Online ISSN: 2515-8260

Keywords : lidocaine

Observational Study Of Lidocaine Induced Systemic Toxicity When Used By Various Methods Of Administration

Dr. Shakeer Sayeed, Dr. Syed Nazima, Dr. Farhana Bashir, Dr. Saba Ahad, Dr. Yasir Wani, Dr. Farzana Bashir

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3939-3948

Systemic local anesthetic toxicity is rare but can be fatal because of relative resistance of local anesthetic–induced cardiac arrest to standard resuscitative measures.
Aim: To observe Lidocaine induced systemic toxicity when it is used by its various methods of administration and review treatment and management strategies available for lidocaine toxicity.
Method: Prospective , observational study conducted on 120 patients, between the age group of 20-60 years ( of either sex ) of ASA grade 1-2, undergoing surgical procedures in which lidocaine (0.25-4%) was  administered by different modes at various  associated hospitals of GMC Srinagar.
Results:  In the present study, out of 120 patients, 7 patients developed systemic symptoms following lidocaine administration by different routes. Patients were categorised into three groups- epidural group, brachial plexus blockade group and local infiltration group (40 patients in each group). 4 patients developed symptoms following epidural administration and 3 patients following brachial plexus blockade and none with local infiltration. Systemic manifestations were more when lidocaine was used for epidural anesthesia followed by brachial plexus blockade and least with local infiltration. Conclusion: We concluded that the dose and route of administration of lidocaine are statistically significant factors in considering systemic manifestation. The treatment of systemic toxicity is primarily supportive with oxygenation, fluid administration and administration of benzodiazepines.CNS toxicity is either self limiting or quite amenable to treatment with benzodiazepines. Cardiac toxicity may require resuscitation with fluids but the prognosis after return to spontaneous circulation is often very good.

Assessment of effect of intracameral 0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine in initiation and maintenance of the pupillary mydriasis during phacoemulsification under topical anaesthesia

Dr. Amanpreet Kaur, Dr. Karamjit Singh, Dr. Prempal Kaur, Dr. Sahil Kundal, Dr. Gurleen Kaur, Dr. Brijesh Singla

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 2078-2085

This clinical study was conducted to assess the effect of intracameral 0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine in initiation and maintenance of pupillary mydriasis during phacoemulsification under topical anaesthesia.
Materials & methods: This study was conducted on randomly selected 100 patients with immature or mature senile cataract, who were planned for phacoemulsification followed by intraocular lens implantation. All patients selected for intracameral injection were instilled with single drop of topical anaesthetic proparacaine 0.5% three times, five minutes before surgery. Pre prepared 0.2 ml combination of mydriatic and anaesthetic agents was given intracameral to all patients undergoing surgery after initial clear corneal incision. All data was analysed by using statistics software SPSS 26, IBM, USA. Pearson Chi-square test, Pearson correlation 2-tailed tests were used for statistical analysis. p-values of <0.05 were considered significant.
Results: It was observed that a maximum of 7.54±0.44 mm mean mydriasis was achieved with ICM combination of mydriatics and anaesthetic in all patients. Mean time taken to achieve maximum mydriasis was 8.92±1.64 seconds. Sustained mydriasis was observed in 99% of cases throughout the surgery. A statistically significant positive correlation was observed in patient’s comfort and surgeon’s comfort. Highly significant difference in preoperative and postoperative BCVA was observed statistically.
Conclusion: Intracameral injection of 0.02% of tropicamide + 0.31% phenylephrine + 1% lidocaine, along with topical anaesthesia, is rapid, effective and safe in inducing and maintaining intra-operative mydriasis in phacoemulsification, as demonstrated by pupillary diameter measurements during surgery, patient's feedback and surgeon’s feedback.

Comparison of Lidocaine Plus Ropivacaine with Lidocaine Plus Bupivacaine for Peribulbar Anaesthesia During Phacoemulsification Cataract Surgery: A Double-Blinded Randomized Study

Vishnu Kumar Garg; Sunil Chauhan; Jigyasa Shahani; Mangilal Deganwa; PS Lamba

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1374-1380

Introduction: The regional anaesthesia for cataract surgery is associated with lesser respiratory and hemodynamic events and quick recovery of function than general anaesthesia.

Diabetic Peripheral Neuropathy: article review

Ghadeer Mohammed Alaidarous, Thamir Abid Y Khayyat, Manal Mohammadsadiq S Qnadeli

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3369-3381

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes affecting over 90% of the diabetic patients. Due to the toxic effects of hyperglycemia there is development of this problem. It is classically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. Hence DPN is often inadequately treated, and the role of improving glycemic control in diabetes. Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin–noradrenaline reuptake inhibitors, and anti- consultants that act on calcium channels. Other therapies include opioids and topical agents such as capsaicin and lidocaine. The objectives of this paper are to review current guidelines for the pharmacological management of DPN