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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Ethyl vinyl chloride vapocoolant spray fails to decrease pain associated with intravenous cannulation in children.

Mary Costello¹, Maria Ramundo, Norman C Christopher

¹Department of Pediatrics, Northeastern Ohio Universities College of Medicine, Rootstown, OH, USA.

Clinical Pediatrics

|August 25, 2006

Summary

Ethyl vinyl chloride vapocoolant spray did not reduce pain during intravenous cannulation in children. Pain scores were similar compared to isopropyl alcohol spray or no spray.

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Area of Science:

Pediatric Emergency Medicine
Pain Management
Anesthesiology

Background:

Intravenous cannulation is a common procedure in pediatric emergency departments.
Effective pain management during this procedure is crucial for patient comfort and cooperation.
Vapocoolant sprays are used to provide localized cooling and reduce pain perception.

Purpose of the Study:

To evaluate the efficacy of ethyl vinyl chloride vapocoolant spray in alleviating pain during intravenous cannulation in children.
To compare the pain reduction effects of ethyl vinyl chloride spray against a placebo (isopropyl alcohol spray) and a control group (no spray).

Main Methods:

A randomized, double-blinded, placebo-controlled trial was conducted.
127 children aged 9-18 years undergoing intravenous cannulation were enrolled.
Participants were randomized to receive ethyl vinyl chloride spray, isopropyl alcohol spray, or no spray.
Pain was assessed using a 100-mm visual analog scale (VAS).

Main Results:

Mean VAS pain scores were 34 for ethyl vinyl chloride spray, 33 for isopropyl alcohol spray, and 31 for the control group.
Ethyl vinyl chloride spray did not demonstrate a significant reduction in pain compared to the placebo or control group.
No measurable difference in pain was observed between the intervention and control groups.

Conclusions:

Ethyl vinyl chloride vapocoolant spray is not effective in reducing pain associated with intravenous cannulation in pediatric patients.
Current evidence does not support the use of ethyl vinyl chloride spray for pain management during this procedure.
Further research may explore alternative pain relief methods for pediatric intravenous cannulation.