the question whether this decreased efficacy is due
to a disparity between the time the chloroprocaine anesthesia resolves and the onset of
epidural morphine analgesia, resulting in a time window of pain (2). The duration of action
of epidural 2-CP anesthesia is 30-45 minutes and the onset of epidural morphine analgesia is
60-70 minutes, therefore the regression of sensory blockade before the onset of the morphine
analgesia could result in a window of pain (2). Hess and colleagues studied epidural morphine
analgesia and women who had a Cesarean delivery under spinal bupivacaine anesthesia (3).
Subjects were randomized to receive epidural 2-CP and morphine or epidural saline and
morphine. There was no difference in postoperative analgesia between the two groups (3 and
personal communication, Dr. Philip Hess). A literature search cross referencing epidural
chloroprocaine, using Pub Med, did not produce any articles comparing epidural morphine given
before the procedure (in an attempt to time the onset of analgesia with the resolution of
chloroprocaine anesthesia) to the standard administration time after the procedure.
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