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Sample records for local anesthesia optimizing

  1. Local anesthesia: a review.

    Science.gov (United States)

    Malamed, S F; Sykes, P; Kubota, Y; Matsuura, H; Lipp, M

    1992-01-01

    Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

  2. [Emergencies evolving from local anesthesia].

    Science.gov (United States)

    Kaufman, E; Garfunkel, A; Findler, M; Elad, S; Zusman, S P; Malamed, S F; Galili, D

    2002-01-01

    Local anesthesia is without doubt the most frequently used drug in dentistry and in medicine. In spite of records of safety set by using these drugs, there is evidence to adverse reactions ranging from 2.5%-11%. Most of the reactions originate from the autonomic system. A recent, well-planned study indicates that adverse reactions are highly correlated to the medical status of the patient: the higher the medical risk, the greater the chance to experience an adverse reaction. This study also found that adverse reactions highly correlated to the concentration of adrenalin. Another recent study found a direct relationship between adverse reactions and the level of anxiety experienced by the patient and to the dental procedure. Most of the reactions in this study occurred either immediately at injection time and within 2 hours following the injection. Since the beginning of last century, vasoconstrictors have been added to local anesthesia solutions in order to reduce toxicity and prologue activity of the LA. However, today it is commonly agreed that this addition to local anesthesia should not be administered to cardiac patients especially those suffering from refractory dysrhythmias, angina pectoris, post myocardial infarction (6 months) and uncontrolled hypertension. Other contraindications to vasoconstrictors are endocrine disorders such as hyperthyroidism, hyperfunction of the medullary adrenal (pheochromocytoma) and uncontrolled diabetes mellitus. Cross reactivity of local anesthetic solutions can occur with MAO inhibitors, non specific beta adrenergic blockers, tricyclic antidepressants, phenothiazides and cocaine abusers. Noradrenaline added to local anesthetics as a vasoconstrictor has been described as a trigger to a great increase in blood pressure and therefore has been forbidden for use in many countries. This paper describes 4 cases of severe complications following the injections of local anesthesia of which three ended in fatality.

  3. Local anesthesia: A feasible option for pediatric frontalis sling surgery.

    Science.gov (United States)

    William, Jerald; Abbott, Joseph; Kipioti, Athina; Reuser, Tristan

    2011-01-01

    The purpose of this study was to demonstrate the suitability of local anesthesia in the pediatric age group for oculoplastic procedures. The authors present a case of frontalis sling surgery performed under local anesthesia in a 15-year-old boy with bilateral congenital ptosis. No significant technical difficulties were encountered during the procedure. Optimal intraoperative eyelid placement was facilitated by the patient's comfort and cooperation. For some selected children, local anesthesia is a good alternative to general anesthesia to obtain the best outcome.

  4. [Carotid endarterectomy under local anesthesia].

    Science.gov (United States)

    Kuz'min, A L; Belov, Iu V

    2001-01-01

    Results of carotid endarterectomy (CEAE) in 193 patients with different degree of cerebrovascular insufficiency were analyzed. All the patients were men with carotid atherosclerosis (age from 39 to 68 years, mean age 53.6 +/- 0.4). A total of 253 CEAEs were performed under local anesthesia (60 patients underwent consecutive bilateral operations). In early postoperative period 3 patients died, one of them--of ischemic stroke due to thrombosis of internal carotid artery on the side of the operation. Non-fatal stroke was in 1 patient. There were no intraoperative cerebral complications. This testifies to reliability of cerebral circulation control through direct contact with patient.

  5. SPLIT SKIN GRAFT HARVESTING UNDER LOCAL ANESTHESIA INFILTRATION VERSUS TOPICAL LOCAL ANESTHESIA

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    Shahi

    2014-04-01

    Full Text Available OBJECTIVE: To compare the effectiveness of topical local anesthesia using PRILOX cream versus local anesthesia infiltration using lignocaine and adrenaline in harvesting split skin graft. METHODS: A prospective study of 58 patients requiring split skin graft was carried. One group comprising 29 patients underwent harvesting of split skin graft under topical local anesthesia using PRILOX cream while the other group had local anesthesia infiltration using lignocaine and adrenaline. RESULTS: There were no significant differences between the 2 groups in terms of operating time, per operative pain, post-operative pain and post-operative requirement of analgesia. There was significant difference in time and pain during administration of local anesthesia and patient’s acceptability/ satisfaction with method of anesthesia. CONCLUSION: Topical local anesthesia using PRILOX cream can be used effectively for harvesting of split skin graft and is good alternative to local anesthesia infiltration.

  6. Advances in local anesthesia in dentistry.

    Science.gov (United States)

    Ogle, Orrett E; Mahjoubi, Ghazal

    2011-07-01

    Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.

  7. Optimization of Spinal Anesthesia in Surgery of Intervertebral Disks

    Directory of Open Access Journals (Sweden)

    V. I. Gorbachev

    2006-01-01

    Full Text Available The paper gives the data of preoperative evaluation of autonomous nervous system tone and its correction, pharmacokinetics of local anesthetics in the subarachnoidal space, as well as the optimization of a procedure for spinal anesthesia in patients operated on for lumbosacral radiculitis. 

  8. [Clinical utility of thoracoscopy under local anesthesia].

    Science.gov (United States)

    Ishii, Yoshiki

    2007-07-01

    Thoracoscopy has been recently established as an indispensable technique for diagnosis and treatment of respiratory diseases. Although, thoracoscopy is usually applied under general anesthesia by a surgeon, it can also be applied by a chest physician under local anesthesia if the target is limited to pleural diseases. The main objective of medical thoracoscopy under local anesthesia is to establish a diagnosis of pleural effusions by means of observation and biopsy in the thoracic cavity. Our main target diseases are the pleuritis carcinomatosa, malignant mesothelioma and tuberculous pleuritis. These 3 diseases are the diseases with which medical thoracoscopy is most useful because they can be reliably diagnosed by biopsies and because early diagnosis and early treatment are essential. In case of the pneumothorax, treatment with bulla looping or cauterization may be possible, but we do not treat pneumothorax with medical thoracoscopy because it is impossible to approach and find air leaks of lesions located in or near blind spots such as the apex or mediastinal part In case of acute emphysema, it is important to release adhesions and perform effective drainage using thoracoscopy as soon as possible since deposition of fibrin tends to form quickly compartments that make drainage difficult. Scince medical thoracoscopy under local anesthesia is rapid, easy, safe, and well-tolerated procedure with an excellent diagnostic yield, it is recommended as a diagnostic procedure for cases with pleural diseases.

  9. Outpatient varicocelectomy performed under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    Geng-Long Hsu; Pei-Ying Ling; Cheng-Hsing Hsieh; Chii-Jye Wang; Cheng-Wen Chen; Hsien-Sheng Wen; Hsiu-Mei Huang; E. Ferdinand Einhorn; Guo-Fang Tseng

    2005-01-01

    Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS)was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible,simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.

  10. Herniorrafia inguinal: anestesia local ou regional? Inguinal herniorrhaphy: local or regional anesthesia?

    Directory of Open Access Journals (Sweden)

    Kelston Paulo Felice de Sales

    2000-05-01

    Full Text Available A herniorrafia inguinal é um dos procedimentos cirúrgicos mais realizados no mundo. Devido a isso tem-se procurado otimizar o procedimento, diminuindo custos, tempo de internamento e complicações decorrentes do ato operatório e da anestesia. Neste trabalho, fizemos uma análise comparativa entre anestesia regional e anestesia local na herniorrafia de 32 pacientes divididos em dois grupos. No grupo 1, foi utilizada anestesia regional e, no grupo 2, anestesia local. Em relação ao desconforto transoperatório, o método de anestesia regional se mostrou mais efetivo. Já em relação a incidência de complicações pós-operatórias e diminuição do tempo de internamento, a anestesia local se mostrou mais eficiente.Inguinal herniorrhaphy is one of the most frequent surgical procedures around the world. Therefore its optimization has been tried to reduce expenses, hospitalization time and complications resulting from surgical and anesthetic procedures. This experiment compared regional and local anesthesia in herniorrhaphy of 32 patients divided into two groups. Regional anesthesia was applied to group one patients and local anesthesia was applied to group two patients. Regional anesthesia showed to be more effective in terms of trans-surgical discomfort while local anesthesia showed to be more efficient in reducing post-surgical complications and hospitalization time.

  11. Inguinal hernioraphy under local anesthesia in the elderly patients

    OpenAIRE

    2012-01-01

    Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years) and theyounger. Anesthesia methods, additional anesthesia r...

  12. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

    Full Text Available Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years and theyounger. Anesthesia methods, additional anesthesia requirementand complications were compared.Results: Of totally 177 patients, 30.5% were elderly.Operation type, anesthesia method and score of operationalrisk differed between groups. The percentage of comorbidity (55.6% in the elderly was significantly high (p<0.001. Among elderly, the frequency of co morbidity wasslightly higher in patients who had local anesthesia comparedto spinal and general anesthesia. Patients in youngand middle ages preferred to be operated less under localanesthesia (34.1% compared to elderly (70.4%. Therewas one case (2.6% converted to general anesthesiaas an additional anesthesia in the elderly group. Postoperativecomplications were slight more frequent in elderly.These cases were five in number (31.3% and were operatedunder spinal or general anesthesia (p=0.002.Conclusions: The frequency of co morbidity and riskscore of operation (ASA category rise in the elderly.However, inguinal hernioraphy can be performed underlocal anesthesia without complication and conversion togeneral anesthesia.Key words: Inguinal hernia; aged; comorbidity; local anesthesia

  13. Use of local anesthesia during dental rehabilitation with general anesthesia: a survey of dentist anesthesiologists.

    Science.gov (United States)

    Townsend, Janice A; Hagan, Joseph L; Smiley, Megann

    2014-01-01

    The purpose of this study was to document current practices of dentist anesthesiologists who are members of the American Society of Dentist Anesthesiologists regarding the supplemental use of local anesthesia for children undergoing dental rehabilitation under general anesthesia. A survey was administered via e-mail to the membership of the American Society of Dentist Anesthesiologists to document the use of local anesthetic during dental rehabilitations under general anesthesia and the rationale for its use. Seventy-seven (42.1%) of the 183 members responded to this survey. The majority of dentist anesthesiologists prefer use of local anesthetic during general anesthesia for dental rehabilitation almost always or sometimes (90%, 63/70) and 40% (28/70) prefer its use with rare exception. For dentist anesthesiologists who prefer the administration of local anesthesia almost always, they listed the following factors as very important: "stabilization of vital signs/decreased depth of general anesthesia" (92.9%, 26/28) and "improved patient recovery" (82.1%, 23/28). There was a significant association between the type of practice and who determines whether or not local anesthesia is administered during cases. The majority of respondents favor the use of local anesthesia during dental rehabilitation under general anesthesia.

  14. Randomized study of phentolamine mesylate for reversal of local anesthesia.

    Science.gov (United States)

    Laviola, M; McGavin, S K; Freer, G A; Plancich, G; Woodbury, S C; Marinkovich, S; Morrison, R; Reader, A; Rutherford, R B; Yagiela, J A

    2008-07-01

    Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).

  15. TONSILLECTOMY UNDER LOCAL ANESTHESIA IN MALI

    Directory of Open Access Journals (Sweden)

    SACKO HB

    2015-04-01

    Full Text Available BACKGROUND The objective of this study was to analyze a series of tonsillectomies performed in the ENT Reference CentreoftheHealth, DistrictIVBAMAKOMALI PATIENTS and METHODS The study was conducted between June 2003 and May 2013 focused on 166 patients. Patients with chronic tonsillitis, obstructive hypertrophy of the Palatine tonsils, caseous tonsillitis were included in the study. The method of dissection of the tonsils in sitting position (home position was the technique used. RESULTS A predominance of female 114 (68.70% were observed. The average age of the patients was 25 years with extremes from 12 to 54 years. Tonsillectomy was bilateral in all patients of the study. The main indications were: chronic tonsillitis 101 (60.84%. There was no major complication during the postoperative period. CONCLUSION Tonsillectomy under local anesthesia is well tolerated by patients in a tropical environment. Its cost is less.

  16. Current options in local anesthesia for groin hernia repairs.

    Science.gov (United States)

    Kulacoglu, Hakan; Alptekin, Alp

    2011-01-01

    Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

  17. Local anesthesia for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Verhoeven, ELG; Cina, CS; Tielliu, IFJ; Zeebregts, CJ; Prins, TR; Eindhoven, GB; Span, MM; Kapma, MR; van den Dungen, JJAM

    2005-01-01

    Objectives: This study reports the results of a prospective continuous cohort of patients treated for endovascular aneurysm repair (EVAR) with a unified anesthetic strategy based on the use of local anesthesia (LA) in all patients, while reserving regional (RA) or general anesthesia (GA) only for th

  18. Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure.

    Science.gov (United States)

    Vaz, Filinto Aníbal Alagia; Abreu, Rone Antônio Alves; Soárez, Patrícia Coelho de; Speranzini, Manlio Basílio; Fernandes, Luís Cesar; Matos, Delcio

    2010-01-01

    Studies in the area of health economics are still poorly explored and it is known that the cost savings in this area is becoming more necessary, provided that strict criteria. To perform a cost-effectiveness analysis of spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure. This was a randomized clinical trial with 50 patients undergoing loop colostomy closure either under spinal anesthesia (n = 25) or under local anesthesia plus sedation (n = 25). The duration of the operation, time spent in the post-anesthesia recovery room, pain, postoperative complications, length of hospital stay, laboratory and imaging examinations and need for rehospitalization and reoperation were analyzed. The direct medical costs were analyzed. A decision tree model was constructed. The outcome measures were mean cost and cost per local and systemic postoperative complications avoided. Incremental cost-effectiveness ratios were presented. Duration of operation: 146 +/- 111.5 min. vs 105 +/- 23.6 min. (P = 0.012); mean time spent in post-anesthesia recovery room: 145 +/- 110.8 min. vs 36.8 +/- 34.6 min. (Pplus sedation (Pplus sedation (P = 0.209). Hospitalization + rehospitalization: 4.5 +/- 4.1 days vs 2.9 +/- 2.2 days (Pcost-effectiveness ratio: R$ -474.78, indicating that the strategy with local anesthesia plus sedation is cost saving. In the present investigation, loop colostomy closure under local anesthesia plus sedation was effective and appeared to be a dominant strategy, compared with the same surgical procedure under spinal anesthesia.

  19. Optimal Technique in Cardiac Anesthesia Recovery

    NARCIS (Netherlands)

    Svircevic, V.

    2014-01-01

    The aim of this thesis is to evaluate fast-track cardiac anesthesia techniques and investigate their impact on postoperative mortality, morbidity and quality of life. The following topics will be discussed in the thesis. (1.) Is fast track cardiac anesthesia a safe technique for cardiac surgery?

  20. Advanced techniques and armamentarium for dental local anesthesia.

    Science.gov (United States)

    Clark, Taylor M; Yagiela, John A

    2010-10-01

    Computer-controlled local anesthetic delivery (C-CLAD) devices and systems for intraosseous (IO) injection are important additions to the dental anesthesia armamentarium. C-CLAD using slow infusion rates can significantly reduce the discomfort of local anesthetic infusion, especially in palatal tissues, and facilitate palatal approaches to pulpal nerve block that find special use in cosmetic dentistry, periodontal therapy, and pediatric dentistry. Anesthesia of single teeth can be obtained using either C-CLAD intraligamentary injections or IO injections. Supplementary IO anesthesia is particularly suited for providing effective pain control of teeth diagnosed with irreversible pulpitis.

  1. Optimizing anesthesia techniques in the ambulatory setting

    NARCIS (Netherlands)

    E. Galvin

    2007-01-01

    textabstractAmbulatory surgery refers to the process of admitting patients, administering anesthesia and surgical care, and discharging patients home following an appropriate level of recovery on the same day. The word ambulatory is derived from the latin word ambulare, which means ''to walk''. This

  2. Effect of a training model in local anesthesia teaching

    NARCIS (Netherlands)

    Brand, H.S.; Baart, J.A.; Maas, N.E.; Bachet, I.

    2010-01-01

    The aim of this study was to evaluate the preclinical use of a training model in local anesthesia teaching on the subsequent clinical administration of a local anesthetic. Sixty-five dental students gave their first injection to a fellow dental student: twenty-two students after previous experience

  3. Effect of a training model in local anesthesia teaching

    NARCIS (Netherlands)

    Brand, H.S.; Baart, J.A.; Maas, N.E.; Bachet, I.

    2010-01-01

    The aim of this study was to evaluate the preclinical use of a training model in local anesthesia teaching on the subsequent clinical administration of a local anesthetic. Sixty-five dental students gave their first injection to a fellow dental student: twenty-two students after previous experience

  4. Surgically assisted rapid maxillary expansion under local anesthesia: case report

    Directory of Open Access Journals (Sweden)

    João Frank Carvalho DANTAS

    2009-12-01

    Full Text Available is indicated for the treatment of transverse maxillary deficiency in patients with skeletal maturity, through the association of orthodontic and surgical procedures. It leads to an increase in the maxillary arch, resulting in better accommodation of the tongue and correcting the black corridors. This procedure can be performed under local anesthesia with low risk of complications, thus being considered a practical alternative treatment. Case report and conclusion: This article reports a case of surgically assisted maxillary expansion performed under local anesthesia in an outpatient setting. The patient had a clinical picture of transverse maxillary deficiency. Performing SARPE under local anesthesia in an outpatient setting is a viable procedure, of low cost, easy implementation and low risk of complications once it is performed according to the appropriate technique.

  5. INGUINAL HERNIOPLASTY IN ELDERLY PATIENTS UNDER LOCAL ANESTHESIA

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    Shahi

    2014-05-01

    Full Text Available OBJECTIVE: To evaluate the feasibility and safety of inguinal hernioplasty under local anesthesia in elderly patients with significant comorbidity. METHODS: A prospective study of 68 patients requiring inguinal mesh hernioplasty for inguinal hernia was carried. One group comprising 34 patients under 60 years of age underwent inguinal mesh hernioplasty while the other group comprising 34 patients over 60 years of age. The comorbid conditions and complications were compared between both groups. RESULTS: Inguinal mesh hernioplasty in elderly patients is more likely associated with comorbid conditions than younger patients in terms of hypertension, chronic obstructive pulmonary disease, cardiovascular diseases, benign prostatic hyperplasia etc. CONCLUSION: Elective inguinal mesh hernioplasty under local anesthesia has good results in elderly patients with significant comorbidities. Inguinal mesh hernioplasty under local anesthesia is safe and results in good success rate in elderly patients with significant comorbidities

  6. Linear Hand Burn Contracture Release under Local Anesthesia without Tourniquet.

    Science.gov (United States)

    Prasetyono, Theddeus O H; Koswara, Astrid F

    2015-10-01

    The objective of this report is to present a case of hand burn linear contracture release performed under local anesthesia. It also introduces the one-per-mil tumescent solution consisted of 0.2% lidocaine and 1:1.000.000 epinephrine as a local anesthesia formula, which has the potential of providing adequate anesthesia as well as hemostatic effect during surgery of the hand without tourniquet. The surgery was performed on a 19 year-old male patient with multiple thumb and fingers flexion linear contracture for 105 minutes without any obstacle. The patient did not complain any pain and discomfort during the procedure; while bloodless operative field was successfully achieved. At four-month follow up, the patient could fully extend his thumb, middle and ring finger, while the index was limited by 10° at the DIP joint. Overall, the patient was satisfied with the outcome.

  7. [Practical advices in choosing local anesthesia tools in dentistry. Management of carpule's quality in local anesthesia in dentistry].

    Science.gov (United States)

    Kuzin, A V

    2014-01-01

    The equipment for local anesthesia is described in this article. Practical recommendations for the selection of the injection needle length, size, bevel type is given. Using dental needle for local anesthesia should be guided by the "one injection - one needle" rule, as a needle tends to deform by even the slightest contact with jawbone. Some of the shortcomings of carpule quality may be detected before use: signs of cup corrosion, the presence of sediment, air bubbles, rubber plunger disposition. In the case of such defects being identified all the package should not be used. The use of such carpule in clinical practice is unsafe.

  8. Local anesthesia in dentistry - Clinical Considerations

    OpenAIRE

    Sharmraaj Subramaniam; Prasanna Neelakantan

    2013-01-01

    Local anaesthesia is commonly employed prior to most dental procedures. It is imperative to understand the mechanisms by which local anaesthetics work, so that their efficacy can be improved for painless dental care. Local anaesthesia also has major clinical implications in that it can precipitate emergencies in patients with an underlying systemic disease. It is imperative that a dentist have a thorough knowledge of the considerations one must take when administering local anaesthesia in pat...

  9. Review of knee arthroscopy performed under local anesthesia

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    Law Billy

    2009-01-01

    Full Text Available Abstract Local anesthesia for knee arthroscopy is a well documented procedure with diagnostic and therapeutic role. Numerous therapeutic procedures including partial menisectomy, meniscus repair, abrasion chondroplasy, synovectomy, loose body removal can be performed safely and comfortably. Appropriate case selection, anesthetic strategy and technical expertise are the key to smooth and successful surgery.

  10. Comparison of Sedation With Local Anesthesia and Regional Anesthesia in Transurethral Resection of Prostate (TURP

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    H Aghamohammadi

    2008-12-01

    Full Text Available ABSTRACT: Introduction & Objective: Transurethral Resection of Prostate (TURP is usually performed under regional or general anesthesia. An alternative to conventional anesthesia is performing of TURP under local anesthetic infiltration with sedation. The aim of this study was to evaluate the efficacy and complication of sedoanalgesia in TURP. Material & Methods: In a prospective clinical trial from September 2006 to December 2007, 60 patients (30 in each group with prostate hypertrophy, candidate for TURP, were randomly assigned into two groups. In the first group, standard spinal anesthesia was done. In the second group, five minutes before the operation, 25 mgs of diazepam plus 25-50 mgs of pethedine was intravenously administered followed by injection of 10 ml lidocaine 2% gel in the urethra and the skin in the suprapubic area was anesthetized with 2 ml of 1% lidocaine. Using a 22 gauge nephrostomy needle, the suprapubic skin was punctured and the needle was directed toward prostate apex and 10-20ml of 1% lidocaine was injected at the serosal aspect of the rectal wall. For dorsal nerve block, 5-10ml of 1% lidocaine was injected at penopubic junction, and then a standard TURP was performed. Patients were switched to another anesthetic technique if the selected technique failed. Severity of pain was assessed by visual analogue scale. Results: The average prostate size was 25 grs (range10-50grs in the local anesthetic group (group 1 and 27.5 grs (range 10-50 grs in the spinal group (group2. In the local anesthetic group, 82.3% had no or mild pain while moderate to severe pain was reported in 16, 7% of the patients. In the group with spinal anesthesia, these were 93.1% and 6.9% respectively. Intolerable pain was observed in 23.3% and 13.8% of groups 1 and 2 respectively (p>0.05. Two patients in spinal group and 5 in local anesthetic group (3 due to severe pain and 2 for unsatisfaction required conversion to general anesthesia or receiving

  11. Local anesthetis and adjuvants in pediatric regional anesthesia.

    Science.gov (United States)

    Mossetti, Valeria; Vicchio, Noemi; Ivani, Giorgio

    2012-06-01

    The pediatric loco-regional techniques are considered very safe and effective, first of all because they target the therapy directly to the site of surgery, decreasing the risks of intravenous analgesia. The quality of local anesthesia is influenced by structural and biophysical characteristics of local anesthetics drug, dose, site of injection, mixture of local anesthetics and possible addition of a vasoconstrictor or an adjuvant to prolong the analgesic effect. In children, unlike adults, small nerve diameters and short distance between Ranvier nodes permit to use large volumes and low concentrations of local anesthetics. The clinical practice has shown that in pediatric population, effective analgesia is obtained by 1% mepivacaine, 1% lidocaine and 0.25% bupivacaine or better 0.2% ropivacaine, 0.2-0.25% levobupivacaine. In addition, levobupivacaine and ropivacaine have a better profile in terms of safety in comparison to bupivacaine and are the local anesthetics of choice for the daily clinical practice also in children as in adults. Among the adjuvant, clonidine and ketamine showed the best pharmacokinetic and pharmacodynamic profiles of effective and safety, improving and prolonging the action of associated local anesthetics. Therefore, the use of enantiomers, in association with adjuvants as clonidine or ketamine, using the multimodal approach of integrated anesthesia, makes the clinical practice effective and safe in the pediatric operating rooms. This review focuses on the overview of local anesthetics and adjuvants used today in locoregional pediatric anesthesia, with an emphasis on the advantages and disadvantages of each drug.

  12. Cleft-lift operation for pilonidal sinuses under tumescent local anesthesia

    DEFF Research Database (Denmark)

    Bertelsen, Claus Anders

    2011-01-01

    The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before.......The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before....

  13. An update on local anesthesia for pediatric dental patients

    OpenAIRE

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.

  14. An update on local anesthesia for pediatric dental patients

    Science.gov (United States)

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients. PMID:25885712

  15. An update on local anesthesia for pediatric dental patients

    OpenAIRE

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.

  16. Local anesthesia selection algorithm in patients with concomitant somatic diseases.

    Science.gov (United States)

    Anisimova, E N; Sokhov, S T; Letunova, N Yu; Orekhova, I V; Gromovik, M V; Erilin, E A; Ryazantsev, N A

    2016-01-01

    The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

  17. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  18. Local anesthesia part 2: technical considerations.

    Science.gov (United States)

    Reed, Kenneth L; Malamed, Stanley F; Fonner, Andrea M

    2012-01-01

    An earlier paper by Becker and Reed provided an in-depth review of the pharmacology of local anesthetics. This continuing education article will discuss the importance to the safe and effective delivery of these drugs, including needle gauge, traditional and alternative injection techniques, and methods to make injections more comfortable to patients.

  19. Local Anesthesia Part 2: Technical Considerations

    Science.gov (United States)

    Reed, Kenneth L.; Malamed, Stanley F.; Fonner, Andrea M.

    2012-01-01

    An earlier paper by Becker and Reed provided an in-depth review of the pharmacology of local anesthetics. This continuing education article will discuss the importance to the safe and effective delivery of these drugs, including needle gauge, traditional and alternative injection techniques, and methods to make injections more comfortable to patients. PMID:23050753

  20. Guidelines for administration of local anesthesia for dermatosurgery and cosmetic dermatology procedures

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatosurgery and Cosmetic dermatology procedures are being performed by increasing number of dermatologists. Most dermatosurgeries are performed in an outpatient setting and as day care surgeries, under local anesthesia. Hence, it is important to improve patient comfort during all procedures. These guidelines seek to lay down directives in the use of local anesthesia, outline the different local anesthetics, the mode of administration, complications arising out of such procedure and management of the same. Facility for administration of local anesthesia: Local anesthesia is usually administered in the dermatologist′s procedure room. The room should be equipped to deal with any emergencies arising from administration of local anesthesia. Qualifications of local anesthesia administrator: Local anesthesia administrator is a person who applies or injects local anesthetic agent for causing analgesia. Procedures done under local anesthesia are classified as Level I office procedures and require the administrator to have completed a course in Basic Cardiac Life Support (BCLS. Evaluation of patients for topical or infiltrative anesthesia: Details of patient′s past medical history and history of medications should be noted. Allergy to any medications should be specifically enquired and documented. Patients for tumescent anesthesia need additional precautions to be observed as described in these guidelines. Methods of administration of local anesthesia: Different methods include topical anesthesia, field block, ring block, local infiltration and nerve block. Also, it includes use of local anesthetics for anesthetizing oral and genital mucosa. Tumescent anesthesia is a special form of local anesthesia used in liposuction and certain selected procedures. Local anesthetic agents: Different local anesthetics are available such as lignocaine, prilocaine, bupivacaine. The dermatologist should be aware of the

  1. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Coturel A

    2015-11-01

    Full Text Available Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar results regarding recurrence. It has no specific complications of spinal anesthesia. Performed a randomized missing on costs, pain and quality of life postoperatively prospective analysis

  2. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

    OpenAIRE

    2015-01-01

    Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar res...

  3. [Value of flexible fiberoptic bronchoscopy under local anesthesia in infants].

    Science.gov (United States)

    Bodart, E; De Lange, M; Vliers, A

    1993-06-01

    From October 1991 through April 1992, 16 infants aged 5 to 25 months (mean age 14.3 months) underwent bronchoscopy with a flexible fiberoptic bronchoscope, under local anesthesia. The technique is described in detail. Reasons for bronchoscopy included recurrent or persistent pneumonia (n = 4), persistent atelectasia (n = 4), lymphadenopathy and/or airway compression (n = 2), suspected foreign body (n = 2), bronchoalveolar lavage to investigate diffuse interstitial lung disease (n = 2), and severe recurrent wheezing (n = 2). The procedure established the accurate diagnosis in 14 cases. Adverse events (32%) were minor (transient hypoxia, n = 3; moderate fever, n = 1; and laryngospasm, n = 1) and resolved completely. Flexible fiberoptic bronchoscopy under local anesthesia is a simple procedure which is safe in patients under 30 months of age when performed by a experienced operator in an adequate facility. This method is useful for the diagnosis and/or treatment of a broad spectrum of conditions.

  4. Influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients' intra-operative serum indexes

    Institute of Scientific and Technical Information of China (English)

    Sheng-Yong Liang

    2015-01-01

    Objective:To analyze the influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients’ intra-operative serum indexes.Methods: 162 patients who received EMR from September 2013 to September 2014 in our hospital were enrolled and randomly divided into the observation group, including 81 cases, who received local mucosal anesthesia combined with non tracheal intubation general anesthesia, and the control group, including 81 cases, who received local mucosal anesthesia combined with routine tracheal intubation general anesthesia. Then inflammation index, stress index and immune index, etc were compared.Results:1) after general anesthesia, serum cytokine levels of IL-23, IL-32, PCT,β-EP and TNF-α, etc of the observation group were all significantly lower than those of the control group(P<0.05); 2) after general anesthesia, serum cytokine levels of COR, ET, TH and Ins, etc of the observation group were significantly lower than those of the control group(P<0.05); 3) after general anesthesia, serum levels of sICAM 1, CD11b, CD18 and CD20 of the observation group were lower than those of the control group; CD56 level was higher than that of the control group(P<0.05).Conclusion:Local mucosal anesthesia combined with non tracheal intubation general anesthesia provides sufficient anesthetic depth for EMR patients, and at the same time, can effectively reduce intra-operative systemic inflammatory response and stress response and contribute to the protection of body's immune function.

  5. MR arthrography of the shoulder: Do we need local anesthesia?

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio, E-mail: claudio.spick@meduniwien.ac.at [Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090 Vienna (Austria); Szolar, Dieter H.M.; Reittner, Pia; Preidler, Klaus W.; Tillich, Manfred [Diagnostikum Graz-Südwest, Weblinger Guertel 25, 8054 Graz (Austria)

    2014-06-15

    Purpose: To assess pain intensity with and without subcutaneous local anesthesia prior to intraarticular administration of contrast medium for magnetic resonance arthrography (MRa) of the shoulder. Materials and methods: This single-center study was conducted after an IRB waiver of authorization, between January 2010 and December 2012. All patients provided written, informed consent for the procedure. Our prospectively populated institutional database was searched, based on our inclusion criteria. There were 249 outpatients (178 men and 71 women; mean age, 44.4 years ± 14.6; range, 15–79) who underwent MRa and were enrolled in this study. Patients were excluded if they had received surgery of the shoulder before MRa, had undergone repeated MRa of the same shoulder, and/or had undergone MRa of both shoulders on the same day. Patients were randomly assigned into one of three groups. Patients in group A (n = 61) received skin infiltration with local anesthesia. Patients in control group B (n = 92) and group C (n = 96) did not receive local anesthesia. Pain levels were immediately assessed after the injection for MRa using a horizontal visual analog scale (VAS) that ranged from 0 to 10. To compare the pain scores of the three groups for male and female patients, a two-way analysis of variance was used. A p-value equal to or less than 0.05 was considered to indicate a significant result. Results: Patients who received local anesthesia (group A) showed a mean pain level on the VAS of 2.6 ± 2.3. In patients who did not receive local anesthetics (groups B and C), a mean pain level on the VAS of 2.6 ± 2.2 and 2.7 ± 2.4 were detected, respectively. Between the three groups, no statistically significant difference in pain intensity was detected (p = .960). There were significant differences in subjective pain perception between men and women (p = .009). Moreover, the sex difference in all three groups was equal (p = .934). Conclusion: Local anesthesia is not required to

  6. Use of the Computadorized Local Anesthesia System The Wand in Pediatric Dentistry

    OpenAIRE

    Faraco Junior, Italo Medeiros; Ana Letícia Rower DABLE; Ottoni,Andréia Bertani; Marquezan,Marcela; Tovo, Maximiano Ferreira; Kramer,Paulo Floriani

    2007-01-01

    Introduction: The positive behavior of pediatric patients depends, among others variables, on the success of local anesthesia. Objective: In sight of this, we carried out a review about anesthesic techniques using the computerized anesthesia. This system has as main objective to reduce the discomfort caused by the traditional anesthesia, by controlling two important factors for the success of the local anesthesia: the pressure and the volume of anesthesic. Conclusion: The majority of the revi...

  7. Use of the Computadorized Local Anesthesia System The Wand in Pediatric Dentistry

    OpenAIRE

    Faraco Junior,Italo Medeiros; Ana Letícia Rower DABLE; Andréia Bertani OTTONI; MARQUEZAN,Marcela; Maximiano Ferreira TOVO; Kramer,Paulo Floriani

    2007-01-01

    Introduction: The positive behavior of pediatric patients depends, among others variables, on the success of local anesthesia. Objective: In sight of this, we carried out a review about anesthesic techniques using the computerized anesthesia. This system has as main objective to reduce the discomfort caused by the traditional anesthesia, by controlling two important factors for the success of the local anesthesia: the pressure and the volume of anesthesic. Conclusion: The majority of the revi...

  8. ARTHROSCOPIC MENISCUS REPAIR WITH BIOABSORBABLE ARROWS IN LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Vladimir Senekovič

    2004-11-01

    Full Text Available Background. The menisci have important function in the knee joint. Because of this it is universally accepted that we have to preserve them as much as possible. After open and partially arthroscopic suture techniques new methods of all-inside meniscus repair with bioabsorbable arrows have been developed in the last decade. The meniscus repair using these arrows represents an easy task for a skilled surgeon. In addition, it can be performed in local anesthesia. We have evaluated the results of the first group of patients who were treated by this method.Methods. From February 2001 to August 2002 15 patients with torn meniscuses have been treated at the Clinical Department for Traumatology, University Medical centre, Ljubljana. We repaired their torn menisci arthroscopically with bioabsorbable arrows in local anesthesia. We divided patients in three groups: a group with isolated meniscus injury, a group with meniscus injury and anterior cruciate ligament injury and a group with associated pathology. Four patients had incarcerated meniscuses. Preoperative Lysholm score in the first group was 38, in the second 42 and in the third group 48. We repaired 12 medial and 3 lateral meniscuses. On average we need 45 minutes for therapeutic arthroscopy. Torn meniscus was fixated with minimum of 1 and maximum of 5 bioabsorbable arrows. All patients except one had the affected knee immobilized with cylinder plaster for 15 days on average.Results. At least three months after the arthroscopic fixation of the torn meniscus in local anesthesia another clinical evaluation was made. In all groups significant improvement was observed regarding the range of motions and absence of pain. Postoperative Lysholm score in the first group was 89, in the second 75 and in the third 71. Average deficit of flexion was 3 degrees while extension was full. One patient complained about the same pain in the joint, he underwent another arthroscopy which showed that the meniscus was

  9. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial.

    Science.gov (United States)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels; Johnsen, Søren P; Yoo, Albert J; Andersen, Grethe; Rasmussen, Mads

    2016-12-01

    Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether the choice of anesthetic regime during endovascular therapy for acute ischemic stroke influence patient outcome. Our hypothesis is that that conscious sedation is associated with less infarct growth and better functional outcome. GOLIATH is an investigator-initiated, single-center, randomized study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary outcomes include 90-day modified Rankin Scale score, time parameters, blood pressure variables, use of vasopressors, procedural and anesthetic complications, success of revascularization, radiation dose, and amount of contrast media. Choice of anesthesia may influence outcome in acute ischemic stroke patients undergoing endovascular therapy. The results from this study may guide future decisions regarding the optimal anesthetic regime for endovascular therapy. In addition, this study may provide preliminary data for a multicenter randomized trial. © 2016 World Stroke Organization.

  10. [Infracondylar abscess formation: a rare complication of local anesthesia].

    Science.gov (United States)

    Dojcinovic, I; Hugentobler, M; Richter, M

    2006-11-01

    Ninety percent of oro-facial infections arise from a dental origin. The remaining 10% are the consequence of oro-pharyngeal, cutaneous or iatrogenic problems, such as in the present case. A 24-year-old patient consulted the emergency room because of a left mandibular swelling, accompagnied by trismus. Four days earlier, extraction of the 38 was performed under inferior alveolar nerve block anesthesia. A first drainage by vestibular approach was performed under general anesthesia. Because of the absence of improvement, a CT-scan was performed and an abscess localized at the base of the condyle, surrounding the posterior margin of the mandible, very high above the lingula. Outcome was favourable after a second surgery. Formation of an abscess very high above the lingula, around the condylar neck is rarely reported in the literature. In this patient it was certainly a complication resulting from the injection of local anesthesic with a vasoconstrictor. CT-scan should be performed to guide diagnosis in the event of an unusual course after the first surgical procedure and an adequate antibiotic regimen.

  11. Ocular complications associated with local anesthesia administration in dentistry.

    Science.gov (United States)

    Boynes, Sean G; Echeverria, Zydnia; Abdulwahab, Mohammad

    2010-10-01

    The most widely used method for controlling pain during dental procedures is the intraoral administration of local anesthetics in close proximity to a specific nerve or fiber to obtund nerve conduction. The most commonly anesthetized nerves in dentistry are branches or nerve trunks associated with the maxillary and mandibular divisions of the trigeminal nerve (cranial nerve V). However, other nerves may be inadvertently affected by intraoral local anesthesia injections, resulting in anesthetic complications of structures far from the oral cavity. Practitioners should be aware of potential ocular complications following intraoral injections in dentistry. These complications include oculomotor paralysis and vision loss. The knowledge of these conditions and their potential cause should alert the dentist to the importance of appropriate injection techniques and an understanding of management protocol.

  12. Local Anesthesia Combined With Sedation Compared With General Anesthesia for Ambulatory Operative Hysteroscopy

    DEFF Research Database (Denmark)

    Brix, Lone Dragnes; Thillemann, Theis Muncholm; Nikolajsen, Lone

    2016-01-01

    anesthesia combined with sedation (group LA + S; n = 76) or general anesthesia (group GA; n = 77). Primary outcome was the worst pain intensity score in the postanesthesia care unit (PACU) rated by the patients on a numerical rating scale. FINDING: Data from 144 patients were available for analysis (LA + S...... was shorter (P anesthesia with sedation can be recommended as a first choice anesthetic technique for operative ambulatory hysteroscopy....

  13. Optimal dose of dexmedetomidine for sedation during spinal anesthesia

    Science.gov (United States)

    Ok, Hwoe-Gyeong; Baik, Seong-Wan; Kim, Hae-Kyu; Shin, Sang-Wook; Kim, Kyung-Hoon

    2013-01-01

    Background Sedation in spinal anesthesia can reduce patient's anxiety and discomfort. Dexmedetomidine has a sedative, hypnotic, analgesic, and minimal respiratory depression effect. However, use of the dexmedetomidine is associated with prolonged recovery. This study was designed to investigate the optimal dose of intravenous dexmedetomidine for proper sedation with minimal recovery time in spinal anesthesia. Methods One hundred twenty eight patients, aged 20-70 years (58.8 ± 0.7), were recruited. After performing the spinal anesthesia with hyperbaric bupivacaine (13 mg), a loading dose of dexmedetomidine (1 µg/kg) was administered for 10 min, followed by the maintenance infusion of the following: Group A (n = 33; normal saline), Group B (n = 35; dexmedetomidine 0.2 µg/kg/hr), and Group C (n = 39; dexmedetomidine 0.4 µg/kg/hr). Heart rate, blood pressure, and the bispectral index score (BIS) were recorded during the operation. In the recovery room, modified aldrete score (MAS) was measured. Results There were no significant differences in mean blood pressure and heart rate among the three groups. BIS was not significantly different among the three groups from baseline to 60 min after the infusion of dexmedetomidine. BIS were significantly increased in Group A after 70 and 80 min, and Group A and B after 90, 100, 110 min of dexmedetomidine infusion (P < 0.05). MAS was higher in Group A as compared to Group B and C, within 30 min after admission in the recovery room (P < 0.05). Conclusions The loading dose (1 µg/kg/10 min) of dexmedetomidine was sufficient for surgery of less than 60 min. Dexmedetomidine infusion followed by maintenance dose (0.2 µg/kg/hr) was sufficient for surgery within 90 min. PMID:23741565

  14. Comparative study of general, local and topical anesthesia for cataract surgery

    Directory of Open Access Journals (Sweden)

    Tarighat Monfared MH

    2001-07-01

    Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

  15. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Directory of Open Access Journals (Sweden)

    Liehua Liu

    2016-01-01

    Full Text Available Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females with osteoporotic vertebral compression fractures with a mean age of 71.4±8.8 years (range: 60 to 89 received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA. Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5±0.7 and 4.3±1.0, respectively, and there was significant difference (P=0.001. In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

  16. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Science.gov (United States)

    2016-01-01

    Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of 71.4 ± 8.8 years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA). Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5 ± 0.7 and 4.3 ± 1.0, respectively, and there was significant difference (P = 0.001). In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty. PMID:27766261

  17. Nursing and psychological treatment during tension-free inguinal hernia repair under local nerve blocked anesthesia

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li-hui

    2007-01-01

    Tension-free inguinal hernia repair under local nerve blocked anesthesia ia an up-to-date technology and is different from the traditional approach.The aim of this study isto evaluate the nursing and psychological treatment during operation under local nerve blocked anesthesia.

  18. Electronic dental anesthesia in a patient with suspected allergy to local anesthetics: report of case.

    Science.gov (United States)

    Malamed, S F; Quinn, C L

    1988-01-01

    A 56-year-old patient with alleged allergy to local anesthetics required restorative dental treatment. Electronic dental anesthesia was used successfully, in lieu of injectable local anesthetics, to manage intraoperative pain associated with the restoration of vital mandibular teeth.

  19. Optimized PID control of depth of hypnosis in anesthesia.

    Science.gov (United States)

    Padula, Fabrizio; Ionescu, Clara; Latronico, Nicola; Paltenghi, Massimiliano; Visioli, Antonio; Vivacqua, Giulio

    2017-06-01

    This paper addresses the use of proportional-integral-derivative controllers for regulating the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. In fact, introducing an automatic control system might provide significant benefits for the patient in reducing the risk for under- and over-dosing. In this study, the controller parameters are obtained through genetic algorithms by solving a min-max optimization problem. A set of 12 patient models representative of a large population variance is used to test controller robustness. The worst-case performance in the considered population is minimized considering two different scenarios: the induction case and the maintenance case. Our results indicate that including a gain scheduling strategy enables optimal performance for induction and maintenance phases, separately. Using a single tuning to address both tasks may results in a loss of performance up to 102% in the induction phase and up to 31% in the maintenance phase. Further on, it is shown that a suitably designed low-pass filter on the controller output can handle the trade-off between the performance and the noise effect in the control variable. Optimally tuned PID controllers provide a fast induction time with an acceptable overshoot and a satisfactory disturbance rejection performance during maintenance. These features make them a very good tool for comparison when other control algorithms are developed. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Comparison of two epinephrine concentrations in an articaine solution for local anesthesia in children

    OpenAIRE

    Zurfluh, Monika A.; Daubländer, Monika; van Waes, Hubertus J M

    2015-01-01

    Painless dental treatment is of major interest in pediatric dentistry. Local anesthesia contains epinephrine, which prolongs soft tissue anesthesia.This, however, is often a source of iscomfort for children and is responsible for certain side effects (e.g., self-inflicted soft tissue lesions). The aim of this study was to investigate whether an epinephrine-reduced articaine solution could reduce the duration of soft tissue anesthesia and thereby reduce the risk of self-inflicted soft tissue l...

  1. Tetrodotoxin-Bupivacaine-Epinephrine Combinations for Prolonged Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Christina Bognet

    2011-12-01

    Full Text Available Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is in phase III clinical trials as an injectable systemic analgesic for chronic cancer pain. Here, we examine dose-duration relationships and sciatic nerve histology following local nerve blocks with combinations of Tectin with bupivacaine 0.25% (2.5 mg/mL solutions, with or without epinephrine 5 µg/mL (1:200,000 in rats. Percutaneous sciatic blockade was performed in Sprague-Dawley rats, and intensity and duration of sensory blockade was tested blindly with different Tectin-bupivacaine-epinephrine combinations. Between-group comparisons were analyzed using ANOVA and post-hoc Sidak tests. Nerves were examined blindly for signs of injury. Blocks containing bupivacaine 0.25% with Tectin 10 µM and epinephrine 5 µg/mL were prolonged by roughly 3-fold compared to blocks with bupivacaine 0.25% plain (P < 0.001 or bupivacaine 0.25% with epinephrine 5 µg/mL (P < 0.001. Nerve histology was benign for all groups. Combinations of Tectin in bupivacaine 0.25% with epinephrine 5 µg/mL appear promising for prolonged duration of local anesthesia.

  2. Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients.

    Science.gov (United States)

    Mittal, M; Kumar, A; Srivastava, D; Sharma, P; Sharma, S

    2015-01-01

    Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups.

  3. [Hernia repair and local anesthesia. Results of a controlled randomized clinical trial].

    Science.gov (United States)

    Milone, F; Salvatore, G; Leongito, M; Milone, M

    2010-01-01

    In the past, general and spinal anesthesia were used for hernia surgery, but nowadays local anesthesia has become the method of choice for hernia repair, especially in outpatient patients. The one-day surgery is sufficient in the management of this pathology. The advantages of local anesthesia are simplicity, safety, extended postoperative analgesia, early mobilization, lack post-anesthesia effects, and low costs. From January 2004 to December 2008 we observed 297 male patients with inguinal hernia. These patients were divided, with rigorous chronological order of hospital admission, in two study groups, different for anesthetic techniques used. Our controlled randomized clinical trial examines the effectiveness of local anesthesia to reduce the time of hospitalization, without alteration of results, and particularly the degree of satisfaction of patients surgical treated for inguinal hernia.

  4. Serial bronchoscopic lung lavage in pulmonary alveolar proteinosis under local anesthesia

    Directory of Open Access Journals (Sweden)

    K Rennis Davis

    2015-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare disease, characterized by alveolar accumulation of surfactant composed of proteins and lipids due to defective surfactant clearance by alveolar macrophages. Mainstay of treatment is whole lung lavage, which requires general anesthesia. Herein, we report a case of primary PAP, successfully treated with serial bronchoscopic lung lavages under local anesthesia.

  5. Large area local anesthesia (LALA) in submuscular breast augmentation.

    Science.gov (United States)

    Parker, Wendy L; Charbonneau, Roland

    2004-01-01

    Large area local anesthesia (LALA) has been recommended for decreasing localized pain and shortening discharge time after breast augmentation surgery. However, quantifiable, objective outcome data for evaluation of the effectiveness of LALA in aesthetic plastic surgery procedures have not yet been reported. We conducted a retrospective patient chart review to determine whether irrigation of the submuscular pocket with bupivacaine in retropectoral breast augmentation procedures quantifiably alters the patient's postoperative course with respect to narcotic requirement, nausea and vomiting, and time to discharge. The findings were evaluated in the context of a critical review of the literature dealing with pain management after breast augmentation, and in particular with the use of LALA. All procedures were performed by the senior author in a private surgical facility. All patients received an identical general anesthetic plus local infiltration of incisions with 1% lidocaine with epinephrine. An inframammary approach was used in all cases; retropectoral dissection was performed with electrocautery dissection followed by hemostasis. In one cohort of patients the submuscular pocket was irrigated with 10 mL of 0.125% bupivacaine before dissection of the contralateral side; in a second control cohort it was not. Postoperative care was the same for both groups. We found a trend toward decreased nausea and vomiting and narcotic use, and a statistically significant decrease in time to discharge, for the cohort that received intraoperative bupivacaine irrigation. LALA is an effective means to decrease recovery time and possibly postoperative pain, nausea and vomiting, and narcotic requirements. Because evidence-based medicine is the surest basis for clinical decisions, evaluation of LALA as well as other treatment modalities should include quantifiable outcome measures.

  6. Local Anesthesia in Cataract Surgery-A Comparison of Different Methods

    Institute of Scientific and Technical Information of China (English)

    Nolan; J; Aziz; M; Ahmad; M; Shehata; M; Iqbal; F

    1993-01-01

    Seven groups of thirty patients undergoing cataract extraction under local anesthesia were each given different combinations of local anesthesia. These varied from a maximum approach using supra-orbital, infra-orbital and facial blocks with Hyalase, orbital compression and pre-operative Acetazolamide down to a minimum group receiving purely an infra- orbital and supra-orbital block with a Ugnocaine/Bupivacaine mixture. There was no significant difference in local analgesia or in the complication rates b...

  7. [Our experience with prostatic incision (TUIP) with local anesthesia].

    Science.gov (United States)

    Del Boca, C; Colloi, D; Guardamagna, A; Bolis, C; Giuberti, A C; Tzoumas, S; Ferrari, C

    1997-02-01

    The Authors present their experience in the treatment of prostatic obstruction with bladder neck incision (TUIP) performed under local anesthesia. An Hulbert 6 Fr endoscopic needle is used to infiltrate the prostatic area submitted to TUIP with 200 mg of Lidocaine 2%. The TUIP was done with a single deep incision at 7 hours using a 24 Fr Iglesias resector with Collins device. 28 patients with an age range from 69 to 85 years (mean 74) affected by IPB in an obstructed fase were submitted to this procedure. Various parameters were achieved for the selection of the patients: urodynamic diagnosis of low urinary tract obstruction, prostatic volume less than 50 ml without important prostatic median lobe, high anesthesiological risk, absence of correlated vesical complications. A clinical follow up was done at 1-6 and 12 months. The results obtained showed a good compliance of the patients treated with satisfactory urodynamic patterns. The Authors conclude that this less invasive approach, in selected cases, is the treatment of choice not only for low invasivity and morbidity rate but also for the reduced time of catheterization, hospitalization and costs.

  8. Effect of Hypnosis During Administration of Local Anesthesia in Six- to 16-year-old Children.

    Science.gov (United States)

    Oberoi, Jyoti; Panda, Anup; Garg, Iti

    2016-01-01

    Hypnosis is a tool that can help pediatric dentists allay fear or increase patient cooperation while administering local anesthesia. The purpose of this study was to determine whether hypnosis altered a patient's physical and/or verbal resistance and oxygen saturation or heart rate during administration of local anesthesia. Two hundred six- to 16-year-olds were randomly allocated to either a control group or an experimental group that received hypnotic induction prior to the delivery of local anesthesia. Subjects were monitored for signs of physical or verbal resistance and changes in pulse rate and oxygen saturation at baseline and upon administration of local anesthetic. Children under hypnosis exhibited significantly less resistance to administration of local anesthesia (Phypnosis may increase patient cooperation, decrease resistance during painful procedures, and lead to a lower heart rate.

  9. Hemodynamic Changes during Epidural Anesthesia with Various Local Anesthetics

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Central hemodynamic stability during gynecological laparoscopic operations remains an important problem of anes-thesiological monitoring. Subjects and methods. Fifty-eight patients who had undergone various gynecological laparoscopic operations were examined. According to the mode of anesthesia, the patients were divided into 2 groups: 1 29 patients who received epidural anesthesia with ropivacaine; 2 29 who had epidural anesthesia using lidocaine. The indices of cardiac performance (stroke volume, stroke index, and cardiac output, blood (diastolic, systolic, and mean pressure, vascular parameters (linear blood flow velocity, total peripheral vascular resistance were determined by volumetric compression oscillometry. Results. The study indicated that all the modes of anesthesia demonstrated the satisfactory condition of the cardiovascular system, but the highest stability of hemodynamic parameters was recorded in the epidural ropivacaine group. In this group, there were steady-state reductions in diastolic, systolic, mean blood pressures, and total vascular peripheral resistance and increases in stroke index, stroke volume, and linear blood flow velocity. Conclusion. Epidural anesthesia using ropivacaine during gynecological surgical endoscopic interventions is the method of analgesia causing minimal hemodynamic disorders. Key words: hemodynamics, epidural anesthesia, laparoscopic gynecological operations.

  10. The feasibility of local anesthesia for the surgical treatment of umbilical hernia: a systematic review of the literature

    NARCIS (Netherlands)

    P.M. Jairam (Pushpa); R. Kaufmann; F.E. Muysoms (Filip); J. Jeekel (Hans); J.F. Lange (Johan)

    2017-01-01

    textabstractBackground: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well.

  11. Endoscopic Carpal Tunnel Release using a modified application technique of local anesthesia: safety and effectiveness

    Directory of Open Access Journals (Sweden)

    Al-Khayat Jehad

    2008-04-01

    Full Text Available Abstract Background Local anesthesia is widely used for open carpal tunnel release. However, injection of local anesthesia as described by Altissimi and Mancini (1988 can interfere with endoscopic carpal tunnel release, by increasing the bulk of synovial layers and consequently result in worsening of the view. Purpose The purpose of this study was to evaluate the safety, efficacy using modified technique for application of local anesthesia. Methods 33 patients suffering from gradual increasing symptoms of carpal tunnel syndrome. The patients were also asked to evaluate the pain associated with injection as well as tourniquet during surgery using Visual Analogue Scale (VAS (ranging from 0 = no pain to 10 = maximum pain. Results One patient required additionally local anesthesia because of mild pain in the hand. The tourniquet was inflated for 13.00 (2.8 min. The pain score related to injection was 2.5 (0.8 and to tourniquet was 3.6 (0.9. Inflation of the tourniquet was well tolerated by all patients. Postoperative neurological sensory and motor deficits related to surgery and local blocks were not occurred. Conclusion Endoscopic release of the carpal tunnel syndrome in local anesthesia is effective, well tolerated and safe. This kind of application of local anesthesia did not reduce visibility.

  12. When local anesthesia becomes universal: pronounced systemic effects of subcutaneous lidocaine in bullfrogs (Lithobates catesbeianus)

    DEFF Research Database (Denmark)

    Williams, catherine; Alstrup, Aage Kristian Olsen; Bertelsen, Mads

    2017-01-01

    Sodium channel blockers are commonly injected local anesthesia but are also routinely used in general immersion anesthesia for fish and amphibians. Here we report the effects of subcutaneous injection of lidocaine (5 or 50 mg kg-1) in the hind limb of bullfrogs (Lithobates catesbeianus) on reflexes......). Reflexes were regained over 4 h. Systemic sedative effects were not coupled to local anti-nociception, as a forceps pinch test at the site of injection provoked movement at the height of the systemic effect (tested at 81 ± 4 min). Amphibians are routinely subject to general anesthesia via exposure...

  13. Effective local anesthesia for onabotulinumtoxin A injections to treat hyperhidrosis associated with traumatic amputation

    OpenAIRE

    Shi, Lucy L; Sargen, Michael R.; Chen, Suephy C.; Arbiser, Jack L.; Pollack, Brian P.

    2016-01-01

    Background: Botulinum toxin type A (BTX-A) injections are an effective treatment for controlling hyperhidrosis at sites of amputation. Hyperesthesia associated with amputated limbs is a major barrier to performing this procedure under local anesthesia. Objective: To present a novel method for improving local anesthesia with BTX-A injections. Methods & Results: A 29-year-old military veteran with a below-the-knee amputation of his right leg was suf...

  14. Articaine: a review of its use for local and regional anesthesia

    Directory of Open Access Journals (Sweden)

    Snoeck M

    2012-06-01

    Full Text Available Marc SnoeckDepartment of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The NetherlandsAbstract: Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.Keywords: articaine, regional anesthesia, pharmacodynamics, pharmacokinetics, therapeutic use, tolerability, neurotoxicity

  15. Evaluation of a Local Anesthesia Simulation Model with Dental Students as Novice Clinicians.

    Science.gov (United States)

    Lee, Jessica S; Graham, Roseanna; Bassiur, Jennifer P; Lichtenthal, Richard M

    2015-12-01

    The aim of this study was to evaluate the use of a local anesthesia (LA) simulation model in a facilitated small group setting before dental students administered an inferior alveolar nerve block (IANB) for the first time. For this pilot study, 60 dental students transitioning from preclinical to clinical education were randomly assigned to either an experimental group (N=30) that participated in a small group session using the simulation model or a control group (N=30). After administering local anesthesia for the first time, students in both groups were given questionnaires regarding levels of preparedness and confidence when administering an IANB and level of anesthesia effectiveness and pain when receiving an IANB. Students in the experimental group exhibited a positive difference on all six questions regarding preparedness and confidence when administering LA to another student. One of these six questions ("I was prepared in administering local anesthesia for the first time") showed a statistically significant difference (pStudents who received LA from students who practiced on the simulation model also experienced fewer post-injection complications one day after receiving the IANB, including a statistically significant reduction in trismus. No statistically significant difference was found in level of effectiveness of the IANB or perceived levels of pain between the two groups. The results of this pilot study suggest that using a local anesthesia simulation model may be beneficial in increasing a dental student's level of comfort prior to administering local anesthesia for the first time.

  16. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

    Directory of Open Access Journals (Sweden)

    Joe Iwanaga

    2016-01-01

    Full Text Available Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.

  17. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...

  18. Optimization of Spinal Anesthesia for Operative Delivery in High-Weight Women

    Directory of Open Access Journals (Sweden)

    I. P. Zharkov

    2008-01-01

    Full Text Available Objective: to develop a scheme for calculating the dose of a local anesthetic (LA for spinal anesthesia (SA during operative delivery, by taking into account the individual physical characteristics of a female patient. Subjects and methods. The course of SA was analyzed in 35 overweight women. In accordance with the body mass index (BMI, the patients were divided into 3 groups. In each group the authors identified subgroups with no arterial hypotension development (NAHD and with arterial hypotension development (AHD until a fetus was extracted. In each specific case, the used dose of a LA was compared with its dose calculated by the height of a patient and the difference between the BMI of a female patient and that taken as the normal value of 25 kg/m2. Results. When the doses of a LA, which were used for SA, were investigated, in all cases the doses of a LA were determined to be smaller than those calculated by the height of a patient. In the NAHD subgroups, the percentage reduction in LA doses was significantly greater than that in the AHD subgroups in all the three groups and the dose was increased as BMI rose from 13.6±1.6% in the NAHD subgroup in Group 1 to 34.7±1.2% in the same subgroup in Group 3. By comparing the percentage reduction in the LA dose and excess BMI, the authors established the correction coefficient for the LA dose calculated by height and derived a formula for calculating the dose of a LA, by taking into account the physical characteristics of a female patient. Conclusion. The LA dose calculation formula considering the individual physical characteristics of a female patient makes the determination of a LA dose more precise in order to optimize the course of anesthesia from the hemodynamic profile. Key words: spinal anesthesia, obesity, cesarean section.

  19. Comparison of two epinephrine concentrations in an articaine solution for local anesthesia in children.

    Science.gov (United States)

    Zurfluh, Monika A; Daubländer, Monika; van Waes, Hubertus J M

    2015-01-01

    Painless dental treatment is of major interest in pediatric dentistry. Local anesthesia contains epinephrine, which prolongs soft tissue anesthesia.This, however, is often a source of iscomfort for children and is responsible for certain side effects (e.g., self-inflicted soft tissue lesions). The aim of this study was to investigate whether an epinephrine-reduced articaine solution could reduce the duration of soft tissue anesthesia and thereby reduce the risk of self-inflicted soft tissue lesions, while still providing an adequate anesthesia. In a non-interventional clinical study, routine dental treatment was performed on children and adolescents. An articaine 4% solution with an epinephrine-reduced solution (Ubistesin™ mite, 1:400,000) and a conventional epinephrine solution (Ubistesin™ forte, 1:100,000) were compared in terms of duration of soft tissue anesthesia. One hundred and fifty-eight patients (mite: 75, forte: 83) were treated (80% with infiltration anesthesia). In both groups, the average volume of the injection was comparable (mite: 1.2 ml, forte: 1.1 ml). One patient from each group showed unwanted side effects. In both groups, the local anesthesia was complete or sufficient (96%) to perform the planned treatment. The average treatment time was 24 minutes in the mite group and 28 minutes in the forte group. The difference in mean duration of soft tissue anesthesia was statistically significant (p = 0.001, mite: 2.1 h, forte: 2.8 h). Thanks to its high efficacy, tolerance, and reduced soft tissue anesthesia, the articaine 4% solution with the reduced epinephrine concentration (1:400,000) was considered a safe and suitable drug for routine treatments in pediatric dentistry.

  20. Comparison of two local anesthesia techniques (conventional & akinosi for inferior alveolar dental nerve

    Directory of Open Access Journals (Sweden)

    Refua Y

    2001-09-01

    Full Text Available Different techniques for local anesthesia are used in the mandible. The purpose of this study"nwas to determine the effects of inferior alveolar dental nerve blocks by comparing the two akinosi and"nconventional techniques. 80 patients (aged 15-60 years old were randomly divided into tow groups for"nextracting the mandibuler posterior teeth by akinosi and conventional techniques. Patients were all"ninjected with 1.8 ml of Lidocaine 2% plus Adernaline j^nnnn .Then the Pain Sensation during injection,"npositive aspiration, beginning time of anesthesia, duration of anesthesia depth of anesthesia, and the anesthesia of soft tissue related to sensory nerves were evaluated. The results showed that the pain sensation in conventional technique was significantly higher than that of akinosi technique. The number of positive aspirations in conventional technique (12,5% was higher than that of akinosi (5% but not significantly different. The long buccal nerve anesthesia in akinosi technique (75% was significantly higher than that of conventional technique. There was no significant difference between the two techniques for the depth of anesthesia. The success rate was 87.5% in conventional technique and 80% in akinosi technique. The average time of lips anesthesia in conventional technique was 3 minutes compared with 4 minutes in akinosi technique, which was not significantly different from each other. However, the beginning time of aneshtesia in tongue was significantly lower in conventional technique. No significant difference in the duration of anesthesia in lips and tonques between the two techniques was observed.

  1. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...... less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy....

  2. Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Spero Theodorou, MD

    2013-08-01

    Conclusions: In appropriately selected patients, RFAL arm contouring under local anesthesia represents an alternative procedure with acceptably low morbidity and high patient satisfaction. To achieve consistent results while minimizing complications, consideration to anatomic details, infiltration of the local anesthetic, and application of the radiofrequency energy must be given.

  3. Anesthesia Awareness

    Science.gov (United States)

    ... biopsy or a dental procedure Local or regional anesthesia, such as an epidural or spinal block, or a nerve block To reduce your risk of experiencing awareness during procedures with general anesthesia, it is important to tell your physician anesthesiologist ...

  4. Diagnostic laparoscopy and laparoscopic ultrasonography with local anesthesia in hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Mariano Gómez-Rubio; Mercedes Moya-Valdés; Jesús García

    2005-01-01

    Diagnosis of hepatocellular carcinoma (HCC), a common digestive malignancy, remains a challenge. The aim of this study was to evaluate the feasibility of performing laparoscopy and laparoscopic ultrasound with local anesthesia as a diagnostic procedure in HCC. Laparoscopy and laparoscopic ultrasound with local anesthesia was performed in the gastrointestinal endoscopy unit in three patients diagnosed of HCC. Endoscopy staged diffuse liver disease. Laparoscopic ultrasonography identified all liver tumors not visible during endoscopy and guided needle biopsy in one case. No complications happened. In conclusion, laparoscopy and laparoscopic ultrasound,performed as a minimally invasive diagnostic procedure can be a safe and very promising tool in planning therapy of HCC.

  5. [Technical Tips for Spinal Anesthesia].

    Science.gov (United States)

    Shima, Takeshi

    2015-09-01

    Spinal anesthesia is a standard technique for all anesthesiologists and surgeons. This review deals with basic knowledge and tips for spinal anesthesia in an empirical manner. It is important to understand practical knowledge about specific character of each local anesthetic, spread patterns of the anesthetics in the subarachnoid space and relation between anesthesia level and puncture site. This review also introduces tips for subarachnoid puncture and divided administration method of isobaric local anesthetic solution based on the literature. Anesthesiologists and surgeons have to recognize that it is necessary to take enough time to perform precious and optimal spinal anesthesia.

  6. Evaluation of new injection and cavity preparation model in local anesthesia teaching

    NARCIS (Netherlands)

    Yekta, S.S.; Lampert, F.; Kazemi, S.; Kazemi, R.; Brand, H.S.; Baart, J.A.; Mazandarani, M.

    2013-01-01

    The aim of this study was to evaluate a recently developed preclinical injection and cavity preparation model in local anesthesia. Thirty-three dental students administered an inferior alveolar nerve block injection in the model, followed by preparation on a tooth. The injection was evaluated by thr

  7. Intraperitoneal instillation of saline and local anesthesia for prevention of shoulder pain after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Bjerrum, Flemming; Gögenür, Ismayil

    2013-01-01

    instillation (IPI) of saline and local anesthesia (LA) to minimize SP. METHODS: A search of the literature was conducted using PubMed and Excerpta Medica Database (EMBASE). Eligibility criteria were: randomized clinical trials (RCT) evaluating IPI of saline and/or LA to minimize incidence or severity of SP...

  8. Force-length recording of eye muscles during local-anesthesia surgery in 32 strabismus patients

    NARCIS (Netherlands)

    H.J. Simonsz (Huib)

    1994-01-01

    textabstractAbstract. Force-length recordings were made from isolated human eye muscles during strabismus surgery in local, eye-drop anesthesia in 32 adult patients. From each muscle three recordings were made: (1) while the patient looked with the other eye into the field of action of the recorded

  9. Endovascular repair of acute AAAs under local anesthesia with bifurcated endografts : A feasibility study

    NARCIS (Netherlands)

    Verhoeven, ELG; Prins, TR; van den Dungen, JJAM; Tielliu, IFJ; Hulsebos, RG; van Schilfgaarde, R

    2002-01-01

    Purpose: To evaluate endovascular repair of abdominal aortic aneurysms (AAA) under local anesthesia in the acute setting. Methods: Between 1998 and 2001, 47 patients with an acute AAA were evaluated for endovascular repair after informed consent, provided they were in a stable, albeit hypotensive co

  10. Evaluation of new injection and cavity preparation model in local anesthesia teaching

    NARCIS (Netherlands)

    Yekta, S.S.; Lampert, F.; Kazemi, S.; Kazemi, R.; Brand, H.S.; Baart, J.A.; Mazandarani, M.

    2013-01-01

    The aim of this study was to evaluate a recently developed preclinical injection and cavity preparation model in local anesthesia. Thirty-three dental students administered an inferior alveolar nerve block injection in the model, followed by preparation on a tooth. The injection was evaluated by

  11. Using Mixed-Reality Technology to Teach Techniques for Administering Local Anesthesia

    Science.gov (United States)

    Hanson, Kami M.

    2011-01-01

    The ability to perform local anesthesia on dental patients is an important clinical skill for a dental hygienist. When learning this procedure in an academic situation, students often practice on their peers to build their skills. There are multiple reasons why the peer practice is not ideal; consequently, educators have sought the means to…

  12. Local anesthesia and exposure for carotid endarterectomy: background and technical realization.

    Science.gov (United States)

    Falkensammer, J; Duschek, N; Skrinjar, E; Hirsch, K; Senekowitsch, C; Assadian, A

    2012-02-01

    While carotid endarterectomy is an established method for the treatment of symptomatic as well as high-grade asymptomatic carotid artery stenoses, there is a considerable variation concerning the kind of anesthesia used as well as technical details of the operation. In the present article differing arguments on local versus general anesthesia as well as a transverse versus a longitudinal skin incision will be discussed. Furthermore, possible access routes to the carotid bifurcation, the retrojugular compared to the ventrojugular approach, will be presented in detail.

  13. Endotracheal intubation under local anesthesia and sedation in an infant with difficult airway

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2012-01-01

    Full Text Available Management of the difficult airway in an infant is a challenge for the anesthesiologist. A 10-month-old infant presented to an otolaryngologist with nasopharyngeal mass since birth, which had increased rapidly in size in the last 1 month and was hanging through the cleft palate into the oropharynx. The infant was scheduled for excision of the nasopharyngeal mass through a maxillary approach and the tongue mass through an oral approach under general anesthesia. This case report describes endotracheal intubation performed successfully under sedation and local anesthesia in an infant with a nasal mass protruding through the cleft palate into the oropharynx.

  14. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    2001-01-01

    To evaluate the feasibility and safety of unmonitored local anesthesia (ULA) for elective open inguinal hernia repair, we made a prospective, consecutive data collection from 1000 operations on primary and recurrent hernias. Follow-up consisted of a questionnaire 1 mo after surgery and retrieval...... from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthesia, day-case setup, or both, primarily because of intraoperative pain (n = 74; 7.8%). We conclude that open inguinal hernia repair can be conducted under ULA, regardless of comorbidity, with a small rate of deviation from day-case setup and minimal morbidity. It provides a safe alternative to other...

  15. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    2001-01-01

    To evaluate the feasibility and safety of unmonitored local anesthesia (ULA) for elective open inguinal hernia repair, we made a prospective, consecutive data collection from 1000 operations on primary and recurrent hernias. Follow-up consisted of a questionnaire 1 mo after surgery and retrieval...... from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthesia, day-case setup, or both, primarily because of intraoperative pain (n = 74; 7.8%). We conclude that open inguinal hernia repair can be conducted under ULA, regardless of comorbidity, with a small rate of deviation from day-case setup and minimal morbidity. It provides a safe alternative to other...

  16. [Iontophoresis - local anesthesia at the ear canal and tympanic membrane (author's transl)].

    Science.gov (United States)

    Tolsdorff, P

    1980-02-01

    Operations to the external ear canal and tympanic membrane necessitate sufficient local anesthesia. General sedation followed by infiltration anestesia, is rather time-consumming, can be painful due to the injection, and is not particularly satisfactory for the treatment of outpatients. The iontophorese-technique, however, of local anesthesia, is applicable particularly for the treatment of outpatients. Principally, the local anesthetic is transported in ionisised form to the nerve membrane, by means of calvanic currents through the healthy surface epithelial tissue of the external ear canal or the eardrum. The technique described for the first time in 1911 no longer shows toxic sides-effects since the introduction of improved electrodes and more modern local anesthetic. The anatomic, pharmacological, chemical and physical basics of the technique will be described. The lecture will be based on personal experience of the method, taken from large groups of patients over a period of more than two years, using equipment specially designed for this purpose.

  17. [Intravenous regional anesthesia with long-acting local anesthetics. An update].

    Science.gov (United States)

    Atanassoff, P G; Lobato, A; Aguilar, J L

    2014-02-01

    Intravenous regional anesthesia is a widely used technique for brief surgical interventions, primarily on the upper limbs and less frequently, on the lower limbs. It began being used at the beginning of the 20th century, when Bier injected procaine as a local anesthetic. The technique to accomplish anesthesia has not changed much since then, although different drugs, particularly long-acting local anesthetics, such as ropivacaine and levobupivacaine in low concentrations, were introduced. Additionally, drugs like opioids, muscle relaxants, paracetamol, neostigmine, magnesium, ketamine, clonidine, and ketorolac, have all been investigated as adjuncts to intravenous regional anesthesia, and were found to be fairly useful in terms of an increased onset of operative anesthesia and longer lasting perioperative analgesia. The present article provides an overview of current knowledge with emphasis on long-acting local anesthetic drugs. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  18. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  19. Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

    Directory of Open Access Journals (Sweden)

    Marco Felipe Francisco Honorato Barros

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate. MATERIAL AND METHODS: This was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure. RESULTS: The DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01. In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia. CONCLUSION: Use of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

  20. Local Anesthesia at ST36 to Reveal Responding Brain Areas to deqi.

    Science.gov (United States)

    Jin, Ling-Min; Qin, Cai-Juan; Lan, Lei; Sun, Jin-Bo; Zeng, Fang; Zhu, Yuan-Qiang; Yu, Shu-Guang; Yin, Hai-Yan; Tang, Yong

    2014-01-01

    Background. Development of non-deqi control is still a challenge. This study aims to set up a potential approach to non-deqi control by using lidocaine anesthesia at ST36. Methods. Forty healthy volunteers were recruited and they received two fMRI scans. One was accompanied with manual acupuncture at ST36 (DQ group), and another was associated with both local anesthesia and manual acupuncture at the same acupoint (LA group). Results. Comparing to DQ group, more than 90 percent deqi sensations were reduced by local anesthesia in LA group. The mainly activated regions in DQ group were bilateral IFG, S1, primary motor cortex, IPL, thalamus, insula, claustrum, cingulate gyrus, putamen, superior temporal gyrus, and cerebellum. Surprisingly only cerebellum showed significant activation in LA group. Compared to the two groups, bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC were remarkably activated. Conclusions. Local anesthesia at ST36 is able to block most of the deqi feelings and inhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC might be the key brain regions responding to deqi.

  1. Local Anesthesia at ST36 to Reveal Responding Brain Areas to deqi

    Directory of Open Access Journals (Sweden)

    Ling-min Jin

    2014-01-01

    Full Text Available Background. Development of non-deqi control is still a challenge. This study aims to set up a potential approach to non-deqi control by using lidocaine anesthesia at ST36. Methods. Forty healthy volunteers were recruited and they received two fMRI scans. One was accompanied with manual acupuncture at ST36 (DQ group, and another was associated with both local anesthesia and manual acupuncture at the same acupoint (LA group. Results. Comparing to DQ group, more than 90 percent deqi sensations were reduced by local anesthesia in LA group. The mainly activated regions in DQ group were bilateral IFG, S1, primary motor cortex, IPL, thalamus, insula, claustrum, cingulate gyrus, putamen, superior temporal gyrus, and cerebellum. Surprisingly only cerebellum showed significant activation in LA group. Compared to the two groups, bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC were remarkably activated. Conclusions. Local anesthesia at ST36 is able to block most of the deqi feelings and inhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC might be the key brain regions responding to deqi.

  2. A Comparative Study Between 1% and 0.1% Lidocain with Adrenaline in Skin Local Anesthesia

    Directory of Open Access Journals (Sweden)

    A. Zamanian

    2005-01-01

    Full Text Available Lidocain solution 1-2% have used with or without adrenaline for skin local anesthesia. Also normal salin, diphenhydramine and bacteriostatic salin have been used. The purpose of this study was to compare the effectiveness of 1% lidocain with 0.1% lidocain in local skin anesthesia.This study was carried out by triple blind method on 140 patients that submitted to Hamedan Sina Hospital in 2000. These patients divided in two groups randomly, 70 cases received 1% lidocain and other 70 cases received 0.1% lidocain. The pain assessment score was between 0-10 that was asked from each patient and collected data analyzed by statistical methods.This study showed that 51.1% of patients that received 1% lidocain and 48.9% that received 0.1% lidocain did not have any pain during injection (P>0.05. Also 54.3% of patients that received 1% lidocain and 45.7% that received 0.1% lidocain solution did not have any pain throw the procedure (P>0.05.The effect of 0.1% lidocain solution had no much difference from 1% lidocain in skin local anesthesia and thus it is suggested to use it for wide anesthesia in skin surgeries.

  3. Anesthesia-related changes in information transfer may be caused by reduction in local information generation.

    Science.gov (United States)

    Wollstadt, Patricia; Sellers, Kristin K; Hutt, Axel; Frohlich, Flavio; Wibral, Michael

    2015-08-01

    In anesthesia research it is an open question how general anesthetics lead to loss of consciousness (LOC). It has been proposed that LOC may be caused by the disruption of cortical information processing, preventing information integration. Therefore, recent studies investigating information processing under anesthesia focused on changes in information transfer, measured by transfer entropy (TE). However, often this complex technique was not applied rigorously, using time series in symbolic representation, or using TE differences without accounting for neural conduction delays, or without accounting for signal history. Here, we used current best-practice in TE estimation to investigate information transfer under anesthesia: We conducted simultaneous recordings in primary visual cortex (V1) and prefrontal cortex (PFC) of head-fixed ferrets in a dark environment under different levels of anesthesia (awake, 0.5% isoflurane, 1.0 % isoflurane). To elucidate reasons for changes in TE, we further quantified information processing within brain areas by estimating active information storage (AIS) as an estimator of predictable information, and Lempel-Ziv complexity (LZC) as an estimator of signal entropy. Under anesthesia, we found a reduction in information transfer (TE) between PFC and V1 with a stronger reduction for the feedback direction (PFC to V1), validating previous results. Furthermore, entropy (LZC) was reduced and activity became more predictable as indicated by higher values of AIS. We conclude that higher anesthesia concentrations indeed lead to reduced inter-areal information transfer, which may be partly caused by decreases in local entropy and increases in local predictability. In revealing a possible reason for reduced TE that is potentially independent of inter-areal coupling, we demonstrate the value of directly quantifying information processing in addition to focusing on dynamic properties such as coupling strength.

  4. Articaine: a review of its use for local and regional anesthesia

    OpenAIRE

    Snoeck M

    2012-01-01

    Marc SnoeckDepartment of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The NetherlandsAbstract: Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects wer...

  5. Pharmacokinetics of Lidocaine With Epinephrine Following Local Anesthesia Reversal With Phentolamine Mesylate

    OpenAIRE

    Moore, Paul A.; Hersh, Elliot V.; Papas, Athena S; Goodson, J. Max; Yagiela, John A; Rutherford, Bruce; Rogy, Seigried; Navalta, Laura

    2008-01-01

    Phentolamine mesylate accelerates recovery from oral soft tissue anesthesia in patients who have received local anesthetic injections containing a vasoconstrictor. The proposed mechanism is that phentolamine, an alpha-adrenergic antagonist, blocks the vasoconstriction associated with the epinephrine used in dental anesthetic formulations, thus enhancing the systemic absorption of the local anesthetic from the injection site. Assessments of the pharmacokinetics of lidocaine and phentolamine, a...

  6. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether....... Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary...

  7. A novel distraction technique for pain management during local anesthesia administration in pediatric patients.

    Science.gov (United States)

    Kamath, Punitha S

    2013-01-01

    The aim of this study was to assess the effect of an active and novel distraction technique WITAUL (Writing In The Air Using Leg) on the pain behavior observed and reported by children receiving local anesthesia injections prior to dental treatment. The study was conducted on 160 children (80 in control and 80 in intervention group) between the ages of 4- 10 years. During the administration of anesthesia the children in the control group were made to relax by means of deep breathing and those in the intervention group were taught to use the WITAUL distraction technique. the behavior of the children aged 4- 5 years was noted using the Modified Toddler- Preschooler Post operative Pain Scale (TPPPS) and that of children aged above 6 years was measured using the FACES Pain Scale-Revised (FPS-R). The use of WITAUL was found to be statistically significant (p value anesthesia administration. The mean Modified TPPPS scores (4- 5 year olds) for the WITAL group was 2.46 +/- 1.752 and that of the control was 5.64 +/- 2.328. The mean FPS-R scores (6 - 10 year olds) for the WITAUL group was 3 +/- 1.748 and that of the control group was 6.26 +/- 1.858. The WITAUL technique therefore appears to be a simple and effective method of distraction during local anesthesia administration in pediatric patients.

  8. The use of local anesthesia during dental rehabilitations: a survey of AAPD members.

    Science.gov (United States)

    Townsend, Janice A; Martin, Ashla; Hagan, Joseph L; Needleman, Howard

    2013-01-01

    The purpose of this study was to document current practices among pediatric and general dentists who are members of the American Academy of Pediatric Dentistry (AAPD) regarding the use of local anesthesia (LA) on children undergoing dental rehabilitation under general anesthesia (GA). A survey was administered via e-mail to AAPD members to document the use of LA during dental rehabilitations under GA and the rationales for its use. A total of 952 of 5,599 members responded to this survey; 79 percent of respondents use LA at least part of the time during dental rehabilitations under GA. "Improved patient recovery" was the most commonly cited rationale for administering LA. Extraction of permanent and primary teeth were the two most common procedures cited for the use of LA, respectively. There is no consensus among the respondents on the use of local anesthesia during dental rehabilitation under general anesthesia, but the majority responded that it does play a role in their perioperative patient management.

  9. Systemic toxisity of local anesthethics during regional anesthesia in orthopedics and traumatology

    Directory of Open Access Journals (Sweden)

    V. A. Koryachkin

    2015-01-01

    Full Text Available There are cases of accidental intravascular injection of local anesthetic when performing regional anesthesia. The frequency of this complication was 0.28 per 1,000. We describe the clinical manifestations and the basic principles of the treatment of local anesthetics systemic toxicity. Discussed in detail the mechanism of action of fat emulsion and the protocol of lipid resuscitation Accidental intravascular injection of local anesthetics. The mechanism of action of fat emulsion and the protocol of lipidrescue accidental intravascular injection of local anesthetics was discussed.

  10. [The possible secondary effects in cases of local anesthesia].

    Science.gov (United States)

    Malamed, S F

    2000-01-01

    Local anesthetics are the safest and most effective drugs for pain control. Over 300 million local anesthetic cartridges are administered by dentists in the United States of America annually, yet serious complications reported number but a handful. Complications are categorised as localised or systemic. Localised complications arise at the site of needle penetration or anesthetic administration while systemic complications involve the entire organism. Localised complications include needle breakage, paresthesia, trismus, haematoma and facial nerve paralysis, while systemic complications are psychogenic to the act of receiving an injection, allergy and drug overdose (toxic reaction). These potential complications are briefly described in the following paper.

  11. [Neonatal circumcision with local anesthesia. Results of a standardized protocol].

    Science.gov (United States)

    Ovalle, Alejandra; López, Pedro-Jose; Guelfand, Miguel; Zubieta, Ricardo

    2016-01-01

    Neonatal circumcision is a common procedure in the US and other countries, with low rates of complications in trained hands. However, it has recently been incorporated into the clinical environment in Chile. Our goal was to establish a local standardised protocol for neonatal circumcision under local anaesthesia, and evaluate the results and possible complications. A standardised prospective protocol was used on patients who underwent neonatal circumcision. The inclusion criteria were: children local anaesthesia and penile block, attrition of redundant prepuce and mucosa with Mogen® clamp, and section with scalpel. The protocol was used and evaluated from November 2005 to October 2014 by a paediatric surgeon and/or paediatric urologist trained in the technique. Complications and conditions until final discharge were analysed. The protocol was applied to 108 patients over a 9year period. The mean age at procedure was 9days (1-52). One patient (0.9%) had immediate bleeding, requiring further surgery. All patients were discharged from further medical checks at 1 month, without any other complications. The reason for the procedure was by parental request in 100% of the cases, and always for sociocultural reasons. Neonatal circumcision under local anaesthesia is a simple procedure, and has excellent results in selected patients, and with no major complications. With proper training, and adapting the initial protocol, it can be performed on an outpatient basis, without putting the neonates through the risks of general anaesthesia. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Topical local anesthesia: focus on lidocaine–tetracaine combination

    Directory of Open Access Journals (Sweden)

    Giordano D

    2015-11-01

    Full Text Available Davide Giordano,1 Maria Gabriella Raso,2 Carmine Pernice,1 Vanni Agnoletti,3 Verter Barbieri1 1Otorhinolaryngology Unit, Department of Surgery, Arcispedale Santa Maria Nuova – IRCCS, Reggio Emilia, 2Anesthesiology, Intensive Care, and Pain Medicine Unit, Department of Surgical Sciences, University Hospital of Parma, Parma, 3Anesthesiology and Intensive Care Unit, Department of Cardiology, Thoracic and Vascular Surgery, and Critical Care Medicine, Arcispedale Santa Maria Nuova – IRCCS, Reggio Emilia, Italy Abstract: In recent years, the popularity of aesthetic and cosmetic procedures, often performed in outpatient settings, has strongly renewed interest in topical anesthetics. A number of different options are widely used, alone or in combination, in order to minimize the pain related to surgery. Moreover, interest in local anesthetics in the treatment of some painful degenerative conditions such as myofascial trigger point pain, shoulder impingement syndrome, or patellar tendinopathy is increasing. Numerous clinical trials have shown that lidocaine–tetracaine combination, recently approved for adults aged 18 or older, is effective and safe in managing pain. The present paper gives an overview of the recent literature regarding the efficacy and safety of lidocaine–tetracaine combination use. Keywords: lidocaine, tetracaine, local anesthetics, efficacy, safety

  13. Simplified Surgical Placement of Tenckhoff Catheter under Local Anesthesia: The Dammam Central Hospital Experience

    Directory of Open Access Journals (Sweden)

    Youmbissi T

    2001-01-01

    Full Text Available Many methods are used for the placement of Tenckhoff catheters. Eighteen consecutive Tenckhoff catheters were placed under local anesthesia through a mini laparotomy with a reduced operating team. There were only three total catheter failures. Complications were infrequent and operating time was less than one hour on average. This simple procedure should be a part of the training program of all junior surgeons and nephrologists.

  14. Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

    OpenAIRE

    2016-01-01

    Background Local anesthesia (LA) has been reported to be the best choice for elective open inguinal hernia repair because it is cost efficient, with less post-operative pain and enables more rapid recovery. However, the role of LA in emergency inguinal hernia repair is still controversial. The aim of this study is to investigate the safety and effectiveness of LA in emergency inguinal hernia repair. Methods All patients underwent emergency inguinal hernia repair in our hospital between Januar...

  15. Effects of opioids on local anesthesia in the rat: a codeine and tramadol study

    Directory of Open Access Journals (Sweden)

    Talita Girio Carnaval

    2013-12-01

    Full Text Available Opioids are central analgesics that act on the CNS (central nervous system and PNS (peripheral nervous system. We investigated the effects of codeine (COD and tramadol (TRAM on local anesthesia of the sciatic nerve. Eighty Wistar male rats received the following SC injections in the popliteal fossa: local anesthetic with epinephrine (LA; local anesthetic without vasoconstrictor (LA WV; COD; TRAM; LA + COD; LA + TRAM; COD 20 minutes prior to LA (COD 20' + LA or TRAM 20 minutes prior to LA (TRAM 20' + LA. As a nociceptive function, the blockade was considered the absence of a paw withdraw reflex. As a motor function, it was the absence of claudication. As a proprioceptive function, it was the absence of hopping and tactile responses. All data were compared using repeated-measures analysis of variance (ANOVA. Opioids showed a significant increase in the level of anesthesia, and the blockade duration of LA + COD was greater than that of the remaining groups (p < 0.05. The associated use of opioids improved anesthesia efficacy. This could lead to a new perspective in controlling dental pain.

  16. Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia

    Directory of Open Access Journals (Sweden)

    Jafar Rafiei Kiasari

    2012-08-01

    Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.

  17. Applicability and Effectiveness of Closed Reduction of Nasal Fractures under Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Vilela, Fernando

    2014-03-01

    Full Text Available Introduction A significant portion of patients treated in emergency departments have nasal fracture. It is important that the otolaryngologist know how to treat such damage. Objectives To evaluate the effectiveness of nasal fracture reduction under local anesthesia and tolerance to the procedure. Methods Twenty-four patients treated in the emergency department with closed reduction under local anesthesia were prospectively followed. Epidemiologic information and data regarding pain and complications during the management were noted. The degree of satisfaction was researched by visual analog scale. Results The majority of patients were male (75%, and the most common cause of injury was motor vehicle accident. We found a significant association between time to reduction and referred pain during the procedure. In patients in whom the procedure was delayed (over 3 days, there was less pain, and those who bled during the procedure had a shorter average time to reduction than the group of patients who did not bleed. Most patients were very satisfied, with more than 95% of these willing to undergo the same process again, if necessary. Conclusions The closed approach in the clinic under local anesthesia was effective and safe in restoration of the nose.

  18. Effects of opioids on local anesthesia in the rat: a codeine and tramadol study.

    Science.gov (United States)

    Carnaval, Talita Girio; Sampaio, Roberta Moura; Lanfredi, Camila Bernadeli; Borsatti, Maria Aparecida; Adde, Carlos Alberto

    2013-01-01

    Opioids are central analgesics that act on the CNS (central nervous system) and PNS (peripheral nervous system). We investigated the effects of codeine (COD) and tramadol (TRAM) on local anesthesia of the sciatic nerve. Eighty Wistar male rats received the following SC injections in the popliteal fossa: local anesthetic with epinephrine (LA); local anesthetic without vasoconstrictor (LA WV); COD; TRAM; LA + COD; LA + TRAM; COD 20 minutes prior to LA (COD 20' + LA) or TRAM 20 minutes prior to LA (TRAM 20' + LA). As a nociceptive function, the blockade was considered the absence of a paw withdraw reflex. As a motor function, it was the absence of claudication. As a proprioceptive function, it was the absence of hopping and tactile responses. All data were compared using repeated-measures analysis of variance (ANOVA). Opioids showed a significant increase in the level of anesthesia, and the blockade duration of LA + COD was greater than that of the remaining groups (p < 0.05). The associated use of opioids improved anesthesia efficacy. This could lead to a new perspective in controlling dental pain.

  19. Feasibility analysis of loop colostomy closure in patients under local anesthesia

    Directory of Open Access Journals (Sweden)

    Abreu Rone Antônio Alves de

    2006-01-01

    Full Text Available PURPOSE: To verify prospectively the practicability of performing loop colostomy closure under local anesthesia and sedation. METHODS: In this study, 21 patients underwent this operation. Lidocaine 2% and bupivacaine 0.5% were utilized. Pain was evaluated during the operation, on the first postoperative day and at hospital discharge. Intraoperative events, postoperative complications and the acceptability of this procedure were analyzed. RESULTS: The mean duration of the operation was 133 minutes (range: 85 to 290 minutes. The mean postoperative hospitalization was four days (range: one to twelve days. No patients died. Complications occurred in two patients (9.4%: abdominal wall hematoma and operative wound infection. With regard to pain severity, scores of less than or equal to three were indicated in the intraoperative evaluation by 80% of the patients (17/21 and on the first postoperative day by 85% (18/21. At hospital discharge, 95.2% of the patients (20/21 said they were in favor of the local anesthesia technique. CONCLUSION: Loop colostomy closure under local anesthesia and sedation is feasible, safe and acceptable to patients.

  20. Repair of Adult Hypospadias Under Local Anesthesia: The Technique and Outcomes

    Directory of Open Access Journals (Sweden)

    Mehmet Kalkan

    2014-03-01

    Full Text Available Aim: In this study, we evaluated the outcomes of a hypospadias repair technique using local anesthesia in adult patients with distal hypospadias. Material and Method: Hypospadias repair was performed under local anesthesia in 24 cases of circumcised males from 2000%u20132010. The type of hypospadias was coronal in 11 cases and subcoronal in 13 cases. Tubularised incised-plate urethroplasty method was used in all of the patients. Subcutaneous prilocaine hydrochloride was administered into the root of the penis and 12.5 g of a gel containing 2% lidocaine was administered into the urethra as an anesthetic agent. The patients%u2019 pain levels were assessed using the Visual Analogue Scale (VAS. Patients were evaluated in terms of pain level, duration of the operation, and early and late complications. Results: All patients easily tolerated the operation, with a mean postoperative VAS pain assessment of 2.04 (0-4. The duration of the operation ranged between 16 and 35 min. One of the patients developed syncope during the operation. Urethral fistula was seen in three patients. No incidence of meatal stenosis or poor cosmetic appearance was observed. Discussion: Hypospadias repair under local anesthesia was demonstrated to be safely practicable with an acceptable degree of postsurgical pain in adult patients with distal hypospadias.

  1. Local Anesthesia in Open Inguinal Hernia Repair Improves Postoperative Quality of Life Compared to General Anesthesia: A Prospective, International Study.

    Science.gov (United States)

    Huntington, Ciara R; Wormer, Blair A; Cox, Tiffany C; Blair, Laurel J; Lincourt, Amy E; Augenstein, Vedra A; Heniford, B Todd

    2015-07-01

    The choice of general (GA) versus local anesthesia (LA) in open inguinal hernia repair (OIHR) has a substantial financial impact and may influence clinical outcomes. Our study compares postoperative quality of life (QOL) in patients undergoing OIHR under LA versus GA. A cooperative prospective study from centers in 10 countries was performed through the International Hernia Mesh Registry from 2007 to 2012. QOL was compared at one, six, 12, and 24 months for LA versus GA with univariate and multivariate analysis controlling for known confounding variables. Of 1128 patients who underwent OIHR, 585(52%) used GA and 533(48%) used LA. Most were male (92%) with unilateral (94%), primary (91%) repairs with a mean age 57 ± 16 years. There was no difference (P > 0.05) in age, gender, operative time, mesh size, length of stay, infection, recurrence, reoperation, or death. Multivariate analysis demonstrated significant QOL differences between groups: GA had higher odds of discomfort at one and six months [odds ratio (OR) 3.3, 2.0], movement limitation at one and six months (OR 3.5, 2.8), and mesh sensation at one and 12 months (OR 2.9, 1.8). Overall, patients undergoing OIHR under LA had improved postoperative QOL in the short and long term compared with GA.

  2. [Percutaneous Endovascular Aortic Repair with Local Anesthesia - One Day Surgery].

    Science.gov (United States)

    Sousa, Joel; Brandão, Daniel; Barreto, Paulo; Ferreira, Joana; Almeida Lopes, José; Mansilha, Armando

    2016-06-01

    Introdução: Avaliar os resultados do tratamento endovascular do aneurisma da aorta abdominal (EVAR) por via percutânea e anestesia local, segundo o conceito de one day surgery.Material e Métodos: Análise retrospetiva, unicêntrica dos doentes com doença aneurismática aorto-ilíaca, consecutivamente submetidos a tratamento endovascular do aneurisma da aorta abdominal por via percutânea (pEVAR) pela técnica de Preclose, seguindo critérios de ambulatorização com pernoita após o procedimento. O sucesso técnico, exclusão do saco aneurismático, endoleak, reintervenção e tempo de internamento foram avaliados.Resultados: Vinte doentes consecutivos (todos homens, idade média 74,65 anos) foram tratados por pEVAR e anestesia local, dos quais 95% (19) apresentavam aneurisma da aorta abdominal e 5% (1) aneurisma da artéria ilíaca comum. Todos os implantes foram realizados com sucesso, com uma taxa de endoleak inicial de 10% (2), à custa de um endoleak 1a corrigido intraoperatoriamente com sucesso, e um endoleak 2a diagnosticado na primeira angio-tomografia computorizada pós-operatória, que selou espontaneamente no controlo aos 6 meses. O sucesso técnico inicial do encerramento percutâneo foi de 97,5%, com um caso reportado de pseudo-aneurisma femoral, corrigido posteriormente por injeção percutânea de trombina. A mediana de internamento foi de 1 dia [1-10], com follow-up médio de 11,4 meses [1-36]. A reintervenção e mortalidade são de 0% no período descrito. Conclusão: O tratamento ambulatório do aneurisma da aorta abdominal por via endovascular com acesso percutâneo segundo o nosso modelo de one day surgery é inovador, seguro e eficaz, respeitando os critérios de seleção.

  3. Children′s behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ali Bagherian

    2016-01-01

    Conclusion: It may be concluded that the cotton-roll vibration method can be more helpful than the routine topical anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.

  4. A questionnaire study regarding local anesthesia in dentistry and safety measures in dental clinics among dental students

    OpenAIRE

    オオケ, ハナコ; クドウ, マサル; シンヤ, ノボル; Hanako, OHKE; Masaru, KUDO; Noboru, SHINYA

    2005-01-01

    This reports the results of a questionnaire study of dental students on the awareness of "local anesthesia" and "use of patient monitoring systems" in dental clinics. Subjects participated in the present study included 96 sixth year dental students (D6) and 93 first year dental students (D1). The results indicate that the majority of respondents including both D6 and D1 support the notion that a "dentist" is the most suitable person to perform local anesthesia in dental treatment. With respec...

  5. [Efficacy and safety of 3% mepivacaine hydrochloride injection for oral local anesthesia].

    Science.gov (United States)

    Ding, Sheng; Zhu, Ya-Qin; Wu, Ying-Na; Cao, Dong

    2008-06-01

    To assess the efficacy and safety of 3% mepivacaine hydrochloride injection for oral local anesthesia. 68 non-hypertension patients and 36 hypertension patients were randomly divided into 2 groups for local anesthesia. 2% lidocaine with adrenaline in same cartridge was as control group and 3% mepivacaine was as the experimental group. The onset time,duration and pain-free time of 2 anaesthetics were examined. The blood pressure and heart rate change, neural reaction and side effect of 2 groups were observed. SAS software package was used for statistical analysis. In the mepivacaine group, the average onset time was 111s, the duration time was 212s and pain-free time was 134 min ,which was similar to those of 2% lidocaine. Immediately after injection, 5 minutes and 10 minutes after injection of anesthesia, and post-operation, there were no significant changes in the systolic blood pressures between 2% lidocaine group and 3% mepivacaine group (P>0.05), but there were significant changes in diastolic blood pressures and heart rate (Pmepivacaine has quick onset, ideal anesthetic effect and little side effect on cardiovascular system.

  6. Ambulatory anesthesia: optimal perioperative management of the diabetic patient

    Directory of Open Access Journals (Sweden)

    Polderman JAW

    2016-05-01

    Full Text Available Jorinde AW Polderman, Robert van Wilpe, Jan H Eshuis, Benedikt Preckel, Jeroen Hermanides Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands Abstract: Given the growing number of patients with diabetes mellitus (DM and the growing number of surgical procedures performed in an ambulatory setting, DM is one of the most encountered comorbidities in patients undergoing ambulatory surgery. Perioperative management of ambulatory patients with DM requires a different approach than patients undergoing major surgery, as procedures are shorter and the stress response caused by surgery is minimal. However, DM is a risk factor for postoperative complications in ambulatory surgery, so should be managed carefully. Given the limited time ambulatory patients spend in the hospital, improvement in management has to be gained from the preanesthetic assessment. The purpose of this review is to summarize current literature regarding the anesthesiologic management of patients with DM in the ambulatory setting. We will discuss the risks of perioperative hyperglycemia together with the pre-, intra-, and postoperative considerations for these patients when encountered in an ambulatory setting. Furthermore, we provide recommendations for the optimal perioperative management of the diabetic patient undergoing ambulatory surgery. Keywords: diabetes mellitus, perioperative period, ambulatory surgery, insulin, complications, GLP-1 agonist, DPP-4 inhibitor

  7. Local anesthesia for cochlear implant surgery: low risks for the patient and few costs for the hospital, a rational alternative.

    Science.gov (United States)

    Hamerschmidt, R; Mocellin, M; Gasperin, A; Faria, J L G; Wiemes, G; Kutianski, V; Pasinato, L; Soares, W

    2011-01-01

    The aim of this article is to illustrate the possibility of performing a cochlear implant with local anesthesia and sedation, the anesthesic technique and the advantages of that in comparison to a general anesthesia. We describe two successful surgeries done with local anesthesia, including the neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. The results of these two surgeries are described regarding the fast recovery, no symptoms of dizziness and vomiting after the surgeries, discharging from the hospital on the same day, and the immediate post operative period by meaning of complaints from the patient. Local anesthesia with sedation for cochlear implant surgery in adults is a very good alternative for lowering the morbidity of the patient, fewer risks, lower costs for the hospital, with a very good control of the surgery.

  8. Optimized Local Trigonometric Bases with Nonuniform Partitions

    Institute of Scientific and Technical Information of China (English)

    Qiao Fang LIAN; Yong Ge WANG; Dun Yan YAN

    2006-01-01

    The authors provide optimized local trigonometric bases with nonuniform partitions which efficiently compress trigonometric functions. Numerical examples demonstrate that in many cases the proposed bases provide better compression than the optimized bases with uniform partitions obtained by Matviyenko.

  9. Analysis of direct costs of anesthesia-related materials between spinal and venous anesthesia with propofol associated with local perianal block in hemorrhoidectomy

    Directory of Open Access Journals (Sweden)

    Paulo Gustavo Kotze

    2011-09-01

    Full Text Available There is no consensus on the ideal anesthesia for hemorrhoidectomy in ambulatory facilities. Spinal anesthesia and venous propofol associated with local perianal block (combined anesthesia are frequently used, and their direct costs may be crucial for the anesthesia type selection. The objective of this study was to compare the direct costs of anesthesia-related materials in hemorrhoidectomy between these two anesthetic techniques.Retrospective and cross-section analysis, comparing the direct costs of the materials of spinal and venous anesthesia with propofol associated with local perianal block, in hemorrhoidectomy. Twenty patients were included, ten submitted to each anesthesia type (five from each gender. The mean age in the spinal anesthesia group was 46.5 years and in the combined anesthesia group, 42.5 years (p=0.334. The mean cost of anesthesia-related materials was R$ 58.50 (R$ 36.48 - R$ 85.79 in the first group versus R$ 190.31 (R$ 98.16 - R$ 358.51 in the second - 69.27% difference between them (pNão há consenso sobre a técnica anestésica de escolha para hemorroidectomias em regime ambulatorial. A raquianestesia e a anestesia combinada (venosa com propofol + local são frequentemente utilizadas, e os custos das mesmas podem ser determinantes na escolha do melhor tipo de anestesia. O objetivo deste trabalho foi avaliar e comparar os custos diretos dos materiais anestésicos utilizados em hemorroidectomias entre essas duas técnicas. Foi feito um estudo retrospectivo e transversal, comparativo entre os custos diretos dos materiais anestésicos entre a raquianestesia e a anestesia venosa com poropofol associada ao bloqueio perianal local, em hemorroidectomias. Foram analisados 20 pacientes, 10 operados com cada técnica anestésica (5 de cada gênero. A média de idade do grupo da raquianestesia foi de 46,5 anos e do grupo da anestesia combinada foi de 42,5 anos (p=0,334. O custo médio do procedimento anestésico no primeiro grupo

  10. Ambulatory hernia surgery under local anesthesia is feasible and safe in obese patients.

    Science.gov (United States)

    Acevedo, A; León, J

    2010-02-01

    Ambulatory hernia surgery under local anesthesia is becoming more widely used worldwide. Although many reports include obese patients, there are no studies that report specifically on the feasibility and safety of ambulatory hernia surgery in this category of patients. This paper documents our experience in this respect. The present investigation is an observational study performed at the CRS Hernia Center, Santiago, Chile, on 510 obese and 1,521 non-obese patients with all kinds of hernias susceptible to ambulatory hernia repair under local anesthesia. Both tissue and mesh repairs were performed. Obesity was defined as a body mass index (BMI) greater than 30. Patients with a BMI greater than 45 were excluded from this study. Operative time and pain experienced during the intervention were recorded. During the controls performed by a staff member at the 7th postoperative day, a questionnaire was answered by each patient regarding satisfaction, complaints, and postoperative pain. A second questionnaire was completed on the 30th postoperative day. Satisfaction and pain were both measured by means of a 10-point visual analog scale (VAS). The mean age was similar in both groups (51 years for non-obese and 52 years for obese patients). Obesity was present in 38.3% of women and in 17.5% of men (P ambulatory abdominal wall hernia repair under local anesthesia is feasible in obese patients. Because of the increased length of surgery in these patients, monitored sedation and prophylactic antibiotic cover should be used. The slight decrease in patient satisfaction is balanced by the lower risks and higher costs associated with full general anesthetic.

  11. Excellent long-term results with iliac stenting in local anesthesia for post-thrombotic syndrome

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Just, Sven; Foegh, Pia

    2015-01-01

    BACKGROUND: Only 20% of iliac veins will recanalize on anticoagulation (AC) treatment alone and may, therefore, develop venous obstruction after iliofemoral deep venous thrombosis (DVT). A considerable number of these patients will suffer from post-thrombotic syndrome (PTS) leading to impaired qu...... stent was 89% (17/19) and 16 patients (84 %) had almost or total symptom relief at follow-up. CONCLUSION: Endovascular stenting of iliac obstruction in local anesthesia is minimally invasive and shows excellent long-term outcomes for patients suffering from PTS....

  12. Surgical anatomy of the orbital region, local anesthesia and general considerations.

    Science.gov (United States)

    Actis, A G; Actis, G; Fea, A; De Sanctis, U; Rolle, T; Grignolo, F M

    2013-12-01

    Orbital region may be divided into four sectors: medial canthus, lateral canthus, lower lid and upper lid. A vertical section of a lid shows 5 layers: skin, subcutaneous tissue with orbicularis muscle, fibrous layer (tarsus-aponeurosis), plain fibers muscle layer (Muller's), conjunctiva. The first two layers form the "anterior lamella" and the other ones the "posterior lamella", divided by the grey line. In this review Authors describe with all details the orbital region and the eyelid layers, considering the most important concepts for surgery. Finally they resume basics of local anesthesia in ophthalmoplastic surgery.

  13. Thoracic and lumbar spinal surgery under local anesthesia for patients with multiple comorbidities: A consecutive case series

    Directory of Open Access Journals (Sweden)

    Muhammad Babar Khan

    2014-01-01

    Full Text Available Background: Although some patients with symptomatic spinal disease may benefit greatly from surgery, their multiple attendant comorbidities may make general anesthesia risky or contraindicated. However, there is scarce literature describing the efficacy and safety of local anesthesia to perform these operations. Here we report seven patients who successfully underwent spinal surgery utilizing local anesthesia to limit the risks and complications of general anesthesia. Methods: Seven patients for whom general anesthesia was contraindicated were prospectively followed for a minimum of 3 months following spinal surgery performed under local anesthesia. Pain and functional improvement were assessed utilizing the Visual Analog Scores (VAS and Oswestry Disability Index (ODI scores. Results: Five patients had interlaminar decompressions for stenosis alone, while two patients had laminectomies for debulking of tumors. The mean duration of surgery was 79.8 ± 16.6 min, the mean estimated blood loss was 157.1 ± 53.4 ml, the mean dose of local anesthetic was 1.9 ± 0.7 mg/kg, and the mean length of hospital stay after surgery was 3.2 ± 1.2 days. There were no intraoperative complications. The surgery resulted in improved VAS and ODI scores consistent with significant improvement in pain (P = 0.017 and functionality (P = 0.011. Conclusions: Performing spinal surgery under local anesthesia is a safe and effective alternative when patient′s major comorbidities preclude a general anesthetic. For all the seven patients studied, spinal surgery, performed under a local anesthetic, resulted in a statistically significant reduction in pain and improvement in function.

  14. Pediatric psychopharmacology and local anesthesia: potential adverse drug reactions with vasoconstrictor use in dental practice.

    Science.gov (United States)

    Waits, Joe; Cretton-Scott, Erika; Childers, Noel K; Sims, Pamela J

    2014-01-01

    Pain management is important when dealing with pediatric dental patients. The use of local anesthetics can be especially challenging for children taking psychotropic medications. The purpose of this paper was to identify pertinent information regarding drug interactions between vasoconstrictor/local anesthetic combinations and medications for the management of psychiatric or behavior disorders in children. Many of the reported interactions are controversial, largely theoretical with very limited clinical evidence, and not well defined. However, when considering the potential for significant increased blood pressure when local anesthesia containing a vasoconstrictor is used, a thorough under standing of the pharmacological actions of medications used to treat psychiatric or behavioral disorders and vasoconstrictors can help dental professionals minimize the potential risk of drug interactions in their practice.

  15. Combined use of remifentanil and propofol to limit patient movement during retinal detachment surgery under local anesthesia

    Directory of Open Access Journals (Sweden)

    Mahfouz Abdul Kader

    2010-01-01

    Full Text Available Background: One of the drawbacks of performing ophthalmic surgery under local anesthesia is patient movement, which might affect optimal surgical outcome. Purpose: The study aims to evaluate the efficacy of the combined use of propofol and remifentanil as a sedative technique in comparison with the use of propofol alone to limit patient discomfort and movement during local anesthesia for vitreo-retinal surgery lasting for more than two hours. Materials and Methods: A total of 140 patients scheduled for vitreo-retinal surgery under local anesthesia, with an expected surgical time of more than two hours, were included in the study. Patients were divided randomly into two equal groups: group I where patients were given propofol and remifentanil by continuous infusion and group II where patients were given propofol alone by continuous infusion. Results: The two groups were comparable with regard to age, weight, gender, ASA physical status and duration of surgery. There was a significant decrease in heart rate and mean arterial blood pressure (MABP in each group 10 minutes after the start of sedation compared with pre-sedation data and continued all through the procedure. There was an insignificant difference between the two groups with regard to changes in heart rate and MABP all through surgical procedure. There was no significant difference between the two groups with regard to the incidence of complications except for an increased incidence of breakthrough pain and discomfort which necessitated the use of fentanyl as a rescue treatment in the propofol group P<0.001. There were no instances of movements with a major effect on the surgical field, which could have affected surgical outcome, in the two groups. The number of patients who did not move was significantly higher, 56 (80%, in group I compared with 38 (54.29% in group II with P<0.001. The ophthalmologist satisfaction scale was significantly higher in group I (4.5±0.63 compared with group

  16. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

    Science.gov (United States)

    D'Antò, Vincenzo; Fauxpoint, Gabriel; De Rosa, Sara; Vallogini, Giulia

    2017-01-01

    Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe. PMID:28293129

  17. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

    Directory of Open Access Journals (Sweden)

    Annelyse Garret-Bernardin

    2017-01-01

    Full Text Available Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years, requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

  18. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System.

    Science.gov (United States)

    Garret-Bernardin, Annelyse; Cantile, Tiziana; D'Antò, Vincenzo; Galanakis, Alexandros; Fauxpoint, Gabriel; Ferrazzano, Gianmaria Fabrizio; De Rosa, Sara; Vallogini, Giulia; Romeo, Umberto; Galeotti, Angela

    2017-01-01

    Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal-Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

  19. Evaluation of new injection and cavity preparation model in local anesthesia teaching.

    Science.gov (United States)

    Said Yekta, Sareh; Lampert, Friedrich; Kazemi, Saeid; Kazemi, Reza; Brand, Henk S; Baart, Jacques A; Mazandarani, Mina

    2013-01-01

    The aim of this study was to evaluate a recently developed preclinical injection and cavity preparation model in local anesthesia. Thirty-three dental students administered an inferior alveolar nerve block injection in the model, followed by preparation on a tooth. The injection was evaluated by three observers, and the feedback from the model was registered. After completion of the practical session, the opinion of the dental students was explored with a ten-item questionnaire. Thirty dental students (91 percent) performed the injection correctly according to the feedback of the model, and twenty-eight students (85 percent) did so according to the expert opinion. The agreement between feedback from the training model and the expert opinion was high. The students were very satisfied with the opportunity to practice with the training model, as indicated by the high scores on each item of the questionnaire. These results suggest that use of this preclinical training model in anesthesia teaching may have beneficial effects on the administration of local anesthetics by dental students.

  20. Anesthesia Basics

    Science.gov (United States)

    ... the Risks? en español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting ... down into three main categories: general, regional, and local. All of these can be given through various ...

  1. An in vivo evaluation of the change in the pulpal oxygen saturation after administration of preoperative anxiolytics and local anesthesia

    Science.gov (United States)

    P. Shetty, Krishna; V. Satish, Sarvepalli; Kilaru, Krishnarao; Chakravarthi Ponangi, Kalyana; M. Luke, Alexander; Neshangi, Srisha

    2016-01-01

    Background. Given the influence of systemic blood pressure on pulpal blood flow, anxiolytics prescribed may alter the pulpal blood flow along with the local anesthetic solution containing a vasoconstrictor. This study evaluated the impact of preoperative anxiolytics and vasoconstrictors in local anesthetic agents on pulpal oxygen saturation. Methods. Thirty anxious young healthy individuals with a mean age of 24 years were randomly selected using the Corah’s Dental Anxiety Scale (DAS). After checking the vital signs the initial pulpal oxygen saturation (initial SpO2) was measured using a pulse oximeter. Oral midzolam was administered at a dose of 7.5 mg. After 30 min, the vital signs were monitored and the pulpal oxygen saturation (anxiolytic SpO2) was measured. A total of 1.5 mL of 2% lidocaine with 1:200000 epinephrine was administered as buccal infiltration anesthesia and 10 min the final pulpal oxygen saturation (L.A SpO2) was measured. Results. The mean initial (SpO2) was 96.37% which significantly decreased to 90.76% (SpO2) after the administration of the anxiolytic agent. This drop was later accentuated to 85.17% (SpO2) after administration of local anesthetic solution. Statistical significance was set at Pcavity preparation. Therefore, maintaining optimal blood flow during restorative procedures may prevent pulpal injury. PMID:27092212

  2. Transrectal ultrasound (TRUS) guided prostate biopsy: Three different types of local anesthesia.

    Science.gov (United States)

    Anastasi, Giuseppina; Subba, Enrica; Pappalardo, Rosa; Macchione, Luciano; Ricotta, Gioacchino; Muscarà, Graziella; Lembo, Francesco; Magno, Carlo

    2016-12-30

    Transrectal Ultrasound (TRUS) guided prostate biopsy is regarded as the gold standard for prostate cancer diagnosis. The majority of patients perceive TRUS-guided prostate biopsy as a physically and psychologically traumatic experience. We aimed to compare in this paper the efficacy of three different anesthesia techniques to control the pain during the procedure. 150 patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy were randomly divided into three groups. Group A included 50 patients who received one hour before the procedure a mixture of 2.5% lidocaine and 2.5% prilocaine, Group B: 50 patients who received intrarectal local anesthetic administration (lidocaine 5 ml 10%) and lidocaine local spray 15 % and Group C included 50 patients who received periprostatic block anesthesia (lidocaine 10 ml 10%). Visual analogue scale (VAS) of patients in different groups was evaluated at the end of the biopsy and 30 minutes after the procedure. The VAS of patients in Group A was 1.32 ± 0.65 (VAS I) and 2.47 ± 0.80 (VAS II). In group B the VAS of patients was 1.09 ± 0.47 (VAS I) and 1.65 ± 0.61 (VAS II). In group C the VAS of patients was 2.63 ± 0.78 (VAS I) and 1.70 ± 0.85 (VAS II). There was no statistically significant difference in term of VAS I between group A and B. A statistically significant difference was determined in terms of VAS II between group A and B. There was no statistically significant difference in term of VAS between group B and C. The most effective of the three methods for pain control we used was intrarectal local anesthetic administration and lidocaine local spray 15% that enables an ideal patient comfort.

  3. Endovenous laser ablation of great saphenous veins performed using tumescent cold saline solution without local anesthesia.

    Science.gov (United States)

    Cavallini, Alvise; Marcer, Daniela; Bernardini, Giovanni; Ferrari Ruffino, Salvatore

    2014-05-01

    In recent years, laser systems with higher wavelengths, associated with new optical fibers, have shown excellent short-term results in treating saphenous veins and reducing the side effects and, in particular, the postoperative pain. However, if the patients are not anesthetized, they may feel pain even when using low energy with the high-wavelength laser; the only tumescent local anesthesia often does not guarantee a complete pain control during endovenous laser ablation (EVLA). Aim of this study was to demonstrate that the local anesthesia during EVLA of great saphenous veins (GSVs) is not essential for the perioperative comfort of the patient if a mild sedation is made. Forty-nine incompetent GSVs were treated by EVLA with a cold saline tumescent solution (CSTS) without local anesthetic drugs. EVLA was performed with a 1540-nm diode laser and a 600-μc ball-tipped fiber. Intraoperative ultrasonography was then used to guide delivery of CSTS (cold saline solution 0.9% at 5°C) using a motor pump under intravenous sedation. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology classification. Patients rated surgery global pain according to 4 types: "extremely," "rather," "slightly," and "not at all" painful. Twenty-five cases (51%) were classified as C3, 20 (41%) as C2, 6 (13%) as C4, and 1 (2%) as C6. Midazolam 2.5 mg + a mean of 0.16 mg of fentanil (minimum: 0.10; maximum: 0.20; standard deviation [SD]: 0.4) + a mean of 178.21 mg of propofol (minimum: 100; maximum: 300; SD: 47.1) were administrated as intravenous sedation. The total average linear endovenous energy density was 57.7 J/cm. Approximately 250 mL (minimum: 100; maximum: 780) of CSTS was administered. No Patient has had pain during the procedure. All patients were discharged 2.5 hrs after surgery. EVLA under sedation using CSTS without diluted anesthetic drugs is a suitable technique in an outpatients clinic, especially useful if the ablation

  4. Surgical treatment of varicose vein using the tumescent technique of local anesthesia

    Directory of Open Access Journals (Sweden)

    Bjelanović Zoran

    2011-01-01

    Full Text Available Background/Aim. Tumescent local anesthesia (TLA is a technique for local and regional anesthesia of the skin and the subcutaneous tissue, using infiltration of large amounts of a diluted solution of local anesthetic. This technique is applied in plastic surgery, liposuction as well as in dermatology for the entire series of dermatocosmetic procedures. The purpose of this study was to determine efficiency of surgical treatment of varicose vein using TLA as an alternative method to a conventional treatment for varicose vein. Methods. Seventy-two patients with varicose vein were enrolled in the study. All of them were operated on applying TLA, from April 2008 to November 2009. TLA solution consisted of local anesthetics was used. TLA solutions used were: 1% prilocaine-chloride with adrenaline supplement, and 2% lidocaine-chloride and adrenaline in concentration of 0.1%-0.4%. Results. Out of 72 patients, we stripped great saphenous vein from 60 patient and did varicectomy as well as ligation of insufficiently perforating veins. In 12 patients we did partial varicectomy and ligation of perforating veins. There were not any patients with the need for continued surgery, as well as bringing patient to the general anesthesia due to pain during the surgery. One patient came for postoperative opening wound in the groin, one for infection of the wound and one for the formation of seroma in the groin. There were not any allergic reactions or systemic complications in the operations as well as postoperative period. Postoperatively, all the patients were treated with compressive elastic bandage during the period of 6 weeks as well as anticoagulation prophylaxis in the duration of 5 days. Conclusion. Surgery of varicose veins with implementation of TLA is easy and safe method with very low percentage of complications and unwanted effects. It is a good alternative method to classic surgery of varicose veins. The economic aspect is a very important component

  5. Relationship between Child and Parental Dental Anxiety with Child's Psychological Functioning and Behavior during the Administration of Local Anesthesia.

    Science.gov (United States)

    Vasiliki, Boka; Konstantinos, Arapostathis; Nikolaos, Kotsanos; Vassilis, Karagiannis; Cor, van Loveren; Jaap, Veerkamp

    The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.

  6. Surgeon-administered conscious sedation and local anesthesia for ambulatory anorectal surgery.

    Science.gov (United States)

    Hina, Miss; Hourigan, Jon S; Moore, Richard A; Stanley, J Daniel

    2014-01-01

    Anorectal procedures are often performed in an outpatient setting using a variety of anesthetic techniques. One technique that has not been well studied is surgeon-administered conscious sedation along with local anesthetic. The purpose of this study was to evaluate the use of this technique with emphasis on safety, efficacy, and patient satisfaction. Chart review was performed on 133 consecutive patients who had anorectal procedures at an outpatient surgery center. Additionally, 65 patients were enrolled prospectively and completed a satisfaction survey. Inclusively, charts of 198 patients who underwent outpatient anorectal surgery under conscious sedation and local anesthesia under the direction of a colorectal surgeon from 2004 through 2008 were reviewed. Parameters related to patient and procedural characteristics, safety, efficacy, and satisfaction were evaluated. Surgeon-administered sedation consisted of combined fentanyl and midazolam in 90 per cent. Eighty per cent of procedures were performed in the prone position and 23 per cent were in combination with an endoscopic procedure. Eighty-two per cent were classified as American Society of Anesthesiologists Grade 1 or 2. Transient mild hypoxemia or hypotension occurred in 4 and 3 per cent of the patients, respectively. Mean operative time was 29 minutes with a mean stay in the postanesthesia care unit of 37 minutes. There were no early major cardiac or respiratory complications. Ninety-seven per cent of the patients surveyed reported a high degree of satisfaction. Surgeon-administered conscious sedation with local anesthesia was well tolerated for outpatient anorectal surgeries. Additional studies are needed to confirm the safety and efficacy of this technique.

  7. Optimizing drugs for local delivery.

    Science.gov (United States)

    Collingwood, S; Lock, R; Searcey, M

    2009-12-01

    An international panel of speakers together with approximately 70 delegates were brought together by The Society for Medicines Research's symposium on Optimising Drugs for Local Delivery, held on June 11, 2009 at the Novartis Institutes for Biomedical Research, Horsham, UK. The focus of the conference was on the delivery of drugs direct to the site of action and the consequences of this delivery route on delivery technologies, formulation science and molecular design.

  8. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: is it Necessary to Use Local Anesthesia for the Application of One Needle Puncture?

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Rho, Myung Ho [Myongji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of); Kim, Ki Nam [Dong-A University, Busan (Korea, Republic of)

    2009-10-15

    This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was

  9. An emphasis on the wide usage and important role of local anesthesia in dentistry: A strategic review

    OpenAIRE

    Preetinder Singh

    2012-01-01

    Local anesthesia forms the major part of pain-control techniques in dentistry. The prevention and elimination of pain during dental treatment has benefited patients, their doctors and dental hygienists, enabling the dental profession to make tremendous therapeutic advances that would otherwise have been impossible. Introduced in the late 1940s, the amide local anesthetics represent the most used drugs in dentistry. Local anesthetics also represent the safest and most effective drugs in all of...

  10. Is it safe to use local anesthesia with adrenaline in hand surgery? WALANT technique.

    Science.gov (United States)

    Pires Neto, Pedro José; Moreira, Leonardo de Andrade; Las Casas, Priscilla Pires de

    2017-01-01

    In the past it was taught that local anesthetic should not be used with adrenaline for procedures in the extremities. This dogma is transmitted from generation to generation. Its truth has not been questioned, nor the source of the doubt. In many situations the benefit of use was not understood, because it was often thought that it was not necessary to prolong the anesthetic effect, since the procedures were mostly of short duration. After the disclosure of studies of Canadian surgeons, came to understand that the benefits went beyond the time of anesthesia. The WALANT technique allows a surgical field without bleeding, possibility of information exchange with the patient during the procedure, reduction of waste material, reduction of costs, and improvement of safety. Thus, after passing through the initial phase of the doubts in the use of this technique, the authors verified its benefits and the patients' satisfaction in being able to immediately return home after the procedures.

  11. Survival and complications of peritoneal dialysis catheters: introducing a laparoscopic method under local anesthesia

    Directory of Open Access Journals (Sweden)

    Chaman R

    2008-10-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Chronic peritoneal dialysis is a safe method for the treatment of end-stage renal failure. Worldwide, patients on chronic peritoneal dialysis constititute approximately 15% of the total number of patients on dialysis. In Iran, very few people have access to chronic peritoneal dialysis, which is targeted by the Ministry of Health. This lack of access is primarily due to the high occurrence of mechanical complications. Improving catheterization procedures is an important way to extend the use of peritoneal dialysis in Iran. Thus, a prospective study was implemented to evaluate the outcome of a new laparoscopic technique for the insertion of peritoneal dialysis catheters under local anesthesia."n"n Methods: A total of 115 catheters (two-cuff, swan-necked, coiled were inserted into the peritoneal cavity of 109 patients with end-stage chronic renal failure during a 16-month period. The method of insertion was a two-port laparoscopic technique with local anesthesia and sedation. All patients were followed for 12 to 28 months. We prospectively evaluated mechanical and infectious complications and survival rates of the catheters."n"n Results: The average age of the patients was 51

  12. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... anesthesia with 20 ml. 1% lidocaine with epinephrine. All patients received an intravenous dose of morphine just before ESWL. The patients were comparable with regard to age, sex, weight, morphine dosage, number of shock waves given and duration of treatment. Median pain score and the amount of supplementary...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  13. Pharmacokinetics and effect of intravenous meloxicam in weaned Holstein calves following scoop dehorning without local anesthesia

    Directory of Open Access Journals (Sweden)

    Coetzee Johann F

    2012-09-01

    Full Text Available Abstract Background Dehorning is a common practice involving calves on dairy operations in the United States. However, less than 20% of producers report using analgesics or anesthetics during dehorning. Administration of a systemic analgesic drug at the time of dehorning may be attractive to dairy producers since cornual nerve blocks require 10 – 15 min to take effect and only provide pain relief for a few hours. The primary objectives of this trial were to (1 describe the compartmental pharmacokinetics of meloxicam in calves after IV administration at 0.5 mg/kg and (2 to determine the effect of meloxicam (n = 6 or placebo (n = 6 treatment on serum cortisol response, plasma substance P (SP concentrations, heart rate (HR, activity and weight gain in calves after scoop dehorning and thermocautery without local anesthesia. Results Plasma meloxicam concentrations were detectable for 50 h post-administration and fit a 2-compartment model with a rapid distribution phase (mean T½α = 0.22 ± 0.087 h and a slower elimination phase (mean T½β = 21.86 ± 3.03 h. Dehorning caused a significant increase in serum cortisol concentrations and HR (P  Conclusions To our knowledge, this is the first published report examining the effects of meloxicam without local anesthesia on SP, activity and performance of calves post-dehorning. These findings suggest that administration of meloxicam alone immediately prior to dehorning does not mitigate signs of acute distress but may have long term physiological, behavior and performance effects.

  14. Laying open(deroofing) and curettage under local anesthesia for pilonidal disease: An outpatient procedure

    Institute of Scientific and Technical Information of China (English)

    Pankaj; Garg; Mahak; Garg; Vikas; Gupta; Sudhir; Kumar; Mehta; Paryush; Lakhtaria

    2015-01-01

    AIM: To test the efficacy of lay open(deroofing, not excision) with curettage under local anesthesia(LOCULA) for pilonidal sinus as an outpatient procedure. METHODS: LOCULA procedure was done for all types of pilonidal disease. The primary outcome measure was cure rate. The secondary outcome measures were hospital stay, operating time, return to work, healing time and complication rate.RESULTS: Thirty-three(M/F-30/3, mean age-23.4 ± 5.8 years) consecutive patients were operated and followed for 24 mo(6-46 mo). Eleven were pilonidal abscess and 22 were chronic pilonidal disease. Six had recurrent disease. Operating time and the hospital stay was 22.3 ± 5.6 min and 63.8 ± 22.3 min respectively. The patients could resume normal work in 4.3 ± 3.2 d and the healing time was 42.9 ± 8.1 d. Thirty(93.8%)patients had complete resolution of the disease and two(6.2%) had a recurrence. Both the recurrences happened in patients who had complete healing but ignored the prescribed recommendations. One out of these got cured after getting operated again with the same procedure. Thus the overall success rate of this procedure was 96.9%.CONCLUSION: Lay open(deroofing) with curettage procedure under local anesthesia is an effective procedure to treat both simple and complicated pilonidal sinus and abscess. It is a simple procedure, has a high cure rate(up to 97%), doesn’t require admission and is associated with minimal morbidity and scarring. Considering the distinct advantages, this procedure has the potential to become the first line procedure for treating pilonidal disease.

  15. Hypnosis and Local Anesthesia for Dental Pain Relief-Alternative or Adjunct Therapy?-A Randomized, Clinical-Experimental Crossover Study.

    Science.gov (United States)

    Wolf, Thomas Gerhard; Wolf, Dominik; Callaway, Angelika; Below, Dagna; d'Hoedt, Bernd; Willershausen, Brita; Daubländer, Monika

    2016-01-01

    This prospective randomized clinical crossover trial was designed to compare hypnosis and local anesthesia for experimental dental pain relief. Pain thresholds of the dental pulp were determined. A targeted standardized pain stimulus was applied and rated on the Visual Analogue Scale (0-10). The pain threshold was lower under hypnosis (58.3 ± 17.3, p local anesthesia. The pain stimulus was scored higher under hypnosis (3.9 ± 3.8) than with local anesthesia (0.0, p Local anesthesia was superior to hypnosis and is a safe and effective method for pain relief in dentistry. Hypnosis seems to produce similar effects observed under sedation. It can be used in addition to local anesthesia and in individual cases as an alternative for pain control in dentistry.

  16. [Efficiency of teeth local anesthesia by articaine-containing formulation with adrenaline and clonidine in pediatric dentistry].

    Science.gov (United States)

    Mel'nikova, A V; Shugaĭlov, I A; Garus, Ia N

    2014-01-01

    The study evaluated duration and depth of the local infiltration anesthesia by articaine with different combinations of epinephrine and clonidine : articaine (4%) + epinephrine (1: 200 000), articaine (4%) + clonidine (1:100 000), articaine (4%) + epinephrine (1:200 000) + clonidine (1:100 000), articaine (4%) + epinephrine (1: 400 000) + clonidine (1:100, 000) in pediatric dental practice. It was revealed that the replacement of the vasoconstrictor epinephrine on clonidine associated with reduced depth and duration of analgesia. This increased efficiency is provided by inclusion of epinephrine (1:200 000), and clonidine (1:100 000) into anesthetic solution, which provided statistically significant increase in depth and duration of anesthesia.

  17. Examination of cardiovascular function variables in tooth extraction under local anesthesia

    Directory of Open Access Journals (Sweden)

    Životić-Vanović Mirjana

    2006-01-01

    Full Text Available Background/Aim. Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline in healthy persons, and in the patients with a certain cardiovascular system disease. The aim of this study was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. Methods. The examinees were divided into the group with cardiovascular diseases (CV, n = 57 of II and III type, according to the American Society of Anesthesiologists (ASA qualification, and healthy persons (H, n = 55. Both groups were randomly divided into two subgroups: CVa and Ha - where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1 : 100 000 adrenaline; CVb and Hb - where the anesthetic solution was without the vasoconstrictor (3% lidocaine. During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc, systolic (TAs and diastolic arterial blood pressure (TAd and ECG were registered. Results. The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05 from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05. The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. Conclusion. This research shoved that tooth

  18. Optimizing preoperative blood ordering with data acquired from an anesthesia information management system.

    Science.gov (United States)

    Frank, Steven M; Rothschild, James A; Masear, Courtney G; Rivers, Richard J; Merritt, William T; Savage, Will J; Ness, Paul M

    2013-06-01

    The maximum surgical blood order schedule (MSBOS) is used to determine preoperative blood orders for specific surgical procedures. Because the list was developed in the late 1970s, many new surgical procedures have been introduced and others improved upon, making the original MSBOS obsolete. The authors describe methods to create an updated, institution-specific MSBOS to guide preoperative blood ordering. Blood utilization data for 53,526 patients undergoing 1,632 different surgical procedures were gathered from an anesthesia information management system. A novel algorithm based on previously defined criteria was used to create an MSBOS for each surgical specialty. The economic implications were calculated based on the number of blood orders placed, but not indicated, according to the MSBOS. Among 27,825 surgical cases that did not require preoperative blood orders as determined by the MSBOS, 9,099 (32.7%) had a type and screen, and 2,643 (9.5%) had a crossmatch ordered. Of 4,644 cases determined to require only a type and screen, 1,509 (32.5%) had a type and crossmatch ordered. By using the MSBOS to eliminate unnecessary blood orders, the authors calculated a potential reduction in hospital charges and actual costs of $211,448 and $43,135 per year, respectively, or $8.89 and $1.81 per surgical patient, respectively. An institution-specific MSBOS can be created, using blood utilization data extracted from an anesthesia information management system along with our proposed algorithm. Using these methods to optimize the process of preoperative blood ordering can potentially improve operating room efficiency, increase patient safety, and decrease costs.

  19. Optimizing radiation exposure for CT localizer radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Bohrer, Evelyn; Maeder, Ulf; Fiebich, Martin [Univ. of Applied Sciences, Giessen (Germany). Inst. of Medical Physics and Radiation Protection-IMPS; Schaefer, Stefan; Krombach, Gabriele A. [Univ. Hospital Giessen (Germany). Dept. of Radiology; Noel, Peter B. [Technische Univ. Muenchen (Germany). Dept. of Diagnostic and Interventional Radiology

    2017-08-01

    The trend towards submillisievert CT scans leads to a higher dose fraction of localizer radiographs in CT examinations. The already existing technical capabilities make dose optimization of localizer radiographs worthwhile. Modern CT scanners apply automatic exposure control (AEC) based on attenuation data in such a localizer. Therefore not only this aspect but also the detectability of anatomical landmarks in the localizer for the desired CT scan range adjustment needs to be considered. The effective dose of a head, chest, and abdomen-pelvis localizer radiograph with standard factory settings and user-optimized settings was determined using Monte Carlo simulations. CT examinations of an anthropomorphic phantom were performed using multiple sets of acquisition parameters for the localizer radiograph and the AEC for the subsequent helical CT scan. Anatomical landmarks were defined to assess the image quality of the localizer. CTDI{sub vol} and effective mAs per slice of the helical CT scan were recorded to examine the impact of localizer settings on a helical CT scan. The dose of the localizer radiograph could be decreased by more than 90% while the image quality remained sufficient when selecting the lowest available settings (80 kVp, 20 mA, pa tube position). The tube position during localizer acquisition had a greater impact on the AEC than the reduction of tube voltage and tube current. Except for the use of a pa tube position, all changes of acquisition parameters for the localizer resulted in a decreased total radiation exposure. A dose reduction of CT localizer radiograph is necessary and possible. In the examined CT system there was no negative impact on the modulated helical CT scan when the lowest tube voltage and tube current were used for the localizer.

  20. Airway Tree Extraction with Locally Optimal Paths

    DEFF Research Database (Denmark)

    Lo, Pechin Chien Pau; Sporring, Jon; Pedersen, Jesper Johannes Holst

    2009-01-01

    This paper proposes a method to extract the airway tree from CT images by continually extending the tree with locally optimal paths. This is in contrast to commonly used region growing based approaches that only search the space of the immediate neighbors. The result is a much more robust method...... for tree extraction that can overcome local occlusions. The cost function for obtaining the optimal paths takes into account of an airway probability map as well as measures of airway shape and orientation derived from multi-scale Hessian eigen analysis on the airway probability. Significant improvements...

  1. [Cervical epidural anesthesia for upper extremity surgery using three different formulations of local anesthetics].

    Science.gov (United States)

    Guevara-López, Uriah; Bárcenas-Olivares, Juan; Gutiérrez-Sougarret, Bernardo; Aldrete, J Antonio; Olascoaga-Ortega, Gabriela

    2005-01-01

    To evaluate the efficiency and safety of the cervical epidural blockade (CEB) in upper extremity surgery, using lidocaine 2%, bupivacaine 5% and a mixture of both local analgesics. Eighty five patients were submitted to upper limb surgery under CEB. They were assigned into one of three groups: group I received 100 mg of 2% lidocaine; group II received 30 mg of 0.5% bupivacaine, and group III received a mixture of 60 mg of 2% lidocaine and 15 mg of 0.5% bupivacaine. We evaluated their effects on vital signs, blockade quality, adverse effects, and patient comfort. Anesthesiologist and surgeon evaluated the technique as "good" in 80% of the patients. Significant differences were found for motor blockade. Group II developed complete motor block (100%). Observed adverse effects were vomiting in groups II and III and dural puncture was present in 6.7% of the cases in group II. This study confirms the safety of cervical epidural anesthesia for upper limb surgery using three different formulations of local anesthetics.

  2. Sigmund Freud (1856-1939) and Karl Köller (1857-1944) and the discovery of local anesthesia.

    Science.gov (United States)

    dos Reis, Almiro

    2009-01-01

    The understanding, occasionally recognized, that Sigmund Freud had the intuition to use cocaine as local anesthetic for surgical procedures, or even that he played any role in the discovery of local anesthesia is not true. The objective of Freud's studies were different, and based in irrefutable evidence, Karl Köller was the real inventor of local anesthesia. In face of those facts, proper knowledge of this historically important subject is due. This report refers to the long-known properties of cocaine. It also remembers personal data, and the professional and scientific activities of Sigmund Freud and Karl Köller. It presents Freud's researches on the pathophysiological effects of cocaine. It exposes the reasons for the harsh criticism of Freud's concepts. It describes the sudden, but conscious and justified, idea of Karl Köller to study scientifically the use of cocaine as a local anesthetic in animals and humans. It indicates how those pioneering studies, that culminated with the discovery of local anesthesia by Köller and two presentations in Vienna on the subject, were done. It also reports the first ophthalmologic surgery under local anesthesia. It shows the immediate dissemination throughout the world of the discovery that marked the beginning of regional blocks. It comments several documents corroborating the role of Köller in this discovery. And, finally, it mentions the numerous homages received by Köller in different areas of the world. COCLUSIONS: Regional block was introduced by Karl Köller in 1884, when he demonstrated the feasibility of performing painless ophthalmologic surgeries by using cocaine as a local anesthetic. Sigmund Freud studied cocaine extensively, but he did not have direct participation in this important discovery.

  3. Sevoflurane anesthesia induces neither contextual fear memory impairment nor alterations in local population connectivity of medial prefrontal cortex local field potentials networks in aged rats.

    Science.gov (United States)

    Xu, Xinyu; Zhang, Qian; Tian, Xin; Wang, Guolin

    2016-08-01

    Sevoflurane has been found to increase apoptosis and pathologic markers associated with Alzheimer disease, provoking concern over their potential contribution to postoperative cognitive dysfunction. This study aimed to determine the effects of sevoflurane on contextual fear memory of aged rats and to characterize local population connectivity of local field potentials (LFPs) in medial prefrontal cortex (mPFC) of aged rats during contextual fear memory. Eighteen-month-old male SD rats were implanted with one multichannel electrode array in mPFC. The aged rats were divided into control group, sevoflurane group (1 MAC sevoflurane for 2 h) and surgical group with 1.0 MAC sevoflurane for 2 h. We then assessed the effect of the anesthesia on contextual fear memory, and alterations in the local population connectivity of mPFC LFP networks by partial directed coherence (PDC). Surgery impaired contextual fear memory and reduced local population connectivity of mPFC LFP networks in aged rats at day 1 after the surgery and anesthesia. 1 MAC Sevoflurane anesthesia induced neither contextual fear memory impairment nor alterations in local population connectivity of mPFC LFP networks in aged rats when tested 1, 7, 15 and 30 days after exposure (P > 0.05). PDC values of theta band mPFC LFPs became strongly increased during contextual fear memory at 1, 7, 15, and 30 days after anesthesia. Our results suggest that 1 MAC sevoflurane anesthesia does not induce contextual fear memory impairment in aged rats and suggest that the increased local population connectivity in theta bands LFPs of mPFC plays a role in contextual fear memory.

  4. Combinatorics of locally optimal RNA secondary structures.

    Science.gov (United States)

    Fusy, Eric; Clote, Peter

    2014-01-01

    It is a classical result of Stein and Waterman that the asymptotic number of RNA secondary structures is 1.104366∙n-3/2∙2.618034n. Motivated by the kinetics of RNA secondary structure formation, we are interested in determining the asymptotic number of secondary structures that are locally optimal, with respect to a particular energy model. In the Nussinov energy model, where each base pair contributes -1 towards the energy of the structure, locally optimal structures are exactly the saturated structures, for which we have previously shown that asymptotically, there are 1.07427∙n-3/2∙2.35467n many saturated structures for a sequence of length n. In this paper, we consider the base stacking energy model, a mild variant of the Nussinov model, where each stacked base pair contributes -1 toward the energy of the structure. Locally optimal structures with respect to the base stacking energy model are exactly those secondary structures, whose stems cannot be extended. Such structures were first considered by Evers and Giegerich, who described a dynamic programming algorithm to enumerate all locally optimal structures. In this paper, we apply methods from enumerative combinatorics to compute the asymptotic number of such structures. Additionally, we consider analogous combinatorial problems for secondary structures with annotated single-stranded, stacking nucleotides (dangles).

  5. Simultaneous occlusion of three cilioretinal arteries following scleral buckling surgery under local anesthesia

    Directory of Open Access Journals (Sweden)

    Napoli PE

    2016-09-01

    Full Text Available Pietro Emanuele Napoli,* Alberto Cuccu,* Roberta Farci, Maurizio Fossarello Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy *These authors contributed equally to this work Background: Cilioretinal artery (CRA occlusions are rare in young patients. In these cases, the most commonly associated causes are considered to be the same as those implicated in central retina artery occlusions, such as vasculitic processes, migraine, cardiac disorder, and coagulation abnormality. The aim of this article was to report for the first time the medical records and investigational results of an unusual case of simultaneous occlusion of three CRAs after scleral buckling surgery under local anesthesia.Methods: A complete ophthalmic examination, including color fundus image, fundus fluorescein angiography, optical coherence tomography, visual field, as well as systemic and laboratory assessments, was performed.Results: A case of contemporaneous blockage of three CRAs after ab externo surgery for retinal detachment in a 29-year-old Caucasian woman was reported. The interdisciplinary approach and the imaging results have allowed us the clinical definition of such a very rare case.Conclusion: Here, we reported that optical coherence tomography is an indispensable tool to better delineate the pathological process and follow atrophic changes in the macula, especially in cases in which fundus fluorescein angiography and systemic tests may be poorly informative. Keywords: cilioretinal artery occlusion, optical coherence tomography, retinal detachment

  6. Postoperative internal carotid artery restenosis after local anesthesia: presence of risk factors versus intraoperative shunt.

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Hajnic, Hrvoje; Ahel, Zaky

    2010-08-01

    Published data suggest that the regional anesthetic technique used for carotid endarterectomy (CEA) increases the systolic arterial blood pressure and heart rate. At the same time local anesthesia reduced the shunt insertion rate. This study aimed to analyze risk factors and ischemic symptomatology in patients with postoperative internal carotid artery restenosis. The current retrospective study was undertaken to assess the results of CEA in 8000 patients who were operated during a five-year period in six regional cardiovascular centers. Carotid color coded flow imaging, medical history, clinical findings and atherosclerotic risk factors were analyzed. Among them, there were 33 patients (0.4%) with postoperative re-occlusion after CEA. The patients with restenosis were re-examined with carotid color coded flow imaging and data were compared with 33 consecutive patients with satisfactory postoperative findings to serve as a control group. In the restenosis group eight risk factors were analyzed (hypertension, smoking, hyperlipidemia, diabetes mellitus, history of stroke, transitory ischemic attack, heart attack and coronary disease), and compared with risk factors in control group. Study results suggested that early postoperative internal carotid artery restenosis was not caused by atherosclerosis risk factors but by intraoperative shunt usage.

  7. Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Song Ee; Oh, Young Taik [Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-09-15

    To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4{+-}1.78: group 2, 2.8{+-}1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

  8. Transnasal tracheobronchial stenting for malignant airway narrowing under local anesthesia: Our experience of treating three cases using this technique

    Directory of Open Access Journals (Sweden)

    Jayanta Medhi

    2016-01-01

    Full Text Available Purpose: To study the technical feasibility of tracheobronchial stenting via transnasal route under bronchoscopy and fluoroscopic guidance in severe malignant airway strictures using self-expandable nitinol stents. Materials and Methods: We describe three patients with malignant airway strictures, treated entirely via transnasal route under local anesthesia using bronchoscopic and fluoroscopic guidance. Nasal route allowed convenient access to the airway for the bronchoscope across the stricture and a guidewire was introduced through its working channel. The 18F tracheal stent and the 6F bronchial stent assembly could be easily introduced and deployed under bronchoscopic (reintroduced through the other nostril and fluoroscopic guidance. Results: We achieved technical success in all the three patients with immediate relief of dyspnea. Conclusion: Transnasal airway stenting with self-expandable nitinol stent using bronchoscopic and fluoroscopic guidance under local anesthesia is a safe and effective method with minimal patient discomfort.

  9. Effect of local anesthesia on atypical odontalgia--a randomized controlled trial.

    Science.gov (United States)

    List, Thomas; Leijon, Göran; Helkimo, Martti; Oster, Anders; Svensson, Peter

    2006-06-01

    The aim of the study was to evaluate the analgesic effect of lidocaine in a double-blind, controlled multi-center study on patients with atypical odontalgia (AO)--a possible orofacial neuropathic pain condition. Thirty-five consecutive AO patients (range 31-81 years) with a mean pain duration of 7.2 years (range 1-30 years) were recruited from four different orofacial pain clinics in Sweden. In a randomized cross-over design, 1.5 ml local anesthesia (20mg/ml lidocaine and 12.5 microg/ml adrenaline) or 1.5 ml saline (9 mg/ml NaCl solution) (placebo) was injected to block the painful area. The VAS pain scores showed an overall effect of time (ANOVA: P<0.001) and treatment (ANOVA: P=0.018) with a significant interaction between the factors (ANOVA: P<0.001). Overall, VAS pain relief was significantly greater at 15-120 min following the lidocaine injections compared to the placebo injections (Tukey: P<0.05). All patients demonstrated significant disturbances in somatosensory function on the painful side compared to the non-painful side as revealed by quantitative sensory tests, however, only one significant inverse correlation was found between percentage pain relief and the magnitude of brush-evoked allodynia (Spearman: P<0.01). In conclusion, AO patients experienced significant, but not complete, pain relief from administration of local anesthetics compared with placebo. The findings indicate that the spontaneous pain in AO patients only to some extent is dependent on peripheral afferent inputs and that sensitization of higher order neurons may be involved in the pathophysiology of AO.

  10. Vessel tree extraction using locally optimal paths

    DEFF Research Database (Denmark)

    Lo, Pechin Chien Pau; van Ginneken, Bram; de Bruijne, Marleen

    2010-01-01

    This paper proposes a method to extract vessel trees by continually extending detected branches with locally optimal paths. Our approach uses a cost function from a multi scale vessel enhancement filter. Optimal paths are selected based on rules that take into account the geometric characteristics...... of the vessel tree. Experiments were performed on 10 low dose chest CT scans for which the pulmonary vessel trees were extracted. The proposed method is shown to extract a better connected vessel tree and extract more of the small peripheral vessels in comparison to applying a threshold on the output...

  11. Experience with polymethylmethacrylate 30% (PMMA) facial filling in patients with facial HIV lipoatrophy using of local anesthesia dentistry

    OpenAIRE

    Matsuda, E; F. Soares; Brigido, L.

    2012-01-01

    Background HIV-associated lipoatrophy in a common and stigmatizing side effect of HIV infection, is aggravated by antiretroviral therapy; its presence causes distress and compromises adherence to therapy. PMMA filling is often associated with pain and discomfort. Objective To evaluate outpatient intervention using local dentistry anesthesia. Methods Patients complaining of facial lipoatrophy, from 10/2007 to 11/2011, were offered the filling with PMMA. Cases with bleeding potential, acute or ...

  12. Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti.

    Science.gov (United States)

    Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V

    2017-01-27

    Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.

  13. Combinatorics of locally optimal RNA secondary structures

    CERN Document Server

    Clote, Peter

    2011-01-01

    It is a classical result of Stein and Waterman that the asymptotic number of RNA secondary structures is $1.104366 \\cdot n^{-3/2} \\cdot 2.618034^n$. To provide a better understanding of the kinetics of RNA secondary structure formation, we are interested in determining the asymptotic number of secondary structures that are {\\em locally optimal}, with respect to a particular energy model. In the Nussinov energy model, where each base pair contributes -1 towards the energy of the structure, locally optimal structures are exactly the {\\em saturated} structures, for which we have previously shown that asymptotically, there are $1.07427\\cdot n^{-3/2} \\cdot 2.35467^n$ many saturated structures for a sequence of length $n$. In this paper, we consider the {\\em base stacking energy model}, a mild variant of the Nussinov model, where each stacked base pair contributes -1 toward the energy of the structure. Locally optimal structures with respect to the base stacking energy model are exactly those secondary structures, ...

  14. A randomized controlled clinical trial to evaluate blood pressure changes in patients undergoing extraction under local anesthesia with vasopressor use.

    Science.gov (United States)

    Uzeda, Marcelo José; Moura, Brenda; Louro, Rafael Seabra; da Silva, Licínio Esmeraldo; Calasans-Maia, Mônica Diuana

    2014-05-01

    The control of hypertensive patients' blood pressure and heart rate using vasoconstrictors during surgical procedures under anesthesia is still a major concern in everyday surgical practice. This clinical trial aimed to evaluate the variation of blood pressure and heart rate in nonhypertensive and controlled hypertensive voluntary subjects undergoing oral surgery under local anesthesia with lidocaine hydrochloride and epinephrine at 1:100,000 (Alphacaine; DFL, Brazil), performed in the Oral Surgery Department, Dentistry School, Fluminense Federal University. In total, 25 voluntary subjects were divided into 2 groups: nonhypertensive (n = 15) and controlled hypertensives (n = 10). Blood pressure and heart rate were measured at 4 different times: T0, in the waiting room; T1, after placement of the surgical drapes; T2, 10 minutes after anesthesia injection; and T3, at the end of the surgical procedure. A statistically significant difference (P 0.05) between the amount administered to nonhypertensive and hypertensive subjects. It was concluded that the local anesthetics studied could safely be used in controlled hypertensive and nonhypertensive patients in compliance with the maximum recommended doses.

  15. [Clinical and physiological rationale for use of clonidine with articaine and adrenaline for local anesthesia in pediatric dentistry].

    Science.gov (United States)

    Mel'nikova, A V; Shugaĭlov, I A

    2014-01-01

    The study evaluated the effect of local anesthesia with articaine in different combinations with epinephrine and clonidine (articaine (4%) + epinephrine (1:200 000), articaine (4%) + clonidine (1:100 000), articaine (4%) + epinephrine (1:200 000) + clonidine (1:100 000), articaine (4%) + epinephrine (1:400 000) + clonidine (1:100 000)), on a number of physiological parameters in pediatric dental practice that characterize cardiovascular system, patient's degree of adaptation to a stressful situation and efficacy of analgesia. It is shown that in terms of impact on the cardiovascular system and stress adaptation indicators anesthesia including combination of epinephrine (1: 200 000) and clonidine (1: 100 000) in the anesthetic solution is the safest. Furthermore, this method ensures the most appropriate analgesic effect.

  16. Colecistectomía con anestesia local como recurso en el paciente anciano Cholecystectomy with local anesthesia as a resource in the elderly

    Directory of Open Access Journals (Sweden)

    Roberto Del Campo Abad

    2011-03-01

    Full Text Available Ante un paciente con colecistitis aguda lo ideal es extirpar la vesícula biliar. A veces se presentan situaciones especiales en ancianos desnutridos, con deterioro de su estado general, en los que una intervención con anestesia prolongada, incluso con medios pocos invasivos como la videocirugía, pone en peligro la vida del enfermo. En tales casos la colecistectomía con anestesia local es una alternativa que se puede considerar.In the case of a patient presenting with acute cholescystectomy ideally is to remove the gallbladder. Sometimes there are special situations in malnourished elderlies with deterioration of its general status in whom a lengthy anesthesia intervention, even using not much invasive means as the videosurgery, put at risk the life of patient. In such cases the cholescystectomy with local anesthesia is an alternative that must to be taken into account.

  17. Hybrid Optimized and Localized Vibrational Coordinates.

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    Klinting, Emil Lund; König, Carolin; Christiansen, Ove

    2015-11-01

    We present a new type of vibrational coordinates denoted hybrid optimized and localized coordinates (HOLCs) aiming at a good set of rectilinear vibrational coordinates supporting fast convergence in vibrational stucture calculations. The HOLCs are obtained as a compromise between the recently promoted optimized coordinates (OCs) and localized coordinates (LCs). The three sets of coordinates are generally different from each other and differ from standard normal coordinates (NCs) as well. In determining the HOLCs, we optimize the vibrational self-consistent field (VSCF) energy with respect to orthogonal transformation of the coordinates, which is similar to determining OCs but for HOLCs we additionally introduce a penalty for delocalization, by using a measure of localization similar to that employed in determining LCs. The same theory and implementation covers OCs, LCs, and HOLCs. It is shown that varying one penalty parameter allows for connecting OCs and LCs. The HOLCs are compared to NCs, OCs, and LCs in their nature and performance as basis for vibrational coupled cluster (VCC) response calculations of vibrational anharmonic energies for a small set of simple systems comprising water, formaldehyde, and ethylene. It is found that surprisingly good results can be obtained with HOLCs by using potential energy surfaces as simple as quadratic Taylor expansions. Quite similar coordinates are found for the already established OCs but obtaining these OCs requires much more elaborate and expensive potential energy surfaces and localization is generally not guaranteed. The ability to compute HOLCs for somewhat larger systems is demonstrated for coumarin and the alanine quadramer. The good agreement between HOLCs and OCs, together with the much easier applicability of HOLCs for larger systems, suggests that HOLCs may be a pragmatically very interesting option for anharmonic calculations on medium to large molecular systems.

  18. Pharmacokinetics of lidocaine with epinephrine following local anesthesia reversal with phentolamine mesylate.

    Science.gov (United States)

    Moore, Paul A; Hersh, Elliot V; Papas, Athena S; Goodson, J Max; Yagiela, John A; Rutherford, Bruce; Rogy, Seigried; Navalta, Laura

    2008-01-01

    Phentolamine mesylate accelerates recovery from oral soft tissue anesthesia in patients who have received local anesthetic injections containing a vasoconstrictor. The proposed mechanism is that phentolamine, an alpha-adrenergic antagonist, blocks the vasoconstriction associated with the epinephrine used in dental anesthetic formulations, thus enhancing the systemic absorption of the local anesthetic from the injection site. Assessments of the pharmacokinetics of lidocaine and phentolamine, and the impact of phentolamine on the pharmacokinetics of lidocaine with epinephrine were performed to characterize this potentially valuable strategy. The blood levels of phentolamine were determined following its administration intraorally and intravenously. Additionally, the effects of phentolamine mesylate on the pharmacokinetics of intraoral injections of lidocaine with epinephrine were evaluated. Sixteen subjects were enrolled in this phase 1 trial, each receiving 4 drug treatments: 1 cartridge lidocaine/epinephrine followed after 30 minutes by 1 cartridge phentolamine (1L1P), 1 cartridge phentolamine administered intravenously (1Piv), 4 cartridges lidocaine/epinephrine followed after 30 minutes by 2 cartridges phentolamine (4L2P), and 4 cartridges lidocaine/epinephrine followed by no phentolamine (4L). Pharmacokinetic parameters estimated for phentolamine, lidocaine, and epinephrine included peak plasma concentration (Cmax), time to peak plasma concentration (Tmax), area under the plasma concentration-time curve from 0 to the last time point (AUClast) or from time 0 to infinity (AUCinf), elimination half-life (t1/2), clearance (CL), and volume of distribution (Vd). The phentolamine Tmax occurred earlier following the intravenous administration of 1Piv (7 minutes than following its submucosal administration in treatment 1L1P (15 minutes) or 4L2P (11 minutes). The phentolamine t1/2, CL, and Vd values were similar for 1L1P, 1Piv, and 4L2P. The Tmax for lidocaine occurred

  19. 局麻与硬膜外麻醉腹股沟疝修补术的临床对比研究%Local anesthesia and epidural anesthesia clinical comparative study of inguinal hernia repair

    Institute of Scientific and Technical Information of China (English)

    郑欣; 王宝

    2014-01-01

    目的:探讨局麻和硬膜外麻醉下行无张力疝修补术的疗效。方法:选择海盐县人民医院2010年12月到2011年12月所实施的无张力疝修补术患者60例,其中局麻组30例,硬膜外麻醉组30例。结果:局麻组患者在术后疼痛程度,术后住院天数以及平均住院费用都优于硬膜外麻醉组,而平均手术时间及术后并发症无显著差异。结论:局麻下无张力疝修补术简便易行,疗效肯定,术后疼痛轻,住院费用低,值得在临床上推广,尤其在基层医院。%Objective:to study the anesthesia and epidural anesthesia downlink without tension hernia repair effect.Methods:choice of haiyan county peo-ple's hospital in December 2010 to December 2011,the implementation of 60 patients with without tension hernia repair,30 cases with local anesthesia group,epidural anesthesia group 30 cases.Results:local anesthesia group of patients in postoperative pain,postoperative hospitalization days and average hospitalization expenses were better than epidural anesthesia group,while the average operation time and postoperative complications had no significant difference.Conclusion:easy without tension hernia repair under local anesthesia,curative effect,light postoperative pain,hospitalization expense is low,is worth popularizing in clinic,especially in basic-level hospitals.

  20. Efficacy of Ketamine as an Adjunct to Local Anesthesia in the Surgical Removal of Impacted Mandibular Third Molars – A Split Mouth Prospective Controlled Clinical Study

    Science.gov (United States)

    Shah, Anand; Halli, Rajshekhar; Kshirsagar, Rajesh; Khurana, Jyotsana

    2016-01-01

    Introduction The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. Aim To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars. Materials and Methods Twenty five patients with bilaterally symmetrical impacted mandibular third molars requiring surgical removal under local anesthesia were selected for the controlled clinical study. The third molar sites of all patients enrolled in the trial were randomly assigned into 2 groups: Local Anesthesia (Lignocaine) Alone [LAA] and Local Anesthesia plus ketamine [LAK]. 5ml of local anesthetic (Lignocaine Hydrochloride 2% with epinephrine 1:100,000) was injected in the ‘LAA’ group while the ‘LAK’ group received 5ml of local anesthetic plus 0.2mg/kg ketamine. Patients were blinded to the solution used and the operator recorded the group (LAA or LAK) and the respective site (Right or Left) for analysis. Bilaterally symmetrical impacted mandibular molars were removed at an interval of 15 days. Results Facial swelling on post-operative days was significantly lower in the LAK group than in the LAA group (pimpacted third molars provides good local anesthesia while alleviating post-operative sequelae for the patient by providing a degree of post-operative analgesia with less swelling. PMID:27891453

  1. Pain and intra-operative amnesia evaluation with local anesthesia and sedation in patients subjected to rhinosseptoplasties

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    Weber, Raimar

    2010-03-01

    Full Text Available Introduction: The local anesthesia practice and sedation to rhinoplasty and others aesthetics procedures of the face are each time more frequents. In the Brazil, the Federal Council of Medicine defines it and regulate its practice. Objective: To analyze the analgesia' effectiveness and of the intro operative amnesia through analogous visual and subjective scales in the rhinosseptoplasties performed under local anesthesia and sedation, looking for associations with the medium quantities of medication utilized. Method: A retrospective study based in reports relatives to 158 aesthetic-functional rhinoplasties. The surgeon recorded in a protocol the data relatives to the use of local anesthetics and sedatives (including concentration and quantities utilized as well as the side effects. In the first return post surgery the patient quantifies the pain that he felt in the intra operative utilizing a analogous visual scale as described by Hasen and collaborators. The Amnesia considered ideal when the patient referred to remind "nothing" or "a few of the procedure. Results: The sample constituted of 80 (73,4% women and 29 26,6% men, average of age of 29,3 ± 9,5 years. The median of the pain by the analogous visual scale was 0,05; 80% under 3,35. The amnesia was ideal in 51 (46,8% surgeries. The midazolam was utilized in all the surgeries. Fentanyl in 32 (29,4% and, pethidine in 77 (70,6%. Had not statistically significants differences between the quantities of medication utilized between the groups of patients with ideal amnesia when compared with those that do not obtained satisfactory amnesia. Conclusion: Local anesthesia and sedation in rhinoplasties are comfortable and secures in the majority of the cases, even without have a satisfactory amnesia.

  2. INFLUENCE OF LOCAL INFILITRATION ANESTHESIA OF SCALP-POINT ON ACUPUNCTURE INDUCED CHANGES OF CEREBRAL BLOOD PERFUSION DETECTED BY SPECT

    Institute of Scientific and Technical Information of China (English)

    郭长春; 王凡; 贾少微

    2003-01-01

    Objective: To observe the influence of local infiltration anesthesia at the scalp-point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp-point used was Motor Area (MS 6). The first syringe needle (gauge-5) was inserted into the scalp from the upper 1/5 of MS-6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS-6 and advanced downward, with the two needles connected to a HAN's Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS-6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp-point can significantly weaken or block EA stimulation induced changes of BFCR%.

  3. Knowledge and attitude of dental surgeons in India toward ocular complications of intra-oral local anesthesia.

    Science.gov (United States)

    Patil, Kavitha; Kumar, Vinod; Munoli, Karishma

    2015-01-01

    Ocular disturbances such as blurring of vision, mydriasis, palpebral ptosis, diplopia, ptosis, enophthalmos, miosis, and blindness (temporary or permanent) are rare complications due to intra-oral local anesthesia. Currently, the guidelines to dentists on preventing and caring for such ocular problems are lacking. Hence, we evaluated the knowledge and attitudes of dentists toward ocular complications of intra-oral anesthesia as a means to assess the need for such guidelines. A cross-sectional prospective survey targeting dentists was conducted using a self-administered questionnaire. Totally 500 standardized self-administered questionnaires were sent out by E-mail to practicing dentists or academicians. In total, 390 replies were received, and the data were analyzed. About 39% of graduates and 14% postgraduate dentists knew about ocular complications. Journals were the leading source of information among both graduates and postgraduate dentists. 8.3% graduates and 17.6% postgraduate dentists encountered ocular complications. Interestingly most of the graduates and postgraduates responded that ocular complications are underreported in the literature. 90.5% graduates and 84.3% postgraduates are in the opinion that more research should be carried on ocular complications. 98.3% postgraduates and 97.3% graduates favored the prevention of ocular complications. The dentist's knowledge about ocular complications due to intra-oral anesthesia in our study group is not adequate and needs improvement. Although the awareness and practice of taking preventive measures are satisfactory, there is a need for specific guidelines to dentists in identifying and clinically managing ocular complications of intra-oral anesthesia.

  4. An emphasis on the wide usage and important role of local anesthesia in dentistry: A strategic review.

    Science.gov (United States)

    Singh, Preetinder

    2012-03-01

    Local anesthesia forms the major part of pain-control techniques in dentistry. The prevention and elimination of pain during dental treatment has benefited patients, their doctors and dental hygienists, enabling the dental profession to make tremendous therapeutic advances that would otherwise have been impossible. Introduced in the late 1940s, the amide local anesthetics represent the most used drugs in dentistry. Local anesthetics also represent the safest and most effective drugs in all of medicine for the prevention and management of pain. They are also accompanied by various adverse effects which should be well known and be able to be controlled by the clinician. The article reviews the types of agents used as local anesthetics and their effects on the human body.

  5. Anestesia local e sedação para cirurgia de implante coclear: uma alternativa possível Local anesthesia for cochlear implant surgery: a possible alternative

    Directory of Open Access Journals (Sweden)

    Rogério Hamerschmidt

    2010-10-01

    Full Text Available Aanestesia geral sempre foi motivo de dúvida dos pacientes que vão ser submetidos a qualquer cirurgia, especialmente o implante coclear. Como já realizamos as cirurgias otológicas com anestesia local e sedação, julgamos perfeitamente possível a realização da cirurgia do implante coclear também com esse tipo de anestesia, diminuindo os riscos, a morbidade e os custos para o hospital. OBJETIVOS: Estudo prospectivo para demonstrar a técnica anestésica e cirúrgica utilizada em três casos de adultos submetidos ao implante coclear, avaliando a segurança e a eficácia de tal técnica. MATERIAL E MÉTODOS: Foram feitas três cirurgias de implante coclear, duas com implante Cochlear e uma com Med-EL, sem intercorrências transoperatórias, durante a telemetria e no pós-operatório imediato. RESULTADOS: Os três pacientes adultos tiveram alta hospitalar aproximadamente três horas após a cirurgia, deambulando, sem eventos nauseosos, relatando um pós-operatório mais fácil do que esperavam, mesmo no momento da telemetria intraoperatória. CONCLUSÃO: Anestesia local e sedação é uma alternativa para casos selecionados de pacientes para o implante coclear, principalmente naqueles de mais idade ou que apresentem contraindicação para a anestesia geral, os riscos e a morbidade são menores.The aim of this paper is to illustrate the possibility of performing a cochlear implant surgery with local anesthesia and sedation, the anesthetic technique and the advantages of that in comparison to a general anesthesia. AIMS: prospective study demonstrating the possibility of doing cochlear implant surgery under local anesthesia and sedation. MATERIALS AND METHODS: we describe three successful cases operated under local anesthesia, including neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. RESULTS: these three surgeries show the possibility of

  6. Local anesthesia for pain control during transrectal ultrasound-guided prostate biopsy: a systematic review and meta-analysis

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    Yan P

    2016-10-01

    Full Text Available Pu Yan,* Xiao-yan Wang,* Wei Huang, Yong Zhang Beijing Tian Tan Hospital, Capital Medical University, Neurology Research Division, China National Clinical Research Center for Neurological Disease, Beijing, People’s Republic of China *These authors contributed equally to this work. Background: A meta-analysis was performed to evaluate the efficacy and safety of intrarectal local anesthestic (IRLA, periprostatic nerve block (PPNB, and the combined modalities in alleviating the pain during transrectal ultrasound (TRUS-guided prostate biopsy.Materials and methods: A literature review was performed to identify all published randomized controlled trials (RCTs about IRLA vs no anesthesia or placebo gel; PPNB vs no injection, periprostatic placebo injection, or IRLA; combined PPNB and IRLA vs PPNB alone; and combined PPNB and intraprostatic nerve block (IPNB vs PPNB alone before TRUS-guided biopsy. Sources included MEDILINE, EMBASE, and Cochrane Library from 1980 to 2016. The main outcomes were biopsy pain score, probe manipulation pain score, and anesthetic infiltration pain score assessed by the visual pain scale.Results: A total of 26 articles involving 36 RCTs were used in this analysis: Although IRLA can lead to pain reduction, the result was not statistically significant when compared with no anesthesia or placebo gel (weighted mean difference [WMD]: -0.22, 95% CI: -0.45 to 0, P=0.06. PPNB can lead to significantly lower biopsy pain scores when compared with no analgesia (WMD: -1.32, 95% CI: -1.68 to -0.95, P<0.00001, placebo injection (WMD: -2.62, 95% CI: -3.16 to -2.07, P<0.00001, or IRLA (WMD: -1.31, 95% CI: -1.40 to -1.22, P<0.00001. PPNB + IRLA can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.45, 95% CI: -0.62 to -0.28, P<0.00001. PPNB + IPNB can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.73, 95% CI: -0.92 to -0.55, P<0.00001. There were no severe

  7. Proximal Tibial Bone Harvesting Under Local Anesthesia Without Intravenous Sedation in the Dental Office: A Case Report

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    Chun-Ming Chen

    2008-02-01

    Full Text Available Maxillary sinus enlargement often occurs in the maxillary posterior edentulous area and reduces the available bone height for implantation. Therefore, maxillary sinus lift and bone graft procedures are necessary to provide sufficient available bone. Autogenous bone grafting is the best base for implant osseointegration. Recently, tibial bone has been recognized as an alternative extraoral donor site. We present a case in which we used a proximal tibia bone graft for maxillary sinus augmentation under local anesthesia without sedation in the dental office. During a 4-year postoperative follow-up, gait was not disturbed and the scar on the donor site remained unremarkable.

  8. Extraction of swallowed toothbrush in stomach by pneumatic insufflation and gastrotomy under local anesthesia: A rare occurrence.

    Science.gov (United States)

    Gupta, Mahesh; Gupta, Pooja; Gupta, Manoj

    2014-05-01

    Most of the ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation, and bleeding. Spontaneous passage of a toothbrush has not been reported till date and the technique of its removal is a curiosity for surgeons. Endoscopy is a recommended technique for the removal of such complex foreign bodies. However, if it fails, the foreign body can be removed successfully with a laparoscopic gastrotomy. We devised an innovative technique by using pneumatic gastric insufflation and extracted the toothbrush by a tiny gastrotomy under local anesthesia.

  9. Malignant ventricular dysrhythmias in a patient with isovaleric acidemia receiving general and local anesthesia for suction lipectomy.

    Science.gov (United States)

    Weinberg, G L; Laurito, C E; Geldner, P; Pygon, B H; Burton, B K

    1997-12-01

    We report the occurrence of severe ventricular arrhythmias in a patient with isovaleric acidemia during general anesthesia for suction lipectomy. The timing of events and character of the ECG changes are most consistent with bupivacaine toxicity after subcutaneous injection of tumescence solution containing this local anesthetic. The patient had previously documented carnitine deficiency, a condition which, we speculate, may lower the threshold for bupivacaine induced cardiotoxicity. We review clinical considerations in isovaleric acidemia and conclude that the use of bupivacaine in these patients probably should be avoided.

  10. Comparative clinical evaluation of transcutaneous electrical nerve stimulator over conventional local anesthesia in children seeking dental procedures: A clinical study

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    M Varadharaja

    2014-01-01

    Full Text Available Aim: The aim of this study to evaluate the effectiveness of pain control by employing transcutaneous electrical nerve stimulator (TENS over conventional injectable local anesthesia for children requiring restorative procedures under rubber dam. Materials and Methods: The study design considered was the split mouth design, in experiment (right side, dental procedures under rubber dam was performed under TENS and in control (left side, dental procedures under rubber dam was performed under conventional injectable local anesthetic (LA. The level of comfort and discomfort experienced during TENS and conventional LA was determined using visual analog scale (VAS and heart rate. Result: Increase in mean heart rate associated with TENS (0.78% was significantly less compared to increase in heart rate with administration of conventional local anesthesia (11.78%. In VAS, the mean values for pain indicate that minimum pain was felt with TENS, which was closely followed by LA. Conclusion: TENS can offer many safer and psychological advantages and is a valuable alternative to conventional LA for children.

  11. Effect of hydralazine on duration of soft tissue local anesthesia following dental treatment: a randomized clinical trial.

    Science.gov (United States)

    Fakheran Esfahani, Omid; Pouraboutaleb, Mohammad Fazel; Khorami, Behnam

    2015-01-01

    Prolonged numbness following routine dental treatments can cause difficulties in speaking and swallowing and may result in inadvertent biting of soft tissues. Local injection of vasodilator agents may represent a solution to this problem. The aim of this study was to evaluate the effect of submucosal injection of hydralazine hydrochloride (HCl) on the duration of oral soft tissue anesthesia after routine dental treatment. This randomized, single-blinded, controlled clinical trial included 50 patients who received inferior alveolar nerve block (2% lidocaine with 1:100,000 epinephrine) for simple restorative treatment. Upon completion of the dental treatment, patients randomly received a hydralazine HCl or sham injection in the same site as the local anesthetic injection. The reversal time to normal sensation of soft tissues (lips, tongue, and perioral skin) was evaluated and reported every 5 minutes by the patients, who followed an assessment protocol that they were taught in advance of treatment. Median recovery times in the hydralazine group and the sham group were 81.4 (SD, 3.6) and 221.8 (SD, 6.3) minutes, respectively. Based on Kaplan-Meier survival analysis, the duration of soft tissue anesthesia in the 2 groups was significantly different (P local anesthetic-induced soft tissue numbness and the related functional problems.

  12. Local Optimization Strategies in Urban Vehicular Mobility.

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    Pierpaolo Mastroianni

    Full Text Available The comprehension of vehicular traffic in urban environments is crucial to achieve a good management of the complex processes arising from people collective motion. Even allowing for the great complexity of human beings, human behavior turns out to be subject to strong constraints--physical, environmental, social, economic--that induce the emergence of common patterns. The observation and understanding of those patterns is key to setup effective strategies to optimize the quality of life in cities while not frustrating the natural need for mobility. In this paper we focus on vehicular mobility with the aim to reveal the underlying patterns and uncover the human strategies determining them. To this end we analyze a large dataset of GPS vehicles tracks collected in the Rome (Italy district during a month. We demonstrate the existence of a local optimization of travel times that vehicle drivers perform while choosing their journey. This finding is mirrored by two additional important facts, i.e., the observation that the average vehicle velocity increases by increasing the travel length and the emergence of a universal scaling law for the distribution of travel times at fixed traveled length. A simple modeling scheme confirms this scenario opening the way to further predictions.

  13. Propofol anesthesia.

    Science.gov (United States)

    Short, C E; Bufalari, A

    1999-05-01

    , medetomidine) or opioids (e.g., oxymorphone, butorphanol) increase the probability of respiratory depression during anesthesia. Appropriate consideration of dose reduction and speed of administration of propofol reduces the degree of depression. Cardiovascular changes induced by propofol administration consist of a slight decrease in arterial blood pressures (systolic, mean, diastolic) without a compensatory increase in heart rate. Selective premedicants markedly modify this characteristic response. 4. When coupled with subjective responses to painful stimuli, EEG responses during propofol anesthesia provide clear evidence that satisfactory anesthesia has been achieved in experimental dogs. When propofol is used as the only anesthetic agent, a higher dose is required to induce an equipotent level of CNS depression compared with the situation when dogs are premedicated. 5. The propofol induction dose requirement should be appropriately decreased by 20% to 80% when propofol is administered in combination with sedative or analgesic agents as part of a balanced technique as well as in elderly and debilitated patients. As a general recommendation, the dose of propofol should always be carefully titrated against the needs and responses of the individual patient, as there is considerable variability in anesthetic requirements among patients. Because propofol does not have marked analgesic effects and its metabolism is rapid, the use of local anesthetics, nonsteroidal anti-inflammatory agents, and opioids to provide postoperative analgesia improves the quality of recovery after propofol anesthesia. 6. The cardiovascular depressant effects of propofol are well tolerated in healthy animals, but these effects may be more problematic in high-risk patients with intrinsic cardiac disease as well as in those with systemic disease. In hypovolemic patients and those with limited cardiac reserve, even small induction doses of propofol (0.75-1.5 mg/kg i.v.) can produce profound hypotens

  14. Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial.

    Science.gov (United States)

    de Freiras, Guilherme Camponogara; Pozzobon, Roselaine Terezinha; Blaya, Diego Segatto; Moreira, Carlos Heitor

    2015-01-01

    The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18-50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. The side of the mouth where the topical anesthetic (benzocaine 20%) or the placebo was to be applied was chosen by a flip of a coin. The needle used was 27G, and the anesthetic used for administration of local anesthesia was 2% lidocaine with 1:100,000 epinephrine. After receiving the administration of local anesthesia, each patient reported pain perception on a visual analog scale (VAS) of 100-mm length. The results showed that the topical anesthetic and the placebo had similar effects: there was no statistically significant VAS difference between the PSA and the GPN pain ratings. A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN.

  15. Prostate innervation and local anesthesia in prostate procedures Inervação prostática e anestesia local em procedimentos prostáticos

    Directory of Open Access Journals (Sweden)

    Alexandre Oliveira Rodrigues

    2002-01-01

    Full Text Available The nerve supply of the human prostate is very abundant, and knowledge of the anatomy contributes to successful administration of local anesthesia. However, the exact anatomy of extrinsic neuronal cell bodies of the autonomic and sensory innervation of the prostate is not clear, except in other animals. Branches of pelvic ganglia composed of pelvic (parasympathetic and hypogastric (sympathetic nerves innervate the prostate. The autonomic nervous system plays an important role in the growth, maturation, and secretory function of this gland. Prostate procedures under local anesthesia, such as transurethral prostatic resections or transrectal ultrasound-guided prostatic biopsy, are safe, simple, and effective. Local anesthesia can be feasible for many special conditions including uncomplicated prostate surgery and may be particularly useful for the high-risk group of patients for whom inhalation or spinal anesthesia is inadvisable.A prostáta, uma das glândulas sexuais acessórias masculinas, possui inervação muito rica. A anatomia detalhada dos corpos neuronais extrínsecos responsáveis pela inervação autonômica e sensorial da próstata não está totalmente esclarecida, exceto em animais. A próstata é inervada pelos nervos pélvico (parassimpático e hipogástrico (simpático, ramos dos gânglios nervosos pélvicos. O sistema nervoso autonômico possui importante papel no crescimento, maturação e na função secretora desta glândula. Alguns procedimentos prostáticos, como resecção transuretral ou biópsia transretal guiada por ultra-sonografia, são simples, eficazes e seguros com o uso de anestesia local. Esta opção pode ser factível frente à várias condições especiais, como cirurgias prostáticas simples, sendo particularmente útil no grupo de pacientes de alto risco cirúrgico, onde a anestesia inalatória ou espinhal não é aconselhável.

  16. Tumescent Local Anesthesia for Hand Surgery: Improved Results, Cost Effectiveness, and Wide-Awake Patient Satisfaction

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    Donald Lalonde

    2014-07-01

    Full Text Available This is a review article of the wide-awake approach to hand surgery. More than 95% of all hand surgery can now be performed without a tourniquet. Epinephrine is injected with lidocaine for hemostasis and anesthesia instead of a tourniquet and sedation. This is sedation-free surgery, much like a visit to a dental office. The myth of danger of using epinephrine in the finger is reviewed. The wide awake technique is greatly improving results in tendon repair, tenolysis, and tendon transfer. Here, we will explain its advantages.

  17. Herniorrafia inguinal em crianças: valor da anestesia local associada Inguinal hernia repair in children: importance of local anesthesia association

    Directory of Open Access Journals (Sweden)

    José Guilherme Minossi

    2002-07-01

    Full Text Available OBJETIVO: Descrever uma técnica de anestesia local no tratamento de hérnias inguinais em crianças. MÉTODO: Foram operadas 48 crianças com hérnias inguinais sob anestesia local na Santa Casa de Misericórdia de Cerqueira César, SP, sendo 34 do sexo masculino e 14 do sexo feminino, com idades entre 3 meses e 12 anos. Apenas quatro crianças tinham hérnia bilateral. A anestesia local foi realizada com lidocaína a 1% na dose de 5 mg/kg de peso através do bloqueio dos nervos abdominogenitais próximos à espinha ilíaca ântero-superior, à altura do anel inguinal externo e na pele ao redor da incisão. A sedação foi feita com cetamina na dose de 1 a 2 mg/kg e diazepam 0,2 a 0,4 mg/kg de peso. RESULTADOS: Todas as cirurgias puderam ser realizadas com tranqüilidade com este método, com exceção de uma criança em que o bloqueio não foi efetivo e a anestesia complementada com inalação de halogenado, sob máscara. Como complicações pós-operatórias, ocorreram três hematomas, sendo um de parede e dois em bolsa escrotal, todos com boa evolução. CONCLUSÕES: O uso da anestesia local associada à sedação é procedimento simples e seguro para realizar herniorrafias inguinais em crianças.AIM: To describe an anesthetic technique, as well as the results of surgical treatment of the inguinal hernia in children. PATIENTS/METHODS: Forty-eight patients were submitted to inguinal hernia repair under local anesthesia at "Santa Casa de Misericórdia de Cerqueira César", State of São Paulo, Brazil. There were 34 male and 14 female patients, range from 3 months to 12 years old. Local anesthesia was performed with a dose of 5 mg/kg body weight of 1% lidocaine through iliohypogastric and ilioinguinal nerve blocks, medially to the anterior superior iliac spine, and at level of the pubic tubercle. Sedation was done with an association of ketamine (1 to 2 mg/kg and diazepam (0,2 to 0,4 mg/kg. RESULTS: In all patients except one the procedure was

  18. Regional anesthesia for pediatrics

    OpenAIRE

    Türk, Hacer Şebnem; Işıl, Canan Tülay; Açık, Mehmet Eren; Ediz, Naim; Sayın, Pınar; Tombul, Merih; Oba, Sibel

    2015-01-01

    Objectives: Relevancy to regional anesthesia in pediatrics has increased, because it is complementary to general anesthesia, allows conscious postoperative analgesia without respiratory depression, technical difficulties have been defeated and new local anesthetics have been improved. Therefore we reported data of patients who underwent pediatric surgery and received regional anesthesia.Patients and methods: We retrospectively analyzed data of all patients, who were operated in the pediatric ...

  19. Outpatient surgical treatment of female stress urinary incontinence under local anesthesia-sedation with contrasure needleless incision.

    Science.gov (United States)

    Navalón, V; Navalón, P; Pallás, Y; Ordoño, F; Monllor, E

    2014-01-01

    To evaluate the results obtained from out-patient surgical treatment of female stress urinary incontinence (SUI) with the use of trans-obturator tape (TOT) of a single Contrasure-Needleless incision (Neomedic-International). We performed an intervention with local anesthesia-sedation in outpatient regime between January 2007 to December 2011 on 96 patients affected by SUI using the placement of Needleless tension-free suburethral sling. Inclusion and discharge criteria and the results obtained as well as satisfaction grade were evaluated by a questionnaire. All the patients underwent a stress test, urodynamic study and quality of life questionnaire (ICIQ-SF) prior to and at least 3 months after the intervention. Tolerance to the procedure was good. Surgical time was less than 10 minutes and stay in the hospital up to discharge less than 2hours. The results obtained are superimposable to those reached with epidural anesthesia and hospitalization, the grade of satisfactions with the treatment received being superior to 90%. Almost all of the patients affected are candidates for inclusion in an outpatient surgery program. This noticeably improves the cost-efficacy ratio, without decreasing the health care or grade of satisfaction. Furthermore, the Contasure-Needleless system fulfills the criteria for minimally invasive surgery, providing better stability of the sling than the third generation "minibands" due to the greater length of the mesh and less post-operative pain regarding the conventional TOT as no cutaneous incisions are required. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  20. Optimization of a Pain Model: Effects of Body Temperature and Anesthesia on Bladder Nociception in Mice

    Science.gov (United States)

    Sadler, Katelyn E.; Stratton, Jarred M.; DeBerry, Jennifer J.; Kolber, Benedict J.

    2013-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating urological condition that is resistant to treatment and poorly understood. To determine novel molecular treatment targets and to elucidate the contribution of the nervous system to IC/BPS, many rodent bladder pain models have been developed. In this study we evaluated the effects of anesthesia induction and temperature variation in a mouse model of bladder pain known as urinary bladder distension (UBD). In this model compressed air is used to distend the bladder to distinct pressures while electrodes record the reflexive visceromotor response (VMR) from the overlying abdominal muscle. Two isoflurane induction models are commonly used before UBD: a short method lasting approximately 30 minutes and a long method lasting approximately 90 minutes. Animals were anesthetized with one of the methods then put through three sets of graded bladder distensions. Distensions performed following the short anesthesia protocol were significantly different from one another despite identical testing parameters; this same effect was not observed when the long anesthesia protocol was used. In order to determine the effect of temperature on VMRs, animals were put through three graded distension sets at 37.5 (normal mouse body temperature), 35.5, and 33.5°C. Distensions performed at 33.5 and 35.5°C were significantly lower than those performed at 37.5°C. Additionally, Western blot analysis revealed significantly smaller increases in spinal levels of phosphorylated extracellular-signal regulated kinase 2 (pERK2) following bladder distension in animals whose body temperature was maintained at 33.5°C as opposed to 37.5°C. These results highlight the significance of the dynamic effects of anesthesia on pain-like changes and the importance of close monitoring of temperature while performing UBD. For successful interpretation of VMRs and translation to human disease, body temperature should be maintained at 37.5

  1. Optimization of a pain model: effects of body temperature and anesthesia on bladder nociception in mice.

    Science.gov (United States)

    Sadler, Katelyn E; Stratton, Jarred M; DeBerry, Jennifer J; Kolber, Benedict J

    2013-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating urological condition that is resistant to treatment and poorly understood. To determine novel molecular treatment targets and to elucidate the contribution of the nervous system to IC/BPS, many rodent bladder pain models have been developed. In this study we evaluated the effects of anesthesia induction and temperature variation in a mouse model of bladder pain known as urinary bladder distension (UBD). In this model compressed air is used to distend the bladder to distinct pressures while electrodes record the reflexive visceromotor response (VMR) from the overlying abdominal muscle. Two isoflurane induction models are commonly used before UBD: a short method lasting approximately 30 minutes and a long method lasting approximately 90 minutes. Animals were anesthetized with one of the methods then put through three sets of graded bladder distensions. Distensions performed following the short anesthesia protocol were significantly different from one another despite identical testing parameters; this same effect was not observed when the long anesthesia protocol was used. In order to determine the effect of temperature on VMRs, animals were put through three graded distension sets at 37.5 (normal mouse body temperature), 35.5, and 33.5°C. Distensions performed at 33.5 and 35.5°C were significantly lower than those performed at 37.5°C. Additionally, Western blot analysis revealed significantly smaller increases in spinal levels of phosphorylated extracellular-signal regulated kinase 2 (pERK2) following bladder distension in animals whose body temperature was maintained at 33.5°C as opposed to 37.5°C. These results highlight the significance of the dynamic effects of anesthesia on pain-like changes and the importance of close monitoring of temperature while performing UBD. For successful interpretation of VMRs and translation to human disease, body temperature should be maintained at 37.5

  2. [Comparison of two modified lidocaine solutions for local anesthesia in blepharoplasty].

    Science.gov (United States)

    Fonseca Júnior, Nilson Lopes da; Lucci, Lucia Miriam Dumont; Badessa, Marianne Peixoto Sobral Giroldo; Rehder, José Ricardo Carvalho Lima

    2009-01-01

    To compare pain on injection of two modified anesthetic lidocaine solutions for use in upper blepharoplasty: 2% lidocaine with 1:100,000 epinephrine, and 2% lidocaine with 1:100,000 epinephrine buffered 9:1 with 8.4% sodium bicarbonate. In this prospective, double-masked study, 25 consecutive patients undergoing upper blepharoplasty were submitted to the anesthesic procedure. Each eyelid received one of two modified lidocaine solutions. Heart rate, systemic arterial pressure and oxygen saturation level were obtained before, during and after injection of two different anesthetic solutions. Patients used a 4-point scale to rate the perceived pain on injection. All parameters were statistically analyzed and there was a significant difference in heart rate and oxygen saturation level. Pain on injection of eyelid anesthesia does not differ significantly with either buffered or unmodified lidocaine solutions.

  3. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

    Directory of Open Access Journals (Sweden)

    Flamer D

    2011-11-01

    Full Text Available David Flamer, Philip WH PengDepartment of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaPurpose: To provide a review of local anesthetic (LA agents and adjuncts, opioids and muscle relaxants, and their intraoperative effects and postoperative outcomes in intravenous regional anesthesia (IVRA.Source: A search for prospective, double-blind, randomized controlled trials evaluating LA agents, opioids and muscle relaxants as adjuvants for IVRA, was conducted (MEDLINE®, Embase. Intraoperative benefits (onset/recovery of sensory and motor block, intraoperative analgesia, tourniquet pain, postoperative benefits (pain score, analgesic consumption, time to first analgesia, and side effects were recorded. A conclusion for overall benefit was made based on statistical significance and clinical relevance.Findings: Thirty-one studies were evaluated, with data collected on 1523 subjects. LA agents evaluated were lidocaine, ropivacaine, and prilocaine. Adjuncts evaluated were opioids (morphine, fentanyl, meperidine, sufentanil, tramadol and muscle relaxants (pancuronium, atracurium, mivacurium, cisatacurium. There was good evidence that ropivacaine provided effective IVRA and improved postoperative analgesia. Lidocaine and prilocaine were effective LA agents, however they lacked postoperative benefits. Morphine, fentanyl, and meperidine as sole adjuncts did not demonstrate clinically significant benefits or result in an increased risk of side effects. Sufentanil data was limited, but appeared to provide faster onset of sensory block. Tramadol provided faster onset of sensory block and tourniquet tolerance, however postoperative benefits were not consistent and the risk of minor side effects increased. Muscle relaxants improved the quality of motor block, but at the expense of delayed motor recovery. The combination of fentanyl and muscle relaxants can achieve an equivalent quality of IVRA with 50

  4. Evaluating complications of local anesthesia administration and reversal with phentolamine mesylate in a portable pediatric dental clinic.

    Science.gov (United States)

    Boynes, Sean G; Riley, Amah E; Milbee, Sarah; Bastin, Meghan R; Price, Maylyn E; Ladson, Andrea

    2013-08-01

    This study sought to identify and quantify complications with local anesthetic administration and reversal on consecutive patients seen for comprehensive dental care in a school-based, portable dental clinic, and includes data on the patients seen by the participating portable dental providers. In 923 dental visits where local anesthetic was administered, a standardized form was used to gain further information and identify any complications; this was accompanied by a questionnaire for the student's teacher, in order to quantify the student's distraction and disruption ratings following the dental visit. After statistical analysis of the 923 consecutive cases, the overall complication rate was 5.3%. All of the complications were considered to be mild or moderate, and there were no severe event reports. The complications encountered most frequently (n = 49) were associated with self-inflicted soft tissue injury. The results of this study indicate that comprehensive care with local anesthesia delivered by a school-based portable dental clinic has a low risk of complications. Whereas safe administration of dental care is achievable with or without phentolamine mesylate as a local anesthetic reversal agent, its use was determined to improve safety outcomes. Three factors appeared to directly increase the incidence of complications: the administration of an inferior alveolar nerve block, attention deficit disorder, and obesity. Teacher evaluations demonstrated that children receiving care by a portable dental team were able to reorient back to classwork and were not disruptive to classmates.

  5. Modified and systematically-designed installation procedure for spinal cord stimulation in the decubitus position under local anesthesia: a introductory technical case report.

    Science.gov (United States)

    Orita, Sumihisa; Shiga, Yasuhiro; Fujimoto, Kazuki; Sainoh, Takeshi; Kubota, Go; Inage, Kazuhide; Sato, Jun; Yamauchi, Kazuyo; Aoki, Yasuchika; Nakamura, Junichi; Matsuura, Yusuke; Suzuki, Takane; Takahashi, Kazuhisa; Ohtori, Seiji

    2015-01-01

    Spinal cord stimulation (SCS) is sometimes preferable in some refractory chronic lower back pain (LBP) pathologies. SCS involves an insertion of electrode leads into the epidural space in the prone position under local anesthesia, followed by neurostimulator implantation under local/general anesthesia. These continuous procedures can cause transient post-operative LBP exacerbation and to make temporary pockets that will store redundant leads in it with some risk of subcutaneous irritation and infection in addition to making extra incisions. We introduce a modified simpler method for SCS implantation, systematically designed to be performed only under local anesthesia in a decubitus, non-prone position. An 81-year-old patient with FBSS was treated. A physician was able to insert SCS leads with ease while the patient was in a decubitus position. The patient was comfortable, under totally local anesthesia, and the procedure produced no extra subcutaneous pockets. The patient felt almost no LBP and reported no pain exacerbation during the operation. The SCS installation provided the patient with great improvement in both her lower back (NRS from 8 to 0-1) and leg (from 7 to 2) pain with a great improvement in her daily life activities. No adverse events were observed during the perioperative period. The modified SCS insertion method enabled us to achieve both intraoperative pain relief and complete SCS implantation in a minimally invasive manner.

  6. [Professional, criminal and civil responsibility and the legal medical aspects of the performance of the dentist practicing local anesthesia and tooth extractions].

    Science.gov (United States)

    Debernardi, C

    1990-09-01

    The paper affirms that the dentist can come up against severe complications while exercising his profession which expose him to charges outlined by the Penal and Civil Codes. The circumstances in which the operator's responsibility can be questioned during the use of local anesthesia and extraction are discussed.

  7. ON OPTIMAL LOCAL BUFFER ALLOCATION IN FLEXIBLE MANUFACTURING SYSTEMS

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    An optimal design problem of local buffer allocation in the FMS is discussed in order to maximize a reward earned from processed jobs at all workstations. Structural properties of the optimal design problem are analyzed for the model with two job routing policies. Based on these properties, approaches to optimal solutions are given.

  8. Efeitos cardiovasculares da anestesia local com vasoconstritor durante exodontia em coronariopatas Cardiovascular effects of local anesthesia with vasoconstrictor during dental extraction in coronary patients

    Directory of Open Access Journals (Sweden)

    Valeria C. L. S. Conrado

    2007-05-01

    during or after dental treatment under anesthesia with vasoconstrictor (epinephrine. METHODS: A total of 54 coronary patients undergoing dental extraction under local anesthesia with or without vasoconstrictor were included. They were divided into two groups (by drawing envelopes: group I (27 patients using anesthetics with vasoconstrictor, and group II (27 cases without vasoconstrictor. 24-hour Holter monitoring, Doppler-echocardiogram before and after dental intervention, and determination of biochemical markers (CK-MB mass, CK-MB activity, and troponin T before and 24 hours after dental extraction were performed in all patients. Heart rate and blood pressure were also measured in the pre, post-anesthesia and post-dental extraction phases. Doppler echocardiography assessed left ventricular segmental contractility and the occasional occurrence of mitral regurgitation. The usual pharmaceutical treatment prescribed by the cardiologist was maintained in all cases. RESULTS: Three patients in group I presented ST-segment depression (1.0 mm during administration of anesthesia; two other patients in group I had CK-MB mass elevation, and ischemia was not observed in any other case, as assessed by the other methods. No chest pain, arrhythmias, occurrence or worsening of left ventricular segmental hypocontractility or mitral regurgitation were observed in the study. CONCLUSION: Dental extraction performed under anesthesia with 1:100,000 epinephrine does not imply additional ischemic risks, as long as performed with good anesthetic technique and maintenance of the pharmacological treatment prescribed by the cardiologist.

  9. Seniors and Anesthesia

    Science.gov (United States)

    ... Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Seniors and Anesthesia The older you are, the more ...

  10. Comparative evaluation of effectiveness of intra-pocket anesthetic gel and injected local anesthesia during scaling and root planing – A split-mouth clinical trial

    Directory of Open Access Journals (Sweden)

    Kalyan Chintala

    2017-01-01

    Full Text Available Background and Aim: Pain control is an important outcome measure for successful periodontal therapy. Injected local anesthesia has been used to secure anesthesia for scaling and root planing (SRP and continues to be the anesthetic of choice for pain control. Alternatively, intra-pocket anesthetic gel has been used as an anesthetic during SRP. Hence, this clinical trial was done to compare the effectiveness of intra-pocket anesthetic gel and injected local anesthesia during SRP and also to assess the influence of intra-pocket anesthetic gel on treatment outcomes in chronic periodontitis patients. Materials and Methods: Fifteen systemically healthy chronic periodontitis patients were recruited. The dental quadrants on right side received either intra-pocket 20% benzocaine gel (Gel group or infiltration/block by 2% lidocaine with 1:80,000 adrenaline (injection group. Quadrants on the left side received the alternative. Pain perception and patients preference for the type of anesthesia was recorded. Clinical parameters: plaque index, modified gingival index, modified sulcular bleeding index, probing pocket depth, and clinical attachment level were recorded at baseline and 1 month after treatment. Results: No difference was observed in visual analog scale (P > 0.05 and verbal rating scale (P > 0.05 pain perception between gel group and injection group. A slightly increased preference to gel as anesthesia (53% vs. 47% was observed. The treatment outcome after SRP did not show a significant difference between gel and injection group (P > 0.05. Conclusion: Intra-pocket administration of 20% benzocaine gel may be effective for pain control during SRP and may offer an alternative to conventional injection anesthesia.

  11. Ophthalmologic complications after intraoral local anesthesia: case report and review of literature

    NARCIS (Netherlands)

    Steenen, S.A.; Dubois, L.; Saeed, P.; de Lange, J.

    2012-01-01

    Intraoral administration of local anesthetics is one of the most common dental procedures. Ophthalmologic complications can occur after maxillary as well as mandibular local anesthetic injections and may be underreported and sometimes misinterpreted. A review of the literature from the years

  12. [Internal medicine and local anesthesia in dentistry. A review of possible side effects].

    Science.gov (United States)

    Fennis, J F

    1996-05-01

    When using local anaesthesia the dentist may be confronted with a variety of side effects, either caused by the anaesthetic solution itself or its additives, including vasoconstrictive drugs such as epinephrine. Early recognition and treatment of these side-effects are essential. Even more important is the possible prevention of such side-effects by a properly taken medical history before using local anaesthesia.

  13. Ophthalmologic complications after intraoral local anesthesia: case report and review of literature

    NARCIS (Netherlands)

    Steenen, S.A.; Dubois, L.; Saeed, P.; de Lange, J.

    2012-01-01

    Intraoral administration of local anesthetics is one of the most common dental procedures. Ophthalmologic complications can occur after maxillary as well as mandibular local anesthetic injections and may be underreported and sometimes misinterpreted. A review of the literature from the years 1936-20

  14. Student-to-student local anesthesia injections in dental education: moral, ethical, and legal issues.

    Science.gov (United States)

    Rosenberg, Morton; Orr, Daniel L; Starley, Eric D; Jensen, Dayne R

    2009-01-01

    This article reports the findings of a survey-based study conducted to determine U.S. dental schools' institutional protocols regarding the practice of students' administering local anesthetic injections to fellow students as part of their process of learning this skill. The majority of schools ask students to practice local anesthetic injections on each other without obtaining informed consent.

  15. OPTIMIZING LOCAL BUDGET BALANCING IN ROMANIA

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    Gyorgy Adina Crsitina

    2011-07-01

    Full Text Available The importance of the local public finance is growing in accordance with the increasing proportion of the decentralization process. The mechanism of resource allocation, and especially the allocation criteria used, constitutes subjects of debate. Our objective pursued is to assess whether the avoidance of the first step for balancing the allocation of funds can provide enhanced fairness in balancing the local budgets across the country. Local budgets in Romania receive significant resources from the state budget in the form of amounts and quotas distributed from certain taxes, which are revenues for the state budget. Some of these amounts are designed to balance the local budgets. The distribution of funds from the state budget to the local budgets requires two steps. Firstly, the amounts are divided by county, secondly, these amounts are directed within the county especially towards localities which have a lower financial standing. Given the significant disparities between counties, we believe that this mechanism does not ensure fairness in the allocation because the funds distributed according to the first step may not use fair criteria to meet the requirements for balanced local budgets. Therefore, we intend to simulate a balanced allocation of national funds for eliminating the first step that produces the most significant inequities. Direct application of the second step of allocation, with its two phases, will provide more funds serving those local administrative units for the income tax per capita is lower than the national average. Comparing the values allocated for the year 2011 with those obtained in the simulation we will examine changes that occur after the application of this method which seems to be more equitable and appropriate. This work was supported by CNCSISUEFISCSU, project number PNII-IDEI 1780/2008

  16. Optimal hand washing technique to minimize bacterial contamination before neuraxial anesthesia: a randomized control trial.

    Science.gov (United States)

    Siddiqui, N; Friedman, Z; McGeer, A; Yousefzadeh, A; Carvalho, J C; Davies, S

    2017-02-01

    Infectious complications related to neuraxial anesthesia may result in adverse outcomes. There are no best practice guidelines regarding hand-sanitizing measures specifically for these procedures. The objective of this study was to compare the growth of microbial organisms on the operator's forearm between five common techniques of hand washing for labor epidurals. In this single blind randomized controlled trial, all anesthesiologists performing labor epidurals in a tertiary care hospital were randomized into five study groups: hand washing with alcohol gel only up to elbows (Group A); hand washing with soap up to elbows, sterile towel to dry, followed by alcohol gel (Group B); hand washing with soap up to elbows, non-sterile towel to dry, followed by alcohol gel (Group C); hand washing with soap up to elbows, non-sterile towel to dry (Group D) or hand washing with soap up to elbows, sterile towel to dry (Group E). The number of colonies for each specimen/rate per 100 specimens on one or both arms per group was measured. The incidence of colonization was 2.5, 23.0, 18.5, 114.5, and 53.0 in Groups A, B, C, D and E, respectively. Compared to Group A, the odds ratio of bacterial growth for Group B was 1.52 (P=0.519), Group C 5.44 (P=0.003), Group D 13.82 (Phand-sanitizing practices among epidural practitioners. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. [Optimal dose of midazolam as premedicant for combined spinal and epidural anesthesia with midazolam sedation].

    Science.gov (United States)

    Tabuchi, Y

    1992-04-01

    Sixty patients who underwent simple total hysterectomy under combined spinal and epidural anesthesia with midazolam sedation, were the subjects of a randomized double-blind comparison of intramuscular midazolam 4, 4.5 and 5 mg, and a dose determined by body weight as premedicants. Similar changes in arterial pressure and heart rate were observed. Furthermore sedation and the value of pulse oximetry on arrival were the same. Besides half the patients were amnesic during the procedure of regional approach. However the dose of premedicant was inversely correlated with the maintenance dose. The reduction of pulse oximetry reading on the induction was smaller, while the requirement of vasopressor occurred earlier following the larger dose of premedicant. In spite of the slower induction, the fall of pulse oximetry reading did not decrease. One hour after incision, the reduction of PaO2 was not dose related. In addition count of leucocyte and the level of blood glucose were unchanged. Premedicant determined by body weight was not correlated with the induction dose and amnesic effect. Our findings suggest midazolam 5 mg intramuscularly is the more preferable dose, but careful attention on arterial pressure is required.

  18. Onset and duration of anesthesia for local anesthetic combinations commonly used in forefoot surgery; surprise results with sequential blocks.

    Science.gov (United States)

    Blazer, Marie Mantini; Petrozzi, Rocco; Harris, Samantha Y; Greer, Hillary; Goldfarb, Jacqueline; Biernacki, Tomasz; Kawalec, Jill S

    2015-06-01

    Local anesthetic nerve blocks are frequently used for postoperative analgesia and to the best of our knowledge no studies have evaluated the effects of injecting bupivacaine into an area previously injected with lidocaine. Sensation was tested in three groups of subjects receiving local anesthetic digital blocks. Group A received bupivacaine 0.25% plain. Group B received a 1:1 mixture of lidocaine 1% plain and bupivacaine 0.25%. Group C received an initial block of lidocaine 1% plain sequentially followed by bupivacaine 0.25% 1h later. Bupivacaine exhibited a delayed onset and the longest duration when compared to the other two groups. The group receiving the 1:1 mixture showed a rapid onset that resembled that of lidocaine and a shortened duration that did not resemble bupivacaine. The group receiving the sequential injections showed that even after a 1h interval following the lidocaine infiltration, there was a deleterious effect on duration of action of the bupivacaine. Using bupivacaine as a post-surgical block in the presence of residual lidocaine from a preoperative block is not warranted as once again, the extended duration of bupivacaine is mitigated. Bupivacaine alone as an initial operative block affords clinically acceptable onset of anesthesia while also providing extended duration of action.

  19. Tratamento cirúrgico das hérnias inguinais sob anestesia local em ambulatório Inguinal herniorrhaphy with local anesthesia as na outpatient procedure

    Directory of Open Access Journals (Sweden)

    Rafael Melillo Laurino Neto

    2004-04-01

    Full Text Available OBJETIVOS: Apresentar o programa e avaliar a tolerância dos pacientes à correção das hérnias inguinais em ambulatório sob anestesia local. MÉTODO: Foram analisados 61 pacientes submetidos a tratamento cirúrgico de hérnia inguinal unilateral não complicada, sob anestesia local em ambulatório no Serviço de Cirurgia Geral do Conjunto Hospitalar do Mandaqui, entre fevereiro de 2000 e agosto de 2002. Respeitandose rígidos critérios na seleção dos pacientes, e com os mesmos sob sedação e monitorização contínua, realizou-se bloqueio de campo conforme padronização do serviço. A técnica de reforço da parede abdominal foi definida levando-se em consideração o tipo de hérnia, idade do paciente e sua atividade profissional. Todos os pacientes receberam alta hospitalar em até quatro horas após a cirurgia respeitando-se as condições estabelecidas pela resolução CFM nº 1.409/94, com orientações precisas quanto a possíveis complicações imediatas e retorno para atendimento em Pronto-Socorro caso necessário. RESULTADOS: O tempo cirúrgico médio foi de 1h30min. Quanto ao tipo de hérnia, segundo a classificação de Nyhus, prevaleceu o tipo III B (36%, seguido dos tipos III A (34,5% e II (26,2%. A técnica de reforço mais utilizada foi a de Lichtenstein (80,3%. Quanto à avaliação da dor intra-operatória, 73,8% dos pacientes deram notas igual ou inferior a 3 numa escala de 0 a 10 e 95% afirmaram que se submeteriam novamente a tal procedimento sob anestesia local. CONCLUSÕES: O tratamento cirúrgico das hérnias inguinais sob anestesia local em ambulatório, é procedimento seguro e bem aceito pela maioria dos pacientes quando realizado de forma padronizada.BACKGROUND: To present the program and to evaluate the patient's tolerance to herniorrhaphy in an outclinic under local anesthesia. METHODS: Between February 2000 and August 2002, 61 patients with non complicated unilateral inguinal hernia were treated under local

  20. Experience with polymethylmethacrylate 30% (PMMA facial filling in patients with facial HIV lipoatrophy using of local anesthesia dentistry

    Directory of Open Access Journals (Sweden)

    E Matsuda

    2012-11-01

    Full Text Available Background HIV-associated lipoatrophy in a common and stigmatizing side effect of HIV infection, is aggravated by antiretroviral therapy; its presence causes distress and compromises adherence to therapy. PMMA filling is often associated with pain and discomfort. Objective To evaluate outpatient intervention using local dentistry anesthesia. Methods Patients complaining of facial lipoatrophy, from 10/2007 to 11/2011, were offered the filling with PMMA. Cases with bleeding potential, acute or decompensated chronic diseases or use of immunosuppressors or chemotherapy were excluded. Inclusion criteria: perception of distressing malar lipoatrophy and both the assisting physician and the applicant agreeing with potential benefit. After informed consent, patients were infused with 30 mg prilocaine/0.03 IU felypressin in 1.8 ml, using a carpule type syringe aiming to block the posterior superior alveolar nerve. This was followed by PMMA infiltration in different points at the malar region. At first return a simple questionnaire evaluating pain, satisfaction, grading 0 to 10 and if would repeat the procedure. Results All 64 eligible patients were included. Mean age 46 (13 to 73 years, mostly white (71.87%, males (68.75%, 37.5% of them MSM. Arterial hypertension was the most prevalent comorbidity (17%, 78% with viral load <50 c/mL, with a median 585 CD4 cells/mL (95–2063. On a median of 8 years on treatment, 1/3 had been exposed to three classes (NRTI/ NNRTI/PI, one antiretroviral-naïve. Of the 12 patients who had detectable viral load in the first procedure, seven were suppressed to below 50 copies/mL during follow up. Two of the five patients remaining with detectable viremia died from other causes, 2 transferred and 1 remained naïve. 127 procedures were made in 64 patients, a median of 2 (1–6 per patient. After a mean follow-up of 33 weeks, no infection or late complications were observed. Mean dispensed volume was 9 mL (1.5 to 22. Pain grade

  1. Perioperative blood ordering optimization process using information from an anesthesia information management system.

    Science.gov (United States)

    Rinehart, Joseph B; Lee, Tiffany C; Kaneshiro, Kayleigh; Tran, Minh-Ha; Sun, Coral; Kain, Zeev N

    2016-04-01

    As part of ongoing perioperative surgical home implantation process, we applied a previously published algorithm for creation of a maximum surgical blood order schedule (MSBOS) to our operating rooms. We hypothesized that using the MSBOS we could show a reduction in unnecessary preoperative blood testing and associated costs. Data regarding all surgical cases done at UC Irvine Health's operating rooms from January 1, 2011, to January 1, 2014 were extracted from the anesthesia information management systems (AIMS). After the data were organized into surgical specialties and operative sites, blood order recommendations were generated based on five specific case characteristics of the group. Next, we assessed current ordering practices in comparison to actual blood utilization to identify potential areas of wastage and performed a cost analysis comparing the annual hospital costs from preoperative blood orders if the blood order schedule were to be followed to historical practices. Of the 19,138 patients who were categorized by the MSBOS as needing no blood sample, 2694 (14.0%) had a type and screen (T/S) ordered and 1116 (5.8%) had a type and crossmatch ordered. Of the 6073 procedures where MSBOS recommended only a T/S, 2355 (38.8%) had blood crossmatched. The cost analysis demonstrated an annual reduction in actual hospital costs of $57,335 with the MSBOS compared to historical blood ordering practices. We showed that the algorithm for development of a multispecialty blood order schedule is transferable and yielded reductions in preoperative blood product screening at our institution. © 2016 AABB.

  2. Topical anesthesia

    Directory of Open Access Journals (Sweden)

    Mritunjay Kumar

    2015-01-01

    Full Text Available Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel. While using them, careful attention must be paid to their pharmacology, area and duration of application, age and weight of the patients and possible side-effects.

  3. Intracranial hemorrhagic infarct after local anesthesia on nasal mucosa: A case report

    Directory of Open Access Journals (Sweden)

    Murat Koçyiğit

    2015-01-01

    Conclusion: We want to emphasize that all surgeons especially the ENT surgeons should be careful while using local anesthetic medicines which contains adrenaline for rare complication of intracranial hemorrhagic infarction. Another fact is that the patients must sign an informed consent form including those situations even for all minor surgical procedures to avoid a medicolegal problem.

  4. Optimal operation of water distribution networks under local pipe failures

    Institute of Scientific and Technical Information of China (English)

    TIAN Yi-mei; G.Y.FU; CHI Hai-yan; LIU Ye

    2007-01-01

    The optimal operation of water distribution networks under local pipe failures, such as water main breaks, was proposed.Based on a hydraulic analysis and a simulation of water distribution networks, a macroscopic model for a network under a local pipe failure was established by the statistical regression. After the operation objectives under a local pipe failure were determined, the optimal operation model was developed and solved by the genetic algorithm. The program was developed and examined by a city distribution network. The optimal operation alternative shows that the electricity cost is saved approximately 11%, the income of the water corporation is increased approximately 5%, and the pressure in the water distribution network is distributed evenly to ensure the network safe operation. Therefore, the proposed method for optimal operation under local pipe failure is feasible and cost-effective.

  5. General and Optimal Scheme for Local Conversion of Pure States

    Institute of Scientific and Technical Information of China (English)

    JIN Rui-Bo; CHEN Li-Bing; WANG Fa-Qiang; LU Yi-Qun

    2008-01-01

    We present general and optimal schemes for local conversion of pure states, via one specific example. First, we give the general solution of the doubly stochastic matrix. Then, we find the general and optimal positive-operator-valued measure (POVM) to realize the local conversion of pure states. Lastly, the physical realization of the POVM is discussed. We show that our scheme has a more general and better effect than other schemes.

  6. The Effect of Different Local Anesthesia Methods on Pain Relief in Outpatient Endometrial Biopsy: Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Elaheh Olad-Saheb-Madarek

    2013-08-01

    Full Text Available Introduction: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

  7. The pharmacokinetics and effects of meloxicam, gabapentin, and flunixin in postweaning dairy calves following dehorning with local anesthesia.

    Science.gov (United States)

    Glynn, H D; Coetzee, J F; Edwards-Callaway, L N; Dockweiler, J C; Allen, K A; Lubbers, B; Jones, M; Fraccaro, E; Bergamasco, L L; KuKanich, B

    2013-12-01

    Approved analgesic compounds in cattle are not currently available in the United States due to the lack of validated pain assessment methods and marker residue depletion studies. In this study, we compared the pharmacokinetic parameters and effect of preemptive analgesics administered to calves subjected to dehorning with local anesthesia. Holstein steers were randomly assigned to receive one of the following treatments per os (PO) or intravenously (IV) (n = 8/group): meloxicam (1 mg/kg PO), gabapentin (15 mg/kg PO), meloxicam (1 mg/kg), and gabapentin (15 mg/kg) PO, flunixin (2.2 mg/kg IV), or a placebo. Plasma drug, haptoglobin, substance P (SP) concentrations, serum cortisol concentrations, ocular thermography, mechanical nociceptive threshold (MNT), and average daily gain (ADG) were evaluated. Data were analyzed using mixed-effects models and noncompartmental pharmacokinetic analysis. Meloxicam, gabapentin, and meloxicam with gabapentin at the present doses did not reduce cortisol concentrations. Analgesic-treated calves had significantly lower plasma SP concentrations and improved ADG compared with controls. Flunixin calves had reduced circulating cortisol compared with controls. Meloxicam-treated calves showed an increase in MNT at two horn bud sites compared with the other treatments. Analgesics improved ADG and reduced biomarkers of pain, but effects differed by compound and route of administration.

  8. Single-Tooth Osteotomy Combined Wide Linear Corticotomy Under Local Anesthesia for Correcting Anterior Protrusion With Ectopically Erupted Canine.

    Science.gov (United States)

    Iskenderoglu, Nur Serife; Choi, Byung-Joon; Seo, Kyung Won; Lee, Yeon-Ji; Lee, Baek-Soo; Kim, Seong-Hun

    2017-01-01

    This article presents the alternative surgical treatments of both anterior protrusion by carrying out retraction on mandibular anterior fragment, meanwhile applying retraction force on maxilla anterior teeth and ectopically erupted canine with using platelet-rich fibrin (PRF). Anterior segmental osteotomy was combined with linear corticotomy under local anesthesia. The correction of right ectopic canine was achieved through 2 stages. First, dento-osseous osteotomy on palatal side was performed. Then second osteotomy with immediate manual repositioning of the canine with concomitant first premolar extraction was enhanced with PRF, which was prepared by centrifuging patient's blood, applied into buccal side of high canine during osteotomy. Mandibular retraction was accomplished by anterior segmental osteotomy. Single-tooth osteotomy is a more effective surgical method for ankylosed or ectopically erupted tooth in orthodontic treatment. It can reduce the total orthodontic treatment time and root resorption, 1 common complication. Significant improved bone formation was seen with the addition of PRF on noncritical size defects in the animal model. It is reasonable to think that PRF can promote bone regeneration. So early bone formation also can reduce the complication such as postoperative infection. As an alternative to anterior protrusion and ectopically erupted canine treatment, segmental osteotomy and corticotomy combined platelet-rich plasma can enhance orthodontic treatment outcome.

  9. Implantation of venous access devices under local anesthesia: patients’ satisfaction with oral lorazepam

    Directory of Open Access Journals (Sweden)

    Chang DH

    2015-07-01

    Full Text Available De-Hua Chang,1 Sonja Hiss,1 Lena Herich,2 Ingrid Becker,2 Kamal Mammadov,1 Mareike Franke,1 Anastasios Mpotsaris,1 Robert Kleinert,3 Thorsten Persigehl,1 David Maintz,1 Christopher Bangard1 1Department of Radiology, 2Institute of Medical Statistics, Informatics and Epidemiology, 3Department of Surgery, University Hospital of Cologne, Cologne, Germany Objective: The aim of the study reported here was to evaluate patients’ satisfaction with implantation of venous access devices under local anesthesia (LA with and without additional oral sedation.Materials and methods: A total of 77 patients were enrolled in the prospective descriptive study over a period of 6 months. Subcutaneous implantable venous access devices through the subclavian vein were routinely implanted under LA. Patients were offered an additional oral sedative (lorazepam before each procedure. The level of anxiety/tension, the intensity of pain, and patients’ satisfaction were evaluated before and immediately after the procedure using a visual analog scale (ranging from 0 to 10 with a standardized questionnaire.Results: Patients’ satisfaction with the procedure was high (mean: 1.3±2.0 with no significant difference between the group with premedication and the group with LA alone (P=0.54. However, seven out of 30 patients (23.3% in the group that received premedication would not undergo the same procedure without general anesthesia. There was no significant influence of lorazepam on the intensity of pain (P=0.88. In 12 out of 30 patients (40% in the premedication group, the level of tension was higher than 5 on the visual analog scale during the procedure. In 21 out of 77 patients (27.3%, the estimate of the level of tension differed between the interventionist and the patient by 3 or more points in 21 out of 77 patients (27.3%.Conclusion: Overall patient satisfaction is high for implantation of venous access devices under LA. A combination of LA with lorazepam administered

  10. Safety of Local Intracutaneous Lidocaine Anesthesia Used by Dermatologic Surgeons for Skin Cancer Excision and Postcancer Reconstruction: Quantification of Standard Injection Volumes and Adverse Event Rates.

    Science.gov (United States)

    Alam, Murad; Schaeffer, Matthew R; Geisler, Amelia; Poon, Emily; Fosko, Scott W; Srivastava, Divya

    2016-12-01

    Intracutaneous lidocaine is used for anesthesia in dermatologic surgery for skin cancer excision and repair with exceedingly low incidence of reported adverse events. To measure (1) the quantity of lidocaine typically used for facial skin cancer excision and reconstruction; and (2) the frequency and character of associated adverse events. Survey study of dermatologic surgeons with longitudinal reporting. Reported practice during 10 business days: (1) mean volume of 1% lidocaine per skin cancer excision; (2) maximum per excision; (3) mean per reconstruction; and (4) maximum per reconstruction. A total of 437 of 1,175 subjects contacted (37.2%) responded. Mean per excision was 3.44 mL (SD: 2.97), and reconstruction 11.70 mL (10.14). Maximum per excision was 6.54 mL (4.23), and reconstruction was 15.85 mL (10.39). No cases of lidocaine toxicity were reported, diagnosed, or treated. Incidence of adverse events possibly anesthesia related was >0.15%, with most (0.13%) being mild cases of dizziness, drowsiness, or lightheadedness from epinephrine tachycardia. Toxicity associated with local anesthesia other than lidocaine was not studied. Volumes of lidocaine in skin cancer excision and repair are modest and within safe limits. Lidocaine toxicity is exceedingly rare to entirely absent. For comparable indications, lidocaine is safer than conscious sedation or general anesthesia.

  11. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  12. A comparison of two anesthesia methods for the surgical removal of maxillary third molars: PSA nerve block technique vs. local infiltration technique

    OpenAIRE

    Al-Delayme, Ra´ed MA.

    2014-01-01

    Objectives: The purpose of this study was to compare the effect of PSA block injection with infiltration technique regarding local anesthesia for surgical extraction of upper third molar. Material and Methods: A prospective, intra individual, single-blind randomized controlled trial was designed to study the severity of pain during injection and after surgical extraction of the bilaterally and symmetrically similar upper third molar in a total of 53 patients, in addition to evaluating the nee...

  13. [Bilateral tubal occlusion by postpartum mini-laparotomy under local anesthesia and sedation].

    Science.gov (United States)

    Campos Gonzalez, R; López Gonzalez, E; Mercado Montoya, G; Morquecho Escamilla, E

    1993-10-01

    The first 1000 cases of tubal sterilization post-delivery by minilaparotomy with sedation and local anesthetic, were reviewed; these procedures were realized at the Hospital of Zona Francisco del Paso y Troncoso of the IMSS, in México City, during the period comprehended between December 1990 and October 1991. The greatest group of cases by age corresponded to the period between 20 to 29 years in 52.3%. 65% of the women had 3 or 4 children alive. The range of the diastolic blood pressure was between 70-80 mmHg in 66.3%. 19.7% with a value of hemoglobin less than 10 g. 2.3% of the patients with 100-120 kgs. of weight. The contraceptive method used previously with greatest frequency was the DIU in 40.6%. In all of the cases the indication was satisfied parenthood. In 100% of the cases the same drug was used for sedation, diazepam (oral) and chlorhydrate of nalbulfine, with simple lidocaine as a local anesthetic. Likewise in all the cases the Pomeroy technique was performed. The time between the childbirth and the surgery was less than 12 hours in 92.9% of the cases. And the time between the surgery and the recuperation reset was of 12-34 hours in 96%. In 0.8% of the cases the transoperatory complication of the surgery was the bleeding as a result of tearing of the mesosalpinx. The postoperatory complications after one week were the formation of hematoma and/or abscess at the site of the incision representing 0.5% of the cases. All these procedures are realized at a unit that was created especially for this kind of surgery and treatment.

  14. [Cytotoxic effects of local anesthesia through lidocaine/ropivacaine on human melanoma cell lines].

    Science.gov (United States)

    Kang, Ding-Kun; Zhao, Li-Yan; Wang, Hong-Li

    Local anesthetics (LAs) are generally considered as safe, but cytotoxicity has been reported for several local anesthetics used in humans, which is not well investigated. In the present study, the cytotoxicity of lidocaine, ropivacaine and the combination of lidocaine and ropivacaine were evaluated on human melanoma cell lines. Melphalan, a nitrogen mustard alkylating agent, was used as a control agent for comparison of cytotoxic activity. Melanoma cell lines, A375 and Hs294T, were exposed to 1h to different concentrations of above agents. Cell-viability after exposure was determined by flow cytometry. Investigated LAs showed detrimental cytotoxicity on studied melanoma cell lines in time- (p<0.001), concentration- (p<0.001), and agent dependant. In both A375 and Hs294T cell lines, minimum cell viability rates were found after 72h of exposure to these agents. Lidocaine 2% caused a reduction of vital cells to 10%±2% and 14%±2% in A375 and Hs294T, respectively after 72h of exposure. Ropivacaine 0.75% after 72h reduced viable cells to 15%±3% and 25%±3% in A375 and Hs294T, respectively. Minimum cell viability after 72h exposure to the combination was 10%±2% and 18%±2% in A375 and Hs294T, respectively. Minimum cell viability after 72h exposure to melphalan was 8%±1% and 12%±2%, in A375 and Hs294T, respectively. LAs have cytotoxic activity on human melanoma cell lines in a time-, concentration- and agent-dependant manner. Apoptosis in the cell lines was mediated through activity of caspases-3 and caspases-8. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Cytotoxic effects of local anesthesia through lidocaine/ropivacaine on human melanoma cell lines.

    Science.gov (United States)

    Kang, Ding-Kun; Zhao, Li-Yan; Wang, Hong-Li

    Local anesthetics (LAs) are generally considered as safe, but cytotoxicity has been reported for several local anesthetics used in humans, which is not well investigated. In the present study, the cytotoxicity of lidocaine, ropivacaine and the combination of lidocaine and ropivacaine were evaluated on human melanoma cell lines. Melphalan, a nitrogen mustard alkylating agent, was used as a control agent for comparison of cytotoxic activity. Melanoma cell lines, A375 and Hs294T, were exposed to 1h to different concentrations of above agents. Cell-viability after exposure was determined by flow cytometry. Investigated LAs showed detrimental cytotoxicity on studied melanoma cell lines in time- (p<0.001), concentration- (p<0.001), and agent dependant. In both A375 and Hs294T cell lines, minimum cell viability rates were found after 72h of exposure to these agents. Lidocaine 2% caused a reduction of vital cells to 10%±2% and 14%±2% in A375 and Hs294T, respectively after 72h of exposure. Ropivacaine 0.75% after 72h reduced viable cells to 15%±3% and 25%±3% in A375 and Hs294T, respectively. Minimum cell viability after 72h exposure to the combination was 10%±2% and 18%±2% in A375 and Hs294T, respectively. Minimum cell viability after 72h exposure to melphalan was 8%±1% and 12%±2%, in A375 and Hs294T, respectively. LAs have cytotoxic activity on human melanoma cell lines in a time-, concentration- and agent-dependant manner. Apoptosis in the cell lines was mediated through activity of caspases-3 and caspases-8. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  16. Inguinal hernia repair under local anesthesia%腹股沟疝手术局部麻醉方法探讨

    Institute of Scientific and Technical Information of China (English)

    国永生

    2007-01-01

    目的 介绍一种腹股沟疝手术局部麻醉方法.方法 2005年至2006年5月,对450例腹股沟疝患者行局部麻醉下日间手术治疗.结果 450例腹股沟疝患者在局部麻醉下手术均成功,无手术并发症发生.结论 局部麻醉是成年人行可复性腹股沟疝手术最好的麻醉选择.这种方法有安全、简便、有效和经济的特点,无麻醉后不良返应.%Objective To evaluate local infiltration anesthesia technique for inguinal hernia repair. Methods 450 patients with groin hernia underwent day surgery under local anesthesia . Results Procedures were successful in 450 adult patients with groin hernias without postoperative complications. Conclusion Local anesthesia is applicable for all reducible adult inguinal hernia repair.

  17. Effects of local anesthesia of the cerebellum on classical fear conditioning in goldfish

    Directory of Open Access Journals (Sweden)

    Hirano Ruriko

    2010-03-01

    Full Text Available Abstract Background Besides the amygdala, of which emotion roles have been intensively studied, the cerebellum has also been demonstrated to play a critical role in simple classical fear conditioning in both mammals and fishes. In the present study, we examined the effect of local administration of the anesthetic agent lidocaine into the cerebellum on fear-related, classical heart-rate conditioning in goldfish. Methods The effects of microinjection of the anesthetic agent lidocaine into the cerebellum on fear conditioning were investigated in goldfish. The fear conditioning paradigm was delayed classical conditioning with light as a conditioned stimulus and electric shock as an unconditioned stimulus; cardiac deceleration (bradycardia was the conditioned response. Results Injecting lidocaine into the cerebellum had no effect on the base heart rate, an arousal/orienting response to the novel stimulus (i.e., the first presentation of light, or an unconditioned response to electric shock. However, lidocaine injection greatly impaired acquisition of conditioned bradycardia. Lidocaine injection 60 min before the start of the conditioning procedure showed no effect on acquisition of conditioned bradycardia, indicating that the effect of lidocaine was reversible. Conclusions The present results further confirm the idea that the cerebellum in teleost fish, as in mammals, is critically involved in classical fear conditioning.

  18. The Analysis of Local Anesthesia Applied in Surgical Treatment of Inguinal Hernia%腹股沟疝手术的局部麻醉分析

    Institute of Scientific and Technical Information of China (English)

    王勇

    2015-01-01

    目的:分析腹股沟疝手术的局部麻醉效果。方法搜集2013年8月~2014年8月我院接收的腹股沟疝手术55例患者,按照不同麻醉方法分为对照组与研究组。给予对照组26例常规麻醉,给予研究组29例局部麻醉。观察对照组与研究组的麻醉效果,并比较。结果与对照组相比,研究组手术时间较短,并发症的发生率较低,住院天数较短,有明显差异,有统计学意义(P<0.05)。结论腹股沟疝手术局部麻醉效果较好,对减少并发症、促进患者身体恢复具有重要意义,值得推广。%Objective The local anesthesia effect on surgical treatment of inguinal hernia is to be analyzed. Methods Choose 55 patients with inguinal hernia who are treated in hospital from August 2013 to August 2014 and separate them into control group and study group according to different anesthesia methods. 26 patients in control group are given conventional anesthesia treatment,while 29 patients in control group are given local anesthesia treatment,and then observe and compare the anesthesia efficacy of two groups. Results Compared to control group,the surgical time,and hospitalization days of patients in study group are fewer,besides,the patients’complications incidence in study group are less than control group,there is a treatment differential between the two groups,such a differential has statistic value(P<0.05). Conclusion Local anesthesia treatment is much more effective to cure patients with inguinal hernia and reduce complication incidence,in addition,it is conducive to the recovery of patients. Therefore,it is quite worthy to be promoted and applied.

  19. Prosthetic repair of umbilical hernias in adults with local anesthesia in a day-case setting: a comprehensive report from a specialized hernia center.

    Science.gov (United States)

    Kulacoglu, H; Yazicioglu, D; Ozyaylali, I

    2012-04-01

    Umbilical hernia is a common surgical problem. However, there seems to be a certain discrepancy between its importance and the attention it has received in the literature to date. This prospective study aimed to report a detailed analysis of prosthetic umbilical hernia repairs with local anesthesia in a day-case setting. It was planned to enroll 100 consecutive patients who underwent an elective umbilical hernia repair with local anesthesia. Patients who required general anesthesia and simultaneous hernia repairs were excluded. The procedure including local anesthesia and intravenous sedation was explained to the patients in detail by the operating surgeons and the anesthesiologist. The following parameters were strictly recorded: gender, age, body mass index (BMI), concomitant diseases, history of hernia (primary/recurrent), size of fascial defect, duration of operation, level of intravenous sedation (light/moderate), discharge time, and complications. There were 54 male and 46 female patients. The mean age was 48.6 years (24-78 years). Four patients were older than 70 years of age. Forty-one patients had 84 concomitant diseases. Eleven patients had a recurrent hernia. Female patients more frequently presented with a recurrent hernia than male patients (19.6 vs. 3.7%, P = 0.009). A standard polypropylene mesh was used in the onlay position in 91 cases. In nine cases, a light mesh was placed in the preperitoneal space. A closed vacuum drain was left in situ in 37 cases. Light sedation was set in 86 cases, whereas 12 patients received a moderate sedation. Monitored anesthesia care was used in two cases. When moderate sedation was needed, a concurrent increase in lidocaine dose and total volume was recorded. There was a positive correlation between increased lidocaine use and high midazolam dose and additional propofol requirement. The mean total local anesthetic volume was 33 ml (10-63 ml). Lidocaine doses displayed a large range between the cases (70-600 mg). The

  20. Graph-based local elimination algorithms in discrete optimization

    CERN Document Server

    Shcherbina, Oleg

    2009-01-01

    The aim of this paper is to provide a review of structural decomposition methods in discrete optimization and to give a unified framework in the form of local elimination algorithms (LEA). This paper is organized as follows. Local elimination algorithms for discrete optimization (DO) problems (DOPs) with constraints are considered; a classification of dynamic programming computational procedures is given. We introduce Elimination Game and Elimination tree. Application of bucket elimination algorithm from constraint satisfaction (CS) to solving DOPs is done. We consider different local elimination schemes and related notions. Clustering that merges several variables into single meta-variable defines a promising approach to solve DOPs. This allows to create a quotient (condensed) graph and apply a local block elimination algorithm. In order to describe a block elimination process, we introduce Block Elimination Game. We discuss the connection of aforementioned local elimination algorithmic schemes and a way of ...

  1. Randomized clinical trial comparing spinal anesthesia with local anesthesia with sedation for loop colostomy closure Ensaio clínico randomizado comparando raquianestesia com anestesia local, associadas à sedação para o fechamento de colostomia em alça

    Directory of Open Access Journals (Sweden)

    Rone Antônio Alves de Abreu

    2010-09-01

    Full Text Available CONTEXT: Recent studies have shown that local anesthesia for loop colostomy closure is as safe as spinal anesthesia for this procedure. OBJECTIVES: Randomized clinical trial to compare the results from these two techniques. METHODS: Fifty patients were randomized for loop colostomy closure using spinal anesthesia (n = 25 and using local anesthesia (n = 25. Preoperatively, the bowel was evaluated by means of colonoscopy, and bowel preparation was performed with 10% oral mannitol solution and physiological saline solution for lavage through the distal colostomy orifice. All patients were given prophylactic antibiotics (cefoxitin. Pain, analgesia, reestablishment of peristaltism or peristalsis, diet reintroduction, length of hospitalization and rehospitalization were analyzed postoperatively. RESULTS: Surgery duration and local complications were greater in the spinal anesthesia group. Conversion to general anesthesia occurred only with spinal anesthesia. There was no difference in intraoperative pain between the groups, but postoperative pain, reestablishment of peristaltism or peristalsis, diet reintroduction and length of hospitalization were lower with local anesthesia. CONCLUSIONS: Local anesthesia plus sedation offers a safer and more effective method than spinal anesthesia for loop colostomy closure.CONTEXTO: Estudos recentes têm demonstrado que a anestesia local para o fechamento de colostomia em alça é tão segura quanto a raquianestesia para estes procedimentos. OBJETIVOS: Comparar os resultados do fechamento de colostomia em alça usando essas duas técnicas. MÉTODOS: Cinquenta pacientes foram randomizados para o fechamento de colostomia em alça sob raquianestesia (n = 25 e anestesia local (n = 25. No pré-operatório, o cólon foi avaliado por colonoscopia e o preparo intestinal foi realizado com solução oral de manitol a 10% e limpeza com solução salina fisiológica através do orifício distal da colostomia. Todos os

  2. Laser pediatric crowns performed without anesthesia: a contemporary technique.

    Science.gov (United States)

    Jacboson, B; Berger, J; Kravitz, R; Patel, P

    2003-01-01

    Extensive caries resulting in the need for a stainless steel crown in primary teeth may now be prepared with the use of the WaterlaseTM YSGG Laser, (Biolase) hard and soft-tissue laser. The use of the laser eliminates the need for local anesthesia, thereby providing optimal patient comfort and compliance.

  3. Resultados imediatos da herniorrafia inguinal com anestesia local associada com sedação Immediate results of inguinal hernia repair with local anesthesia associated with sedation

    Directory of Open Access Journals (Sweden)

    Edgar Valente de Lima Neto

    2003-10-01

    Full Text Available OBJETIVO: Avaliar os resultados imediatos da herniorrafia inguinal com anestesia local associada com sedação. MÉTODOS: Foram operados 30 pacientes portadores de hérnia inguinal, sendo 26 (86,6% do sexo masculino e 4 (13,4 do sexo feminino. Os anestésicos utilizados foram lidocaína a 1% e bupivacaína a 0,5% sem adrenalina, tendo sido adicionado 1mL de bicarbonato de sódio para cada 9mL da solução anestésica. A sedação foi realizada com midazolan. As hérnias mais freqüentes, de acordo com a classificação de Nyhus, foram as do tipo I, encontradas em 16 (53,3% pacientes. Praticou-se o reparo da parede posterior a em 17 (56,6% e em 13 (43,2% o reparo com prótese. Para a análise estatística utilizou-se o teste de McNemar para avaliar a correlação entre os escores de dor na escala E.V.A. agrupada. RESULTADOS: Em nenhum paciente houve necessidade de mudança da técnica anestésica. Entre as complicações, observaram-se: 1 (3,3% hematoma; 1 (3,3% sangramento e 1 (3,3% infecção da ferida operatória. A deambulação foi precoce em 28 (93,3% pacientes, assim como a alimentação oral. O tempo de internação médio foi 18 horas, e o escore de dor na escala visual analógica (E.V.A. foi menor ou igual a 3 em 80% dos pacientes. CONCLUSÃO: A anestesia local com sedação é um método seguro, eficaz, com baixos índices de complicações imediatas, e alto índice de satisfação para pacientes selecionados, portadores de hérnia inguinal.PURPOSE: To present the immediate results of the inguinal hernia repair with local anesthesia associated with sedation. METHODS: Thirty patients were operated on of which 26 (86,6% were male. The age varied from 21 to 76, and the average was of 47 years. The anesthetics used were lidocaine and bupivacaine, and the sedation was accomplished with midazolan. RESULTS: Among the complications was observed: 1 (3,3% bruising; 1 (3,3% blood; and 1 (3,3% case of infection of the operative wound. Early rise

  4. Parametric optimization of optical devices based on strong photonic localization

    Science.gov (United States)

    Gui, Minmin; Yang, Xiangbo

    2017-07-01

    Symmetric two-segment-connected triangular defect waveguide networks (STSCTDWNs) can produce strong photonic localization, which is useful for designing highly efficient energy storage devices, high power superluminescent light emitting diodes, all-optical switches, and more. Although STSCTDWNs have been studied in previous works, in this paper we systematically optimize the parameters of STSCTDWNs to further enhance photonic localization so that the function of optical devices based on strong photonic localization can be improved. When optimizing the parameters, we find a linear relationship between the logarithm of photonic localization and the broken degree of networks. Furthermore, the slope and intercept of the linear relationship are larger than previous results. This means that the increasing speed of photonic localization is improved. The largest intensity of photonic localizations can reach 1036, which is 16 orders of magnitude larger than previous reported results. These optimized networks provide practical solutions for all optical devices based on strong photonic localization in the low frequency range, such as nanostructured devices.

  5. Geometrical optimization of a local ballistic magnetic sensor

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Yuhsuke; Hara, Masahiro [Graduate School of Science and Technology, Kumamoto University, 2-39-1 Kurokami, Kumamoto 860-8555 (Japan); Nomura, Tatsuya [Advanced Electronics Research Division, INAMORI Frontier Research Center, Kyushu University, 744 Motooka, Fukuoka 819-0395 (Japan); Kimura, Takashi [Advanced Electronics Research Division, INAMORI Frontier Research Center, Kyushu University, 744 Motooka, Fukuoka 819-0395 (Japan); Department of Physics, Kyushu University, 6-10-1 Hakozaki, Fukuoka 812-8581 (Japan)

    2014-04-07

    We have developed a highly sensitive local magnetic sensor by using a ballistic transport property in a two-dimensional conductor. A semiclassical simulation reveals that the sensitivity increases when the geometry of the sensor and the spatial distribution of the local field are optimized. We have also experimentally demonstrated a clear observation of a magnetization process in a permalloy dot whose size is much smaller than the size of an optimized ballistic magnetic sensor fabricated from a GaAs/AlGaAs two-dimensional electron gas.

  6. Global-local optimization of flapping kinematics in hovering flight

    KAUST Repository

    Ghommem, Mehdi

    2013-06-01

    The kinematics of a hovering wing are optimized by combining the 2-d unsteady vortex lattice method with a hybrid of global and local optimization algorithms. The objective is to minimize the required aerodynamic power under a lift constraint. The hybrid optimization is used to efficiently navigate the complex design space due to wing-wake interference present in hovering aerodynamics. The flapping wing is chosen so that its chord length and flapping frequency match the morphological and flight properties of two insects with different masses. The results suggest that imposing a delay between the different oscillatory motions defining the flapping kinematics, and controlling the way through which the wing rotates at the end of each half stroke can improve aerodynamic power under a lift constraint. Furthermore, our optimization analysis identified optimal kinematics that agree fairly well with observed insect kinematics, as well as previously published numerical results.

  7. Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial.

    Science.gov (United States)

    Chang, Hyeyoon; Noh, Jiyoung; Lee, Jungwon; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

    2016-07-01

    Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. Within the limitations of the present study, relief from injection pain is observed using CNR.

  8. A Localization Method for Multistatic SAR Based on Convex Optimization.

    Directory of Open Access Journals (Sweden)

    Xuqi Zhong

    Full Text Available In traditional localization methods for Synthetic Aperture Radar (SAR, the bistatic range sum (BRS estimation and Doppler centroid estimation (DCE are needed for the calculation of target localization. However, the DCE error greatly influences the localization accuracy. In this paper, a localization method for multistatic SAR based on convex optimization without DCE is investigated and the influence of BRS estimation error on localization accuracy is analysed. Firstly, by using the information of each transmitter and receiver (T/R pair and the target in SAR image, the model functions of T/R pairs are constructed. Each model function's maximum is on the circumference of the ellipse which is the iso-range for its model function's T/R pair. Secondly, the target function whose maximum is located at the position of the target is obtained by adding all model functions. Thirdly, the target function is optimized based on gradient descent method to obtain the position of the target. During the iteration process, principal component analysis is implemented to guarantee the accuracy of the method and improve the computational efficiency. The proposed method only utilizes BRSs of a target in several focused images from multistatic SAR. Therefore, compared with traditional localization methods for SAR, the proposed method greatly improves the localization accuracy. The effectivity of the localization approach is validated by simulation experiment.

  9. A Localization Method for Multistatic SAR Based on Convex Optimization.

    Science.gov (United States)

    Zhong, Xuqi; Wu, Junjie; Yang, Jianyu; Sun, Zhichao; Huang, Yuling; Li, Zhongyu

    2015-01-01

    In traditional localization methods for Synthetic Aperture Radar (SAR), the bistatic range sum (BRS) estimation and Doppler centroid estimation (DCE) are needed for the calculation of target localization. However, the DCE error greatly influences the localization accuracy. In this paper, a localization method for multistatic SAR based on convex optimization without DCE is investigated and the influence of BRS estimation error on localization accuracy is analysed. Firstly, by using the information of each transmitter and receiver (T/R) pair and the target in SAR image, the model functions of T/R pairs are constructed. Each model function's maximum is on the circumference of the ellipse which is the iso-range for its model function's T/R pair. Secondly, the target function whose maximum is located at the position of the target is obtained by adding all model functions. Thirdly, the target function is optimized based on gradient descent method to obtain the position of the target. During the iteration process, principal component analysis is implemented to guarantee the accuracy of the method and improve the computational efficiency. The proposed method only utilizes BRSs of a target in several focused images from multistatic SAR. Therefore, compared with traditional localization methods for SAR, the proposed method greatly improves the localization accuracy. The effectivity of the localization approach is validated by simulation experiment.

  10. Local anesthesia reversal.

    Science.gov (United States)

    Malamed, Stanley F

    2010-03-01

    PM (OraVerse) enables the dentist or dental hygienist (where permitted) to significantly decrease the duration of residual STA in patients where such numbness may prove to be potentially injurious (children, geriatric, and special needs patients), or a negative influence on their quality of life (speaking, eating, negative body image). (Note: As of August 3, 2009, dental hygienists are permitted to administer PM in the following states: Alaska, Arkansas, Hawaii, Idaho, Iowa, Louisiana, Montana, Nevada, New York, North Dakota, Oklahoma, Rhode Island, Tennessee, Utah, and Wisconsin.)

  11. Cystolithotripsy under Local Anesthesia

    African Journals Online (AJOL)

    as open cystolithotomy, transurethral cystolithotripsy (TUCL) ... pelvi-abdominal surgery, persistent urinary tract infection .... our study was less (65 versus 73 minutes). In both studies the .... of laparoscopic instruments in percutaneous bladder.

  12. Clinical application of local anesthesia for tension-free hernia repair operation%局麻下无张力疝修补术的临床应用

    Institute of Scientific and Technical Information of China (English)

    邓海

    2014-01-01

    目的:总结应用局麻方式进行无张力疝修补术的方法和特点。方法应用1%利多卡因进行腹股沟区浸润及阻滞麻醉,对2011年1月~2013年12月410例腹股沟疝患者应用补片进行无张力疝修补术,回顾分析患者的临床资料。结果本组患者均治愈,麻醉效果满意,手术时间25~90min,平均38min,5例阴囊肿胀,对症保守治疗后痊愈。切口疼痛轻微,无明显异物感,无切口感染等并发症,术后2~3天出院。随访12~38个月,无复发。结论在腹股沟疝手术治疗中,局部麻醉的方法是安全可行的,镇痛效果良好,易于掌握,对患者干扰小,并发症少,恢复快。%Objective To explore the surgical technique and characteristics of tension-free hernia repair operation with local anesthesia. Methods A retrospective analysis was made on the clinical data of 410 inguinal hernia patients who under-went tension-free hernia repair operation with local anesthesia by 1% lidocaine from Jan 2011 to Dec 2013. Results All the 410 patients were successfully treated with good anesthesia effect. The operation time was 25~90 minutes,average 38 minutes. 5 patients had suffered hydrocele who treated by conservative treatment. Some patients had minor postoperative pain. No obvious foreign body sensation and incision infection was found. The hospitalization time after operation was 2~3 days. No recurrence was observed during the follow-up period of 12~38 months. Conclusion Tension-free hernia repair operation with local anesthe-sia is a safe method with lower anesthesia risk, less complications and less postoperative recovery time.

  13. Local Approximation and Hierarchical Methods for Stochastic Optimization

    Science.gov (United States)

    Cheng, Bolong

    In this thesis, we present local and hierarchical approximation methods for two classes of stochastic optimization problems: optimal learning and Markov decision processes. For the optimal learning problem class, we introduce a locally linear model with radial basis function for estimating the posterior mean of the unknown objective function. The method uses a compact representation of the function which avoids storing the entire history, as is typically required by nonparametric methods. We derive a knowledge gradient policy with the locally parametric model, which maximizes the expected value of information. We show the policy is asymptotically optimal in theory, and experimental works suggests that the method can reliably find the optimal solution on a range of test functions. For the Markov decision processes problem class, we are motivated by an application where we want to co-optimize a battery for multiple revenue, in particular energy arbitrage and frequency regulation. The nature of this problem requires the battery to make charging and discharging decisions at different time scales while accounting for the stochastic information such as load demand, electricity prices, and regulation signals. Computing the exact optimal policy becomes intractable due to the large state space and the number of time steps. We propose two methods to circumvent the computation bottleneck. First, we propose a nested MDP model that structure the co-optimization problem into smaller sub-problems with reduced state space. This new model allows us to understand how the battery behaves down to the two-second dynamics (that of the frequency regulation market). Second, we introduce a low-rank value function approximation for backward dynamic programming. This new method only requires computing the exact value function for a small subset of the state space and approximate the entire value function via low-rank matrix completion. We test these methods on historical price data from the

  14. Structural eigenfrequency optimization based on local sub-domain "frequencies"

    DEFF Research Database (Denmark)

    Pedersen, Pauli; Pedersen, Niels Leergaard

    2013-01-01

    The engineering approach of fully stressed design is a practical tool with a theoretical foundation. The analog approach to structural eigenfrequency optimization is presented here with its theoretical foundation. A numerical redesign procedure is proposed and illustrated with examples.......For the ideal case, an optimality criterion is fulfilled if the design have the same sub-domain ”frequency” (local Rayleigh quotient). Sensitivity analysis shows an important relation between squared system eigenfrequency and squared local sub-domain frequency for a given eigenmode. Higher order...... eigenfrequencies may also be controlled in this manner.The presented examples are based on 2D finite element models with the use of subspace iteration for analysis and a recursive design procedure based on the derived optimality condition. The design that maximize a frequency depend on the total amount...

  15. The effect of timing of oral meloxicam administration on physiological responses in calves after cautery dehorning with local anesthesia.

    Science.gov (United States)

    Allen, K A; Coetzee, J F; Edwards-Callaway, L N; Glynn, H; Dockweiler, J; KuKanich, B; Lin, H; Wang, C; Fraccaro, E; Jones, M; Bergamasco, L

    2013-08-01

    Dehorning is a painful husbandry procedure that is commonly performed in dairy calves. Parenteral meloxicam combined with local anesthesia mitigates the physiological and behavioral effects of dehorning in calves. The purpose of this study was to determine the influence of timing of oral meloxicam administration on physiological responses in calves after dehorning. Thirty Holstein bull calves, 8 to 10 wk of age (28-70 kg), were randomly assigned to 1 of 3 treatment groups: placebo-treated control group (n=10), calves receiving meloxicam administered orally (1 mg/kg) in powdered milk replacer 12h before cautery dehorning (MEL-PRE; n=10), and calves receiving meloxicam administered as an oral bolus (1 mg/kg) at the time of dehorning (MEL-POST; n=10). Following cautery dehorning, blood samples were collected to measure cortisol, substance P (SP), haptoglobin, ex vivo prostaglandin E2 (PgE2) production after lipopolysaccharide stimulation and meloxicam concentrations. Maximum ocular temperature and mechanical nociceptive threshold (MNT) were also assessed. Data were analyzed using noncompartmental pharmacokinetic analysis and repeated measures ANOVA models. Mean peak meloxicam concentrations were 3.61±0 0.21 and 3.27±0.14 μg/mL with average elimination half-lives of 38.62±5.87 and 35.81±6.26 h for MEL-PRE and MEL-POST, respectively. Serum cortisol concentrations were lower in meloxicam-treated calves compared with control calves at 4 h postdehorning. Substance P concentrations were significantly higher in control calves compared with meloxicam-treated calves at 120 h after dehorning. Prostaglandin E2 concentrations were lower in meloxicam-treated calves compared with control calves. Mechanical nociceptive threshold was higher in control calves at 1h after dehorning, but meloxicam-treated calves tended to have a higher MNT at 6h after dehorning. No effect of timing of meloxicam administration on serum cortisol concentrations, SP concentrations, haptoglobin

  16. Curative Efficacy of Tension Free Repair in Inguinal Hernia Under Local Anesthesia%腹股沟斜疝在局麻下行无张力修补术后疗效观察

    Institute of Scientific and Technical Information of China (English)

    刁英怀

    2015-01-01

    目的:评价腹股沟斜疝在局麻下行无张力修补术后疗效。方法局麻下手术84例纳入局麻组,硬膜外麻醉下手术73例纳入硬膜外组,对比相关指标。结果局麻组时间相关指标、总费用、并发率均低于硬膜外组,差异具有统计学意义(P<0.05)。结论局麻有助于改善患者短期预后,加速患者康复,减轻医疗负担。%Objective To evaluate the eficacy of tension free inguinal hernia repair surgery under local anesthesia.Methods Operation of 84 patients included in the local anesthesia group,epidural anesthesia during the operation of 73 patients included in the epidural group,compared related indicators.ResultsThe relevant indicators,local anesthesia group,with the total cost of the time were lower than the rate of epidural anesthesia group,the diference was statisticaly significant(P< 0.05).Conclusion Local anesthesia is helpful to improve the short-term prognosis of patients,accelerate the rehabilitation of patients,reduce the medical burden.

  17. Fusion Global-Local-Topology Particle Swarm Optimization for Global Optimization Problems

    Directory of Open Access Journals (Sweden)

    Zahra Beheshti

    2014-01-01

    Full Text Available In recent years, particle swarm optimization (PSO has been extensively applied in various optimization problems because of its structural and implementation simplicity. However, the PSO can sometimes find local optima or exhibit slow convergence speed when solving complex multimodal problems. To address these issues, an improved PSO scheme called fusion global-local-topology particle swarm optimization (FGLT-PSO is proposed in this study. The algorithm employs both global and local topologies in PSO to jump out of the local optima. FGLT-PSO is evaluated using twenty (20 unimodal and multimodal nonlinear benchmark functions and its performance is compared with several well-known PSO algorithms. The experimental results showed that the proposed method improves the performance of PSO algorithm in terms of solution accuracy and convergence speed.

  18. Localized Multiple Kernel Learning Via Sample-Wise Alternating Optimization.

    Science.gov (United States)

    Han, Yina; Yang, Kunde; Ma, Yuanliang; Liu, Guizhong

    2014-01-01

    Our objective is to train support vector machines (SVM)-based localized multiple kernel learning (LMKL), using the alternating optimization between the standard SVM solvers with the local combination of base kernels and the sample-specific kernel weights. The advantage of alternating optimization developed from the state-of-the-art MKL is the SVM-tied overall complexity and the simultaneous optimization on both the kernel weights and the classifier. Unfortunately, in LMKL, the sample-specific character makes the updating of kernel weights a difficult quadratic nonconvex problem. In this paper, starting from a new primal-dual equivalence, the canonical objective on which state-of-the-art methods are based is first decomposed into an ensemble of objectives corresponding to each sample, namely, sample-wise objectives. Then, the associated sample-wise alternating optimization method is conducted, in which the localized kernel weights can be independently obtained by solving their exclusive sample-wise objectives, either linear programming (for l1-norm) or with closed-form solutions (for lp-norm). At test time, the learnt kernel weights for the training data are deployed based on the nearest-neighbor rule. Hence, to guarantee their generality among the test part, we introduce the neighborhood information and incorporate it into the empirical loss when deriving the sample-wise objectives. Extensive experiments on four benchmark machine learning datasets and two real-world computer vision datasets demonstrate the effectiveness and efficiency of the proposed algorithm.

  19. Evolutionary multimodal optimization using the principle of locality

    KAUST Repository

    Wong, Kachun

    2012-07-01

    The principle of locality is one of the most widely used concepts in designing computing systems. To explore the principle in evolutionary computation, crowding differential evolution is incorporated with locality for multimodal optimization. Instead of generating trial vectors randomly, the first method proposed takes advantage of spatial locality to generate trial vectors. Temporal locality is also adopted to help generate offspring in the second method proposed. Temporal and spatial locality are then applied together in the third method proposed. Numerical experiments are conducted to compare the proposed methods with the state-of-the-art methods on benchmark functions. Experimental analysis is undertaken to observe the effect of locality and the synergy between temporal locality and spatial locality. Further experiments are also conducted on two application problems. One is the varied-line-spacing holographic grating design problem, while the other is the protein structure prediction problem. The numerical results demonstrate the effectiveness of the methods proposed. © 2012 Elsevier Inc. All rights reserved.

  20. Is local participation always optimal for sustainable action?

    DEFF Research Database (Denmark)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-01-01

    . Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market......Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits......-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable...

  1. Local structural modeling for implementation of optimal active damping

    Science.gov (United States)

    Blaurock, Carl A.; Miller, David W.

    1993-09-01

    Local controllers are good candidates for active control of flexible structures. Local control generally consists of low order, frequency benign compensators using collocated hardware. Positive real compensators and plant transfer functions ensure that stability margins and performance robustness are high. The typical design consists of an experimentally chosen gain on a fixed form controller such as rate feedback. The resulting compensator performs some combination of damping (dissipating energy) and structural modification (changing the energy flow paths). Recent research into structural impedance matching has shown how to optimize dissipation based on the local behavior of the structure. This paper investigates the possibility of improving performance by influencing global energy flow, using local controllers designed using a global performance metric.

  2. Local Optimality of User Choices and Collaborative Competitive Filtering

    CERN Document Server

    Yang, Shuang Hong

    2010-01-01

    We describe a novel framework for learning recommender models for recommendation systems, which views user-system-item interactions as an opportunity give-and-take process, and encodes both "collaboration" and "competition" mechanisms underlying the interaction. The proposed framework leverages the latent factor models of collaborative filtering to encode "collaboration" (via factor sharing); and in the meanwhile, it utilizes a type of objectives that implies local optimality of user choices to encode "competition". Specifically, it takes into account both the revenue and the opportunity cost of each user decision; and, by optimizing a new objective that are analogous to the economic profit, it encourages that every opportunity being taken by a user be locally the best among the opportunities being offered to him/her. Such competition among candidates opportunities imposes stronger supervision and in turn leads to better generalization to unseen interactions. Empirical results indicates that the collaborative...

  3. Local Law of Addition of Random Matrices on Optimal Scale

    Science.gov (United States)

    Bao, Zhigang; Erdős, László; Schnelli, Kevin

    2016-11-01

    The eigenvalue distribution of the sum of two large Hermitian matrices, when one of them is conjugated by a Haar distributed unitary matrix, is asymptotically given by the free convolution of their spectral distributions. We prove that this convergence also holds locally in the bulk of the spectrum, down to the optimal scales larger than the eigenvalue spacing. The corresponding eigenvectors are fully delocalized. Similar results hold for the sum of two real symmetric matrices, when one is conjugated by Haar orthogonal matrix.

  4. General Anesthesia

    Science.gov (United States)

    ... unconscious and unable to feel pain during medical procedures. General anesthesia usually uses a combination of intravenous drugs ... 1998-2017 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

  5. Local anesthesia with epinephrine is safe and effective for oral surgery in patients with type 2 diabetes mellitus and coronary disease: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Marcela Alves dos Santos-Paul

    2015-03-01

    Full Text Available OBJECTIVE: To investigate the variations in blood glucose levels, hemodynamic effects and patient anxiety scores during tooth extraction in patients with type 2 diabetes mellitus T2DM and coronary disease under local anesthesia with 2% lidocaine with or without epinephrine. STUDY DESIGN: This is a prospective randomized study of 70 patients with T2DM with coronary disease who underwent oral surgery. The study was double blind with respect to the glycemia measurements. Blood glucose levels were continuously monitored for 24 hours using the MiniMed Continuous Glucose Monitoring System. Patients were randomized into two groups: 35 patients received 5.4 mL of 2% lidocaine, and 35 patients received 5.4 mL of 2% lidocaine with 1:100,000 epinephrine. Hemodynamic parameters (blood pressure and heart rate and anxiety levels were also evaluated. RESULTS: There was no difference in blood glucose levels between the groups at each time point evaluated. Surprisingly, both groups demonstrated a significant decrease in blood glucose levels over time. The groups showed no significant differences in hemodynamic and anxiety status parameters. CONCLUSION: The administration of 5.4 mL of 2% lidocaine with epinephrine neither caused hyperglycemia nor had any significant impact on hemodynamic or anxiety parameters. However, lower blood glucose levels were observed. This is the first report using continuous blood glucose monitoring to show the benefits and lack of side effects of local anesthesia with epinephrine in patients with type 2 diabetes mellitus and coronary disease.

  6. Optimal dose of an anesthetic in epidural anesthesia and its effect on labor duration and administration of vacuum extractor and forceps.

    Science.gov (United States)

    Cutura, N; Soldo, V; Milovanović, S R; Orescanin-Dusić, Z; Curković, A; Tomović, B; Janković-Raznatović, S

    2011-01-01

    This study examined the factors that influence the optimal dose of epidural anesthesia (EA), its effect on labor duration, and the frequency of vacuum and forceps administration at the end of delivery. The study group included 100 women who underwent vaginal delivery with EA with administration of 0.125% bupivacaine. A control group included 100 vaginally delivered women, without EA administration. In both groups delivery was stimulated by syntocinon. The level of labor pain influenced the optimal bolus dose of EA more than the body mass. However, the maintenance dose was influenced by both of these factors equally. Labor in the study group was somewhat shorter. In the group with EA the percentage of forceps and vacuum extractor application was twice that in the control group. There was no difference in average value of 5-minute Apgar scor in newborns.

  7. A Prospective, Comparative Study of the Pain of Local Anesthesia Using 2% Lidocaine, 2% Lidocaine With Epinephrine, and 2% Lidocaine With Epinephrine-Bupivicaine Mixture for Eyelid Surgery.

    Science.gov (United States)

    Han, Jung-Woo; Nah, Seung Kwan; Lee, Sang Yeul; Kim, Chang Yeom; Yoon, Jin Sook; Jang, Sun Young

    A mixture of 2% lidocaine with epinephrine and bupivacaine was developed to achieve the fast-onset anesthetic effect of lidocaine and the long-lasting effect of bupivacaine. The authors compared pain scores between 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture during local anesthesia for eyelid surgeries. This was a double-blind, randomized, prospective, comparative study. In total, 120 consecutive patients (43 males, 77 females, mean age = 47.2 ± 21.2) who underwent bilateral eyelid surgery under subcutaneous anesthesia were asked to report pain scores for each eye during the first injection of anesthesia. Each patient was randomly assigned to receive 1 of the 3 anesthetic agents in 1 eyelid, and 1 of the remaining 2 agents in the other. The pH values of the 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture were 6.23 ± 0.21, 4.21 ± 0.37, and 3.87 ± 0.19, respectively. The pain scores of each were 4.3 ± 1.8, 5.1 ± 1.8, and 5.7 ± 1.9, respectively. The 2% lidocaine with epinephrine produced a statistically significantly higher pain score than 2% lidocaine (p = 0.044, generalized estimating equation method). The mixture also showed a significantly higher pain score than 2% lidocaine (p = 0.003, generalized estimating equation method). Epinephrine seemed to increase subjective pain scores. Compared with 2% lidocaine with epinephrine, 2% lidocaine with epinephrine-bupivicaine mixture was not significantly different in terms of subjective symptoms or pH.

  8. Hernias inguinales bilaterales operadas con anestesia local mediante hernioplastia de Lichtenstein Bilateral inguinal hernias operated on with local anesthesia by Lichtenstein hernioplasty

    Directory of Open Access Journals (Sweden)

    Bárbaro Agustín Armas Pérez

    2009-03-01

    . A descriptive cross-sectional study was conducted among the first 38 patients operated on by Lichtenstein's technique with local anesthesia (Braun and Sheleider's combined technique. The patients underwent ambulatory surgery between January 2001 and December 2007. The patients operated on in the morning were discharged in the afternoon, whereas those operated in the afternoon were discharged next morning in order to prevent the ecchymosis with the early mobilization. RESULTS. Four of the patients had recurrent hernias. The most used prosthetic material was polypropilene (86.9 %. The complications accounted for 9.1 % (referred not to the 38 patients, but to the 76 hernioplasties. After a follow-up ranging from 1 to 36 months, a rejection to the prosthetic material (1.3 % and a relapse (1.3 % were observed. CONCLUSIONS. It was concluded that this material may be applied to bilateral hernias, since stress, institutional costs and the patient's discomforts are reduced, showing this way its efficiency.

  9. Topology Optimization of Continuum Structures with Local Stress Constraints

    DEFF Research Database (Denmark)

    Duysinx, Pierre; Bendsøe, Martin P

    1997-01-01

    We introduce an extension of current technologies for topology optimization of continuum structures which allows for treating local stress criteria. We first consider relevant stress criteria for porous composite materials, initially by studying the stress states of the so-called rank~2 layered m...... of the stress constraints is used. We describe the mathematical programming approach that is used to solve the numerical optimization problems, and show results for a number of example applications.......We introduce an extension of current technologies for topology optimization of continuum structures which allows for treating local stress criteria. We first consider relevant stress criteria for porous composite materials, initially by studying the stress states of the so-called rank~2 layered...... materials. Then, an empirical model is proposed for the power law materials (also called SIMP materials). In a second part, solution aspects of topology problems are considered. To deal with the so-called 'singularity' phenomenon of stress constraints in topology design, an $\\epsilon$ constraint relaxation...

  10. Robust Source Localization in Shallow Water Based on Vector Optimization

    Institute of Scientific and Technical Information of China (English)

    SONG Hai-yan; SHI Jie; LIU Bo-sheng

    2013-01-01

    Owing to the multipath effect,the source localization in shallow water has been an area of active interest.However,most methods for source localization in shallow water are sensitive to the assumed model of the underwater environment and have poor robustness against the underwater channel uncertainty,which limit their further application in practical engineering.In this paper,a new method of source localization in shallow water,based on vector optimization concept,is described,which is highly robust against environmental factors affecting the localization,such as the channel depth,the bottom reflection coefficients,and so on.Through constructing the uncertainty set of the source vector errors and extracting the multi-path sound rays from the sea surface and bottom,the proposed method can accurately localize one or more sources in shallow water dominated by multipath propagation.It turns out that the natural formulation of our approach involves minimization of two quadratic functions subject to infinitely many nonconvex quadratic constraints.It shows that this problem (originally intractable) can be reformulated in a convex form as the so-called second-order cone program (SOCP) and solved efficiently by using the well-established interior point method,such as the software tool,SeDuMi.Computer simulations show better performance of the proposed method as compared with existing algorithms and establish a theoretical foundation for the practical engineering application.

  11. Robust source localization in shallow water based on vector optimization

    Science.gov (United States)

    Song, Hai-yan; Shi, Jie; Liu, Bo-sheng

    2013-06-01

    Owing to the multipath effect, the source localization in shallow water has been an area of active interest. However, most methods for source localization in shallow water are sensitive to the assumed model of the underwater environment and have poor robustness against the underwater channel uncertainty, which limit their further application in practical engineering. In this paper, a new method of source localization in shallow water, based on vector optimization concept, is described, which is highly robust against environmental factors affecting the localization, such as the channel depth, the bottom reflection coefficients, and so on. Through constructing the uncertainty set of the source vector errors and extracting the multi-path sound rays from the sea surface and bottom, the proposed method can accurately localize one or more sources in shallow water dominated by multipath propagation. It turns out that the natural formulation of our approach involves minimization of two quadratic functions subject to infinitely many nonconvex quadratic constraints. It shows that this problem (originally intractable) can be reformulated in a convex form as the so-called second-order cone program (SOCP) and solved efficiently by using the well-established interior point method, such as the software tool, SeDuMi. Computer simulations show better performance of the proposed method as compared with existing algorithms and establish a theoretical foundation for the practical engineering application.

  12. Administration of Anesthesia

    Science.gov (United States)

    ... a Surgeon What We Do Administration of Anesthesia Administration of Anesthesia Oral and maxillofacial surgeons are extensively ... Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral and maxillofacial surgeons are extensively ...

  13. Comparation of Anesthetic Effect of Articaine in the Extraction of Mandibular Posterior Teeth under Local Anesthesia and Periodontal Membrane Anesthesia%阿替卡因两种麻醉方式在下颌后牙拔除术中麻醉效果的对比

    Institute of Scientific and Technical Information of China (English)

    曹静; 张建强; 李岩峰; 高飞

    2013-01-01

    Objective To compare the anesthetic effect of articaine under local anesthesia and periodontal membrane anesthesia on the extraction of mandibular posterior teeth. Methods 204 patients were randomly divided into two groups;local anesthetic group and periodontal membrane anesthetic group. Patients in each group were anesthetized by local anesthesia or periodontal membrane anesthesia. The anesthetic effect was analyzed. Results The excellence rate of periodontal membrane anesthetic group was 84. 3% . Conclusion Periodontal membrane anesthesia for the extraction of mandibular posterior teeth using articaine is more effective than local anesthesia.%目的 比较复方阿替卡因局部浸润麻醉与牙周膜腔麻醉2种方式在下颌后牙拔除术中的麻醉效果.方法 随机选择204名患者,分为局部浸润麻醉组及牙周膜腔麻醉组,采用标尺法由患者对疼痛程度进行打分;口腔医生评价麻醉效果,统计麻醉完全、良好、有效和失败的比例.结果 达到麻醉完全效果的牙周膜腔麻醉与局部浸润麻醉组有显著性差异(P<0.05),两种麻醉方式成功率无显著性差异(P>0.05).结论 用牙周膜腔麻醉效果优于局部浸润麻醉方式.

  14. Traffic optimization in transport networks based on local routing

    Science.gov (United States)

    Scellato, S.; Fortuna, L.; Frasca, M.; Gómez-Gardeñes, J.; Latora, V.

    2010-01-01

    Congestion in transport networks is a topic of theoretical interest and practical importance. In this paper we study the flow of vehicles in urban street networks. In particular, we use a cellular automata model on a complex network to simulate the motion of vehicles along streets, coupled with a congestion-aware routing at street crossings. Such routing makes use of the knowledge of agents about traffic in nearby roads and allows the vehicles to dynamically update the routes towards their destinations. By implementing the model in real urban street patterns of various cities, we show that it is possible to achieve a global traffic optimization based on local agent decisions.

  15. Indoor Wireless Localization-hybrid and Unconstrained Nonlinear Optimization Approach

    Directory of Open Access Journals (Sweden)

    R. Jayabharathy

    2013-07-01

    Full Text Available In this study, a hybrid TOA/RSSI wireless localization is proposed for accurate positioning in indoor UWB systems. The major problem in indoor localization is the effect of Non-Line of Sight (NLOS propagation. To mitigate the NLOS effects, an unconstrained nonlinear optimization approach is utilized to process Time-of-Arrival (TOA and Received Signal Strength (RSS in the location system.TOA range measurements and path loss model are used to discriminate LOS and NLOS conditions. The weighting factors assigned by hypothesis testing, is used for solving the objective function in the proposed approach. This approach is used for describing the credibility of the TOA range measurement. Performance of the proposed technique is done based on MATLAB simulation. The result shows that the proposed technique performs well and achieves improved positioning under severe NLOS conditions.

  16. Clinical study of Modified Kugel herniorrhaphy for inguinal hernia under local anesthesia%局部麻醉下改良Kugel手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    郑向群; 孙晓东; 韩宏光

    2014-01-01

    Objective To explore the application of Modified Kugel mesh in inguinal hernia repair under local anesthesia.Methods Clinical data of 1 62 cases of inguinal hernia underwent Modified Kugel herniorrhaphy under local anesthesia in the first Hospital of Zibo,Weifang Medical University,from January 2009 to December 201 1 ,were collected and analyzed retrospectively.The anesthetic effect,operation time, complications,length of stay and recurrence rate were recorded.Results All operations were performed under local anesthesia,with satisfactory anesthetic effect.The operative time was 28 to 65 minutes,mean of 41 minutes,and the length of stay was 1 to 8 days,mean of 3.7 days.There was a case of incision hematoma,a case of fat liquefaction,and 2 cases of postoperative pain occurred.No wound infection and recurrence were observed.Conclusions Modified Kugel herniorrhaphy is a safe,effective and appropriate precedence for various types of inguinal hernia,which can be accomplished under local anesthesia,and is known as less complications and quick recovery.%目的:探讨局部浸润麻醉下 Modified Kugel 补片在腹股沟疝修补术中的临床应用。方法回顾性分析2009年1月至2011年12月,潍坊医学院附属淄博市第一医院在局部麻醉下行Modified Kugel手术的162例腹股沟疝患者的临床资料,观察局部麻醉效果、手术时间、术后并发症、住院时间及复发情况。结果全部患者在局部麻醉下完成手术,术中麻醉效果满意,手术时间28~65 min,平均41 min,术后住院时间1~8 d,平均3.7 d。切口下血肿1例,切口脂肪液化1例,术后疼痛2例,无切口感染和复发。结论 Modified Kugel补片修补各种类型腹股沟疝,疗效确切,可在局部浸润麻醉下完成,安全可靠,并发症少,恢复快,是较为理想的疝修补术式。

  17. The Study about risk evaluation by Local anesthesia single-port thoracoscopic surgery%局麻单孔胸腔镜手术风险评估

    Institute of Scientific and Technical Information of China (English)

    白峰; 杨剑飞; 张小雷

    2014-01-01

    目的:通过局麻单孔胸腔镜手术并发症发生率与文献报道并发症发生率,传统胸腔穿刺术并发症发生率比较,评估局麻单孔胸腔镜手术风险。方法:随机筛选本院局麻单孔胸腔镜手术的患者200例,作为试验组,同时随机筛选同期行胸腔穿刺术患者200例,作为对照组,观察试验组和对照组以及文献报道并发症发生率。结果:试验组与对照组并发症发生率无显著统计学意义。结论:临床上严格掌握手术指征因其并发症发生率与传统胸腔穿刺术无显著差异,可以推广局麻单孔胸腔镜手术治疗。%Objective:The risk evaluation about Local anesthesia single-port thoracoscopic surgery to find a better therapy by the Study. Methods:With block randomization screening 200 patients used the Local anesthesia single-port thoracoscopic surgery, as the experimental group and the control group 200 used the therapy of pleurocentesis, from 2009-6 to 2014-2. To observe the normal tissue complication probability between the experimental group and the control group. Result:The experimental group overmatches the control group and has not statistical significant. Conclusion:Ours therapy is worthy for extending in clinic because it's better safe, effective and less side-effect.

  18. The Study about risk evaluation by Local anesthesia single-port thoracoscopic surgery%局麻单孔胸腔镜手术风险评估

    Institute of Scientific and Technical Information of China (English)

    白峰; 杨剑飞; 张小雷

    2014-01-01

    通过局麻单孔胸腔镜手术并发症发生率与文献报道并发症发生率,传统胸腔穿刺术并发症发生率比较,评估局麻单孔胸腔镜手术风险。方法:随机筛选本院局麻单孔胸腔镜手术的患者200例,作为试验组,同时随机筛选同期行胸腔穿刺术患者200例,作为对照组,观察试验组和对照组以及文献报道并发症发生率。结果:试验组与对照组并发症发生率无显著统计学意义。结论:临床上严格掌握手术指征因其并发症发生率与传统胸腔穿刺术无显著差异,可以推广局麻单孔胸腔镜手术治疗。%The risk evaluation about Local anesthesia single-port thoracoscopic surgery to find a better therapy by the Study. Methods:With block randomization screening 200 patients used the Local anesthesia single-port thoracoscopic surgery, as the experimental group and the control group 200 used the therapy of pleurocentesis, from 2009-6 to 2014-2. To observe the normal tissue complication probability between the experimental group and the control group. Result:The experimental group overmatches the control group and has not statistical significant. Conclusion:Ours therapy is worthy for extending in clinic because it's better safe, effective and less side-effect.

  19. Compared With Local Anesthesia in Inguinal Hernia Tension-Free Repairsurgery With Epidural Anesthesia%硬膜外麻醉与局部麻醉在腹股沟疝无张力修补术中的应用比较

    Institute of Scientific and Technical Information of China (English)

    李晓耕; 董俊云

    2015-01-01

    ObjectiveTo anesthesia and local anesthesia in inguinal hernia tension-free repair surgery comparison of epidural.Methods The clinical data of 102 cases of inguinal hernia patients.Results Local anesthesia group in operation time, postoperative ambulation time, time of hospitalization and medical costs were lower than the control group.Conclusion Without local anesthesia for treatment of patients with tension-free repair of inguinal hernia, the effect is better.%目的:对硬膜外麻醉与局部麻醉在腹股沟疝无张力修补术中的应用效果进行比较。方法回顾分析102例腹股沟疝患者的临床资料。结果局麻组患者手术时间、术后下床活动时间、住院时间均以及医疗费用均低于对照组。结论对行腹股沟疝无张力修补术治疗的患者实施局部麻醉,效果较好。

  20. Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

    Directory of Open Access Journals (Sweden)

    El-Seify Zeinab

    2010-01-01

    Full Text Available Background: Low flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min as compared to endotracheal tube (ETT. Patients and Methods : Fifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO 2 (ETCO 2 , inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications Results : Two patients in the LMA-group developed initial airway leakage (6.9% versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO 2 , uptake of gases, nor difficulty in swallowing. Conclusion : The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

  1. Avaliação do tratamento da hérnia inguinal sob anestesia local e sedação em 1560 pacientes Outcome of groin hernia repair under local anesthesia and sedation in 1560 patients

    Directory of Open Access Journals (Sweden)

    José Carlos de Rezende Pereira

    2006-12-01

    Full Text Available OBJETIVO: Analisar a aplicabilidade da anestesia local da região inguinal no tratamento da hérnia inguinal. MÉTODO: Foram estudados os dados de 1560 pacientes submetidos ao tratamento operatório para cura de hérnia inguinal, entre maio de 1996 e dezembro de 2003, pela técnica de Lichtenstein, sob anestesia local da região inguinal associada à sedação. Foram analisados so seguintes dados: idade,sexo,índice de massa corporal, número de recidivas, as intercorrências pré e pós-operatórias, tempo de permanência hospitalar. Os tipos de hérnia foram classificados segundo Nyhus. RESULTADOS: Todas as operações foram concluídas sob a anestesia local e sedação não sendo necessário nenhuma complementação. As complicações pós-operatórias ocorreram em 7,16 % dos pacientes, nenhum deles necessitou de reinternação. CONCLUSÕES: A anestesia loco-regional da região inguinal na totalidade dos casos produziu conforto para os pacientes e boas condições de operabilidade para os cirurgiões.BACKGROUND: This study aimed at showing the feasibility of local-regional anesthesia in inguinal hernia repair using the technique of Lichtenstein. METHODS: 1560 patients were operated between May 1996 and December 2003. They were submitted to 1560 surgeries by means of the Lichtenstein technique, operated under local-regional anesthesia in inguinal region. Age, gender, Nyhus classification, and body mass index were analyzed. RESULTS: The post-operative complications had occurred in 7,16% of the patients. Hospitalization average were 6:00 hours. CONCLUSION: We concluded that local-regional anesthesia in the inguinal region provides the same level of comfort for patients as well as for surgeons with the advantage of imposing shorter hospital stay.

  2. Locally optimized separability enhancement indices for urban land cover mapping

    DEFF Research Database (Denmark)

    Feyisa, Gudina L.; Meilby, Henrik; Darrel Jenerette, G.

    2016-01-01

    Landsat data were used to assess urbanization-induced dynamics in Land use/cover (LULC), surface thermal intensity, and its relationships with urban biophysical composition. The study was undertaken in Addis Ababa city, Ethiopia. Ground-based data and high resolution images were used as reference...... data in LULC classification. To more accurately quantify landscape patterns and their changes, we applied new locally optimized separability enhancement indices and decision rules (SEI–DR approach) to address commonly observed classification accuracy problems in urban environments. We tested the SEI...... classification method, use of hotspot analysis, and the investigations of the UHI for an African city fill important research gaps for studies of urban thermal variation....

  3. OPTIMIZED LOCAL TERNARY PATTERNS: A NEW TEXTURE MODEL WITH SET OF OPTIMAL PATTERNS FOR TEXTURE ANALYSIS

    Directory of Open Access Journals (Sweden)

    G. Madasamy Raja

    2013-01-01

    Full Text Available Texture analysis is one of the important as well as useful tasks in image processing applications. Many texture models have been developed over the past few years and Local Binary Patterns (LBP is one of the simple and efficient approach among them. A number of extensions to the LBP method have been also presented but the problem remains challenging in feature vector generation and comparison. As textures are oriented and scaled differently, a texture model should effectively handle grey-scale variation, rotation variation, illumination variation and noise. The length of the feature vector in a texture model also plays an important role in deciding the time complexity of the texture analysis. This study proposes a new texture model, called Optimized Local Ternary Patterns (OLTP in the spatial methods of texture analysis. The proposed texture model is based on Local Ternary Patterns (LTP, which in turn is based on LBP. A new concept called “Level of Optimality” to select the optimal set of patterns is discussed in this study. This proposed texture model uses only optimal patterns to extract the textural information from the digital images and thereby reducing the length of the feature vector. This proposed model is robust to image rotation, grey-scale transformation, histogram equalization and noise. The results are compared with other widely used texture models by applying classification tests to variety of texture images from the standard Brodatz texture database. Experimental results prove that the proposed texture model is robust to grey-scale variation, image rotation, histogram equalization and noise. Experimental results also show that the proposed texture model improves the classification accuracy and the speed of the classification process. In all tested tasks, the proposed method outperforms the earlier methods.

  4. Anesthesia for outpatient female sterilization.

    Science.gov (United States)

    Fishburne, J I

    1983-04-01

    This issue of the Bulletin deals with the principles of anesthesia for outpatient female sterilization with emphasis on techniques for laparoscopy and minilaparotomy. General anesthesia techniques provide analgesia, amnesia, and muscle relaxation and are particularly useful for managing the anxious patient. Disadvantages include increased expense, need for specialized equipment, and highly trained personnel, and delayed recovery. Complications, though relatively rare, can be life-threatening and include aspiration of stomach contents, hypoxia, hypercarbia, hypotension, hypertension, cardiac arrhythmias, cardiorespiratory arrest, and death. There is no single preferred technique of general anesthesia, athough most anesthetists employ methods that allow rapid recovery of faculties, enabling the patient to be discharged soon after surgery. To accomplish this end, light anesthesia with sodium thiopental induction and nitrous oxide maintenance is often used. Short duration muscle relaxation with an agent such as succinylcholine supplements this technique. Other techniques include light anesthesia with inhalational anesthetic agents and the use of intravenous ketamine. Local anesthesia augmented by systemic and/or inhalational analgesia is supplanting general anesthesia techniques for laparoscopy in many locales. This approach is also particularly well-suited for minilaparotomy in developing countries, where it has achieved its greatest popularity. The local technique carries with it reduced morbidity and mortality but may not entirely relieve discomfort. The primary danger of local anesthesia is respiratory depression due to excessive narcosis and sedation. The operator must be alert to the action of the drugs and should always use the minimal effective dose. Although toxicity due to overdosage with local anesthetic drugs is occasionally experienced, allergic reactions to the amide-linkage drugs such as lidocaine or bupivacaine are exceedingly rare. For outpatient

  5. [Obstetrical anesthesia in 15 women with myasthenia gravis].

    Science.gov (United States)

    Santeularia, M T; Unzueta, M C; Casas, J I; Vilanova, F; Roldán, J; Villar Landeira, J

    1998-02-01

    To report our experience in managing anesthesia during obstetric delivery of women with myasthenia gravis (MG) and to review the anesthetic technique of choice for vaginal or cesarean delivery in such cases. Fifteen pregnancies in 12 patients were recorded between 1980 and 1996; 14 cases were documented. Disease course during pregnancy, delivery and postpartum, the course of pregnancy, the presence of severe neonatal myasthenia and anesthetic treatment during vaginal or cesarean delivery were analyzed. Improvement in MG was observed in 6 cases. No change was seen in 4 patients and 3 worsened. In one woman generalized MG debuted 15 days after delivery. Two neonates were premature and a third suffered severe neonatal myasthenia. Six vaginal deliveries were aided by forceps; 8 deliveries were by cesarean and 1 fetus was aborted. Lumbar epidural anesthesia was employed in 73.33% (5 vaginal deliveries and 6 cesareans) and general anesthesia in 26.66% (1 abortion, 1 vaginal delivery and 2 cesareans). Continuous lumbar epidural anesthesia is the technique of choice for vaginal as well as cesarean deliveries. The combination of opioids and local anesthetics is considered particularly beneficial for patients, as it allows the motor blockade to be decreased. General anesthesia is only indicated when there is bulbar involvement. Short-acting non depolarizing agents, among them atracurium Besilate, are the muscle relaxants of choice. Succinylcholine is contraindicated. Thanks to current optimization of anesthetic and recovery techniques and administration of non depolarizing muscle relaxants with neuromuscular monitoring, the prognosis for pregnant MG patients has improved considerably.

  6. Effectiveness of various formulations of local anesthetics and additives for topical anesthesia – a prospective, randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Weilbach C

    2017-05-01

    , the addition of trometamol (Tris/THAM accelerated the onset of the effect compared to the native formulation (at 0.4 and 0.8 N. In all of the adult subjects of this study, the minimum exposure time was 60 min for any of the tested topical anesthetic creams.Conclusion: The results of this study indicate that a cream containing 20% lidocaine, 38% trometamol and 10% propylene glycol may be used as an alternative to lidocaine/prilocaine with a comparable effect and without the need to extend exposure time. Keywords: local anesthetics, topical anesthesia, EMLA®, topical anesthetic cream, lidocaine, prilocaine 

  7. First-principle optimal local pseudopotentials construction via optimized effective potential method

    Science.gov (United States)

    Mi, Wenhui; Zhang, Shoutao; Wang, Yanchao; Ma, Yanming; Miao, Maosheng

    2016-04-01

    The local pseudopotential (LPP) is an important component of orbital-free density functional theory, a promising large-scale simulation method that can maintain information on a material's electron state. The LPP is usually extracted from solid-state density functional theory calculations, thereby it is difficult to assess its transferability to cases involving very different chemical environments. Here, we reveal a fundamental relation between the first-principles norm-conserving pseudopotential (NCPP) and the LPP. On the basis of this relationship, we demonstrate that the LPP can be constructed optimally from the NCPP for a large number of elements using the optimized effective potential method. Specially, our method provides a unified scheme for constructing and assessing the LPP within the framework of first-principles pseudopotentials. Our practice reveals that the existence of a valid LPP with high transferability may strongly depend on the element.

  8. Experience of 154 cases repair of inguinal hernia under local anesthesia%局部麻醉下手术治疗腹股沟疝154例

    Institute of Scientific and Technical Information of China (English)

    孙江阳; 陈大兴; 尹兴峰; 王超英; 袁玉峰; 刘志苏

    2012-01-01

    Objective To discuss the therapeutic effect and technical key points of repair of inguinal hernia under local anesthesia. Methods Retrospectively analyses of the clinical date of 154 cases who suffered inguinal hernia repair under local anesthesia in our hospital from April 2008 to June 2010. Preoperative state, operation time, postoperative complications, hospital stays and the fellow-up results were analyzed. Results The mean operation time were 40 min( range 30-90 min), the mean out-of-bed activity time were 6 h(range 5-12 h),the mean hospital stays were 3d(range 2-7 d). No patients was found with surgical-wound infection and urinary retention postoperation, all postoperative pain were mild,the most common postoperative complication was mild edema of scrotum(20 cases),but it go down after 3-5d with support of the testes. During the fellow-up(4-24 months),only 1 case recurrence, no patient has local pain and testicular atrophy. Conclusion Repair of inguinal hernia under local anesthesia is a simple, effective and safe modus operandi,it is easy to recover with few postoperative complcations and shorter hospital stays. It is especially suitable for old patients with chronic illnesses.%目的 探讨局部麻醉下行腹股沟疝修补术的临床疗效和技术要点.方法 回顾性分析2008年4月至2010年6月局部麻醉下行腹股沟疝修补术的154例的临床资料.对病人的术前状况、手术时间、术后并发症、住院天数以及回访情况进行综合分析.结果 手术时间为30~90 min(平均40 min),术后5~12 h下床活动,住院时间2~7 d(平均3 d).术后无切口感染、尿潴留等并发症,术后疼痛症状轻,最多见并发症为阴囊轻度水肿(20例),垫高阴囊3~5 d可消失.随访4~24个月,无局部疼痛和睾丸萎缩,仅1例复发.结论 局部麻醉下行腹股沟疝修补手术具有简单、有效、安全、并发症少、术后恢复快、缩短住院时间等优点,尤其适合并存慢性内科疾病的老年病人.

  9. 局部麻醉在腹股沟疝无张力修补术中的应用%Local Anesthesia Application in Tension-free Repair of Inguinal Operation

    Institute of Scientific and Technical Information of China (English)

    张育兴; 郑永林; 陈昭丰

    2011-01-01

    目的:通过与硬膜外麻醉比较,评价在局部麻醉下行腹股沟疝修补术的可行性.方法:回顾性分析我院采用人工合成材料行腹股沟无张力修补术的263例成年患者,分为局部麻醉组(112例)和硬膜外组(151例).结果:局部麻醉组患者住院费用和术后尿潴留的发生率均明显小于硬膜外组,两组比较差异有统计学意义(P0.05).结论:成人局部麻醉下进行无张力疝修补术是一种安全、有效的方式.%0bjective:The evaluation of the feasibility of local anesthesia inguinal hernia repair operation by comparing with epidural anesthesia.Methods:Analyze the use of synthetic materials,tension-free repair of inguinal operation in 263 adult patients,which was carried out in our hospital.The patients were divided into local anesthesia group (112 cases)and epidural group (151 cases).Results:The hospitalization costs and the incidence of urinary retention in the local anesthesia group were significantly lower than that of the epidural group.The difference has statistically significant(P<0.05).However,there was no statistically significance if we compared the average operation time,hospital staying,postoperative pain scores,wound infection and hernia recurrence respectively between the two groups(P>0.05).Conclusions:It was a safe and effective way to carry out tension-free hernia repair operations for adult patients under local anesthesia.

  10. Incremental triangulation by way of edge swapping and local optimization

    Science.gov (United States)

    Wiltberger, N. Lyn

    1994-01-01

    This document is intended to serve as an installation, usage, and basic theory guide for the two dimensional triangulation software 'HARLEY' written for the Silicon Graphics IRIS workstation. This code consists of an incremental triangulation algorithm based on point insertion and local edge swapping. Using this basic strategy, several types of triangulations can be produced depending on user selected options. For example, local edge swapping criteria can be chosen which minimizes the maximum interior angle (a MinMax triangulation) or which maximizes the minimum interior angle (a MaxMin or Delaunay triangulation). It should be noted that the MinMax triangulation is generally only locally optical (not globally optimal) in this measure. The MaxMin triangulation, however, is both locally and globally optical. In addition, Steiner triangulations can be constructed by inserting new sites at triangle circumcenters followed by edge swapping based on the MaxMin criteria. Incremental insertion of sites also provides flexibility in choosing cell refinement criteria. A dynamic heap structure has been implemented in the code so that once a refinement measure is specified (i.e., maximum aspect ratio or some measure of a solution gradient for the solution adaptive grid generation) the cell with the largest value of this measure is continually removed from the top of the heap and refined. The heap refinement strategy allows the user to specify either the number of cells desired or refine the mesh until all cell refinement measures satisfy a user specified tolerance level. Since the dynamic heap structure is constantly updated, the algorithm always refines the particular cell in the mesh with the largest refinement criteria value. The code allows the user to: triangulate a cloud of prespecified points (sites), triangulate a set of prespecified interior points constrained by prespecified boundary curve(s), Steiner triangulate the interior/exterior of prespecified boundary curve

  11. 局部神经阻滞麻醉与腰硬联合麻醉下治疗腹股沟疝临床效果观察%Clinical Effect of Local Nerve Block Anesthesia and Epidural Anesthesia in the Treatment of Inguinal Hernia

    Institute of Scientific and Technical Information of China (English)

    荣学武

    2015-01-01

    目的:探究局部神经阻滞麻醉和腰硬联合麻醉对腹股沟疝的临床治疗效果。方法将我院收治的88例腹股沟疝患者作为此研究中的研究对象,按照麻醉方法的不同分为观察组以及对照组,并将局部神经阻滞麻醉与腰硬联合麻醉应用其中,比较两组患者的相关指标。结果观察组通过麻醉之后其手术用时、手术中出血量、伤口感染以及复发率低于对照组,采用统计学软件分析后可知两组间存在统计学意义(P<0.05)。结论腹股沟疝患者应采用局部神经阻滞麻醉其操作过程较为简单,同时具备一定的安全可靠性。%Objective To explore the efficacy of local nerve block anesthesia and epidural anesthesia in the treatment of inguinal hernia.Methods88 patients in our hospital inguinal hernia patients in this study as the object of study,according to different methods of anesthesia were divided into observation group and control group,and the local nerve block anesthesia and epidural anesthesia in which the two groups were compared the relevant indicators.Results The anesthesia after the adoption of its operation time,blood loss,wound infection and recurrence rate was significantly lower than the control group, after the analysis shows that the use of statistical software exists between the two groups was statisticaly significant(P<0.05).ConclusionInguinal hernia patients should use local nerve block anesthesia its operation is simple,but with a certain security and reliability.

  12. Effect of Topical Anesthesia with Lidocaine-prilocaine (EMLA) Cream and Local Pressure on Pain during Infiltration Injection for Maxillary Canines: A Randomized Double-blind clinical trial.

    Science.gov (United States)

    Milani, Amin S; Zand, Vahid; Abdollahi, Amir A; Froughreyhani, Mohammad; Zakeri-Milani, Parvin; Jafarabadi, Mohammad A

    2016-07-01

    This study compared the effect of local pressure and topical lidocaine-prilocaine (EMLA) cream on pain during infiltration injection for maxillary canine teeth. A total of 140 volunteer students participated in this split-mouth design randomized clinical trial. The subjects were randomly divided into four groups (n = 35). Before administration of anesthesia, in each group, one side was randomly selected as the experimental and the opposite side as the control. In group 1, finger pressure was applied on the alveolar mucosa on the experimental side and on the tooth crown on the control side. In group 2, 5% EMLA cream and placebo; in group 3, finger pressure and 5% EMLA cream; and in group 4, 5% EMLA cream and 20% benzocaine gel were applied. In all the groups, a buccal infiltration procedure was carried out. Pain during injection was recorded with visual analog scale (VAS). Wilcoxon and McNemar tests were used for statistical analysis of the results. Statistical significance was set at p effective than 20% benzocaine in reducing pain severity during infiltration injection. However, it was not significantly different in comparison to the application of local pressure.

  13. Strategic integration of in vivo cardiovascular models during lead optimization: predictive value of 4 models independent of species, route of administration, and influence of anesthesia.

    Science.gov (United States)

    Fryer, Ryan M; Harrison, Paul C; Muthukumarana, Akalushi; Nodop Mazurek, Suzanne G; Ng, Khing Jow; Chen, Rong Rhonda; Harrington, Kyle E; Dinallo, Roger M; Chi, Liguo; Reinhart, Glenn A

    2012-04-01

    The strategic integration of in vivo cardiovascular models is important during lead optimization to enable a wide therapeutic index for cardiovascular safety. However, under what conditions (eg, species, route of administration, anesthesia) studies should be performed to drive go/no-go is open to interpretation. Two compounds, torcetrapib and a novel steroid hormone mimetic (SHM-1121X), both with off-target cardiovascular liabilities, were profiled in 4 in vivo cardiovascular models. Overlapping plasma concentrations of torcetrapib were achieved in all models tested; values ranged from therapeutic to supratherapeutic. In anesthetized rats, intravenous torcetrapib elicited dose-dependent increases in mean arterial pressure (MAP; 2-18 mm Hg above vehicle during the low- and high-dose infusion), and in anesthetized dogs, torcetrapib increased MAP from 4 to 22 mm Hg. In conscious rats, a single oral dose of torcetrapib increased MAP from 10 to 18 mm Hg in the low-dose and high-dose groups, respectively, whereas in conscious dogs, MAP increased from 3 to 12 mm Hg. SHM-1121X produced marked hypotension in the same models. Pharmacokinetic-pharmacodynamic analysis demonstrated strong correlation across the models tested for both compounds. Results suggest that equivalency across models allows for flexibility to address key issues and enable go/no-go during lead optimization without concern for discordant results. The predictive value of each model was validated with torcetrapib and, when put into practice, led to a decisive no-go for SHM-1121X.

  14. Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration

    Directory of Open Access Journals (Sweden)

    Aleksandra Gavrilovska-Brzanov

    2016-02-01

    CONCLUSIONS: Between children undergoing inguinal hernia repair, local wound infiltration insures safety and satisfactory analgesia for surgery. Compared to caudal block it is not overwhelming. Caudal block provides longer analgesia, however complications are rather common.

  15. Spinal and epidural anesthesia

    Science.gov (United States)

    ... you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the ... Chan VWS. Spinal, epidural, and caudal anesthesia. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: ...

  16. Anesthesia & Down Syndrome

    Science.gov (United States)

    ... Health Care » Associated Conditions » Anesthesia & Down Syndrome Anesthesia & Down Syndrome Complications of anesthesia (sedation during surgery) occur in ... histories are complicated. Why Would an Individual With Down Syndrome Need A nesthesia? 40-60% of infants born ...

  17. Obesity and Anesthesia

    Science.gov (United States)

    ... Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Obesity and Anesthesia More than one-third of Americans ... Sleep Apnea, a chronic medical problem common with obesity, can present with serious breathing problems before, during, ...

  18. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  19. Cross-approximate entropy of cortical local field potentials quantifies effects of anesthesia - a pilot study in rats

    Directory of Open Access Journals (Sweden)

    Schwarz Cornelius

    2010-09-01

    Full Text Available Abstract Background Anesthetics dose-dependently shift electroencephalographic (EEG activity towards high-amplitude, slow rhythms, indicative of a synchronization of neuronal activity in thalamocortical networks. Additionally, they uncouple brain areas in higher (gamma frequency ranges possibly underlying conscious perception. It is currently thought that both effects may impair brain function by impeding proper information exchange between cortical areas. But what happens at the local network level? Local networks with strong excitatory interconnections may be more resilient towards global changes in brain rhythms, but depend heavily on locally projecting, inhibitory interneurons. As anesthetics bias cortical networks towards inhibition, we hypothesized that they may cause excessive synchrony and compromise information processing already on a small spatial scale. Using a recently introduced measure of signal independence, cross-approximate entropy (XApEn, we investigated to what degree anesthetics synchronized local cortical network activity. We recorded local field potentials (LFP from the somatosensory cortex of three rats chronically implanted with multielectrode arrays and compared activity patterns under control (awake state with those at increasing concentrations of isoflurane, enflurane and halothane. Results Cortical LFP signals were more synchronous, as expressed by XApEn, in the presence of anesthetics. Specifically, XApEn was a monotonously declining function of anesthetic concentration. Isoflurane and enflurane were indistinguishable; at a concentration of 1 MAC (the minimum alveolar concentration required to suppress movement in response to noxious stimuli in 50% of subjects both volatile agents reduced XApEn by about 70%, whereas halothane was less potent (50% reduction. Conclusions The results suggest that anesthetics strongly diminish the independence of operation of local cortical neuronal populations, and that the

  20. Optimal localized observations for advancing beyond the ENSO predictability barrier

    Directory of Open Access Journals (Sweden)

    W. Kramer

    2013-04-01

    Full Text Available The existing 20-member ensemble of 50 yr ECHAM5/MPI-OM simulations provides a reasonably realistic Monte Carlo sample of the El Niño–Southern Oscillation (ENSO. Localized observations of sea surface temperature (SST, zonal wind speed and thermocline depth are assimilated in the ensemble using sequential importance sampling to adjust the weight of ensemble members. We determine optimal observation locations, for which assimilation yields the minimal ensemble spread. Efficient observation locations for SST lie in the ENSO pattern, with the optimum located in the eastern and western Pacific for minimizing uncertainty in the NINO3 and NINO4 index, respectively. After the assimilation of the observations, we investigate how the weighted ensemble performs as a nine-month probabilistic forecast of the ENSO. Here, we focus on the spring predictability barrier with observation in the January–March (March–May period and assess the remaining predictive power in June (August for NINO3 (NINO4. For the ECHAM5/MPI-OM ensemble, this yields that SST observations around 110° W and 140° W provide the best predictive skill for the NINO3 and NINO4 index, respectively. Forecasts can be improved by additionally measuring the thermocline depth at 150° W.

  1. Optimal image interpolation using local low-order surfaces

    Science.gov (United States)

    Gustafson, Steven C.; Claypoole, Roger L., Jr.; Magee, Eric P.; Loomis, John S.

    2002-05-01

    Desirable features of any digital image resolution- enhancement algorithm include exact interpolation (for 'distortionless' or 'lossless' processing) adjustable resolution, adjustable smoothness, and ease of computation. A given low-order polynomial surface (linear, quadratic, cubic, etc.) optimally fit by least squares to a given local neighborhood of a pixel to be interpolated can enable all of these features. For example, if the surface is cubic, if a pixel and the 5-by-5 pixel array surrounding it are selected, and if interpolation of this pixel must yield a 4- by-4 array of sub-pixels, then the 10 coefficients that define the surface may be determined by the constrained least squares solution of 25 linear equations in 10 unknowns, where each equation sets the surface value at a pixel center equal to the pixel gray value and where the constraint is that the mean of the surface values at the sub-pixel centers equals the gray value of the interpolated pixel. Note that resolution is adjustable because the interpolating surface for each pixel may be subdivided arbitrarily, that smoothness is adjustable (within each pixel) because the polynomial order and number neighboring pixels may be selected, and that the most computationally demanding operation is solving a relatively small number of simultaneous linear equations for each pixel.

  2. Towards Optimal Event Detection and Localization in Acyclic Flow Networks

    KAUST Repository

    Agumbe Suresh, Mahima

    2012-01-03

    Acyclic flow networks, present in many infrastructures of national importance (e.g., oil & gas and water distribution systems), have been attracting immense research interest. Existing solutions for detecting and locating attacks against these infrastructures, have been proven costly and imprecise, especially when dealing with large scale distribution systems. In this paper, to the best of our knowledge for the first time, we investigate how mobile sensor networks can be used for optimal event detection and localization in acyclic flow networks. Sensor nodes move along the edges of the network and detect events (i.e., attacks) and proximity to beacon nodes with known placement in the network. We formulate the problem of minimizing the cost of monitoring infrastructure (i.e., minimizing the number of sensor and beacon nodes deployed), while ensuring a degree of sensing coverage in a zone of interest and a required accuracy in locating events. We propose algorithms for solving these problems and demonstrate their effectiveness with results obtained from a high fidelity simulator.

  3. Improvement in Pulmonary Function of Chronic Obstructive Pulmonary Disease (COPD) Patients With Osteoporotic Vertebral Compression Fractures (OVCFs) After Kyphoplasty Under Local Anesthesia.

    Science.gov (United States)

    Sheng, Song; Zhenzhong, Sun; Weimin, Jiang; Yimeng, Wang; Qudong, Yin; Jinhui, Shi

    2015-03-01

    To investigate the changes in respiratory function of COPD patients with osteoporotic vertebral compression fractures (OVCFs) after kyphoplasty (KP). Pain scores, pulmonary function parameters (PFT), and local kyphotic angle (LKA) were measured in 31 older patients (25 women, 6 men) with OVCFs before, 3 days after and 3 months after kyphoplasty. The preoperative and postoperative (3 days, 3 months) PFT parameters were as follows: % pred FVC, 74.33 ± 12.35, 85.23.8 ± 13.23, and 84.86 ± 14.01; % pred FEV1, 60.23 ± 11.2, 60.02 ± 11.90, and 60.78 ± 12.70; FEV1/FVC ratio (%), 68.22 ± 16.74, 59.56 ± 13.23, and 60.77 ± 12.28, % pred MVV 52.46 ± 14.37, 55.23 ± 15.68, and 62.12 ± 14.48, respectively. The preoperative mean VAS score was 8.01 ± 1.41 and significantly decreased to 2.52 ± 0.89 and 2.34 ± 0.78 at 3 days, 3 months after kyphoplasty, respectively. The preoperative local kyphotic angle degree was 21.96 ± 5.75°, significantly decreased to 13.48 ± 6.12° 3 days after KP, and maintained 3 month after KP. The decrease in the VAS scores correlated with the PFT parameters; however, there were no significant correlations between the PFT parameters and the LKA, the VAS scores and the LKA. Kyphoplasty under local anesthesia is a safety treatment for the COPD patients with OVCFS, and is able to improve the lung function impaired by OVCFs.

  4. [Application of Non-intubated Anesthesia in VATS].

    Science.gov (United States)

    Dai, Xiaotan; Song, Pingping; Zhang, Baijiang

    2016-05-20

    Tracheal intubation general anesthesia technique is widely used in video-assisted thoracic surgery (VATS) because it can improve the safety of VATS, but the complications of tracheal intubation can not be avoided. How to develop a "minimally invasive" surgery (including micro anesthesia) has become a hot topic in the field of minimally invasive surgery. Along with the progress of the anesthesia management technology and the risk management in the operation, the technology of non-intubated anesthesia was successfully applied to VATS, namely using local anesthesia to maintain patients intraoperative independent ventilation and intraoperative only mild sedation or fully conscious state of implementation of thoracoscope surgery, therefore is also called awake VATS. The anesthesia method not only reduces the anesthesia injury of tracheal intubation, but also conforms to the idea of rapid rehabilitation surgery. Based on non-intubated anesthesia in VATS in the brief history of development, the anesthesia selection, operation advantages and risks are reviewed in this paper.

  5. Glucose levels and hemodynamic changes in patients submitted to routine dental treatment with and without local anesthesia

    Science.gov (United States)

    Bortoluzzi, Marcelo Carlos; Manfro, Rafael; Nardi, Anderson

    2010-01-01

    OBJECTIVE: The aim of this study was to (1) observe the extent to which hemodynamic and glucose measurements change in patients submitted to a dental procedure with and without a local anesthetic and a vasoconstrictor (LAVA; 2% mepivacaine with adrenaline 1∶100,000) and (2) correlate those parameters with the patients' anxiety levels. METHOD: This was an unblinded, random, prospective, and observational study with paired groups. Patients were evaluated during two different consultations during which they either did or did not receive a local anesthetic/vasoconstrictor. RESULTS: Thirty‐seven patients ranging in age from 18 to 45 years (mean 30.4 ± 5.5 years) were evaluated. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, heart rate, and glucose levels, did not change significantly in healthy patients, regardless of whether a LAVA was administered during the dental treatment. CONCLUSION: The patients' anxiety statuses neither varied significantly nor showed any correlation with the studied hemodynamic parameters and glucose levels, regardless of whether local anesthetics were used. PMID:21120297

  6. Glucose levels and hemodynamic changes in patients submitted to routine dental treatment with and without local anesthesia

    Directory of Open Access Journals (Sweden)

    Marcelo Carlos Bortoluzzi

    2010-01-01

    Full Text Available OBJECTIVE: The aim of this study was to (1 observe the extent to which hemodynamic and glucose measurements change in patients submitted to a dental procedure with and without a local anesthetic and a vasoconstrictor (LAVA; 2% mepivacaine with adrenaline 1100,000 and (2 correlate those parameters with the patients' anxiety levels. METHOD: This was an unblinded, random, prospective, and observational study with paired groups. Patients were evaluated during two different consultations during which they either did or did not receive a local anesthetic/vasoconstrictor. RESULTS: Thirty-seven patients ranging in age from 18 to 45 years (mean 30.4 ± 5.5 years were evaluated. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, heart rate, and glucose levels, did not change significantly in healthy patients, regardless of whether a LAVA was administered during the dental treatment. CONCLUSION: The patients' anxiety statuses neither varied significantly nor showed any correlation with the studied hemodynamic parameters and glucose levels, regardless of whether local anesthetics were used.

  7. [Technical features of intraligamental intraseptal anesthesia].

    Science.gov (United States)

    Kuzin, A V; Voronkov, V V; Stafeeva, M V; Abramova, E S

    2016-01-01

    Based on personal clinical experience the authors provide clinical guidelines for periodontal anesthesia. The by-step protocol for intraligamentary and intraseptal anesthesia is presented. The basic mistakes in technique and possible complications are described. Recommendations for a local anesthetic choice and dosage for different groups of teeth are given.

  8. Local hypothermia and optimal temperature for stroke therapy in rats

    Institute of Scientific and Technical Information of China (English)

    WU Hao; JIANG Li-dan; Karsten H.Wrede; JI Xun-ming; ZHAO Xi-qing; TIAN Xin; GAO Yu-fei; LING Feng

    2009-01-01

    Background Local hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study. Methods Seventy-eight adult male Sprague Dawley rats (260-300 g) were randomly divided into 3 groups: group A, ischemia/reperfusion without cold saline infusion (n=-26) (control group); group B, infusion with 20℃ saline before reperfusion (n=26); group C: infusion with 10~C saline before reperfusion (n=26). In each group, we chose 15 rats for monitoring physical indexes and the temperature of the brain (cortex and striatum) and body (anus), measurement of brain infarction volume, assessment of neurological deficits and the survival rate of reperfusion at 48 hours. Another 8 rats from each group was chosen for examining brain edema, another 3 from each group for histological observation by electron microscopy (EM) and light microscopy (LM) at 48 hours after reperfusion. Results There was no significant difference among the 3 groups for physical indexes during the examination (F(2,45)=0.577, P=0.568; F(2, 45)= 0.42, P=0.78 for blood pressure and blood gas analysis, respectively). The brain temperature was significantly reduced in the group C compared to the other groups (F(2, 45)=37.074, P=0.000; F(2, 45)=32.983, P=0.000, for cortex and striatum temperature respectively), while the difference in rectal temperature between group A and B or C after reperfusion was not significant (F(2, 45)= 0.17115, P=0.637). And the brain infarct volume was significantly reduced in group C (from 40%±10% in group A, 26%±8% in group B, to 12%±6% in group C, F<(2,45)=43.465, P=0.000) with the neurological deficits improving in group C (X2=27.626, P=0.000). The survival rate at 48 hours after 10℃ and 20℃ saline reperfusion was increased by 132.5% and 150%, respectively, as compared to the control group (X2=10.489, P=0.005). The extent of the brain edema showed no

  9. Optimized localization analysis for single-molecule tracking and super-resolution microscopy

    DEFF Research Database (Denmark)

    Mortensen, Kim; Churchman, L. S.; Spudich, J. A.;

    2010-01-01

    We optimally localized isolated fluorescent beads and molecules imaged as diffraction-limited spots, determined the orientation of molecules and present reliable formulas for the precision of various localization methods. Both theory and experimental data showed that unweighted least-squares fitt......We optimally localized isolated fluorescent beads and molecules imaged as diffraction-limited spots, determined the orientation of molecules and present reliable formulas for the precision of various localization methods. Both theory and experimental data showed that unweighted least...

  10. Anesthesia for fetoscopic intervention

    Directory of Open Access Journals (Sweden)

    Jamil S Anwari

    2014-01-01

    Full Text Available This is the first case report on anesthesia for fetoscopy performed in Saudi Arabia. Epidural anesthesia was given to the mother in her late second trimester for the fetoscopic intervention. The anesthesia related issues such as physiological and anatomical changes in pregnancy, tocolytic medications and their interactions with anesthesia, anesthetizing/sedating the primary patient are discussed.

  11. 成人局部麻醉在腹股沟疝无张力修补术中的应用%Application discussion of adult local anesthesia in adult inguinal hernia tension free repair

    Institute of Scientific and Technical Information of China (English)

    和迎春

    2014-01-01

    目的:探讨腹股沟疝无张力修补术局部麻醉的应用体会。方法:收治腹股沟疝患者39例,应用局部麻醉下行无张力疝修补术,对其临床资料进行回顾性分析。结果:39例腹股沟疝患者局麻下行无张力疝修补术效果满意,无术后麻醉及原合并症的并发症发生。结论:局部麻醉应用成人腹股沟疝无张力修补手术,此方法安全、简便、经济、有效,创伤小,恢复快,扩宽了手术指征,值得推广。%Objective:To explore the application experience of adult local anesthesia in inguinal hernia tension free repair. Methods:39 cases with inguinal hernia were selected.They were treated with tension-free hernia repair in local anesthesia.We retrospectively analyzed the clinical data of them.Results:The effect of 39 cases with inguinal hernia treated with tension-free hernia repair in local anesthesia was satisfactory,and no postoperative complications and the complications of anesthesia occurred. Conclusion:The local anesthetic for adult inguinal hernia without tension repair operation is safe,simple,economical,effective.The trauma is small.Recovery is fast.It widens the indications for surgery.So it is worth promoting.

  12. Parallel Guided Local Search and Some Preliminary Experimental Results for Continuous Optimization

    Directory of Open Access Journals (Sweden)

    Nasser Tairan

    2014-02-01

    Full Text Available This paper proposes a Parallel Guided Local Search (PGLS framework for continuous optimization. In PGLS, several guided local search (GLS procedures (agents are run for solving the optimization problem. The agents exchan ge information for speeding up the search. For example, the information exchanged could be kno wledge about the landscape obtained by the agents. The proposed algorithm is applied to co ntinuous optimization problems. The preliminary experimental results show that the algo rithm is very promising .

  13. Endarterectomia de carótida sob anestesia local: evolução de 104 pacientes Carotid endarterectomy under regional anesthesia: follow-up of 104 patients

    Directory of Open Access Journals (Sweden)

    Jair Raso

    2004-09-01

    Full Text Available A estenose carotídea cervical é uma das causas mais freqüentes de acidente vascular cerebral isquêmico. A endarterectomia de carótida é um tratamento eficaz para lesões estenóticas moderadas e graves, tanto sintomáticas quanto assintom��ticas. A endarterectomia realizada sob anestesia local permite a monitorização neurológica do paciente durante o ato cirúrgico. O objetivo deste trabalho foi avaliar as complicações cirúrgicas e acompanhar a evolução dos pacientes submetidos a endarterectomia sob anestesia local em nossa instituição, comparando os resultados com outras publicações. 104 pacientes foram submetidos a 110 procedimentos no período de abril de 1996 a maio de 2002. 64 pacientes eram sintomáticos (61,54% e 40 assintomáticos (38,46%. Todos possuíam grau de estenose carotídea igual ou superior a 70%. Os pacientes foram avaliados retrospectivamente. O tempo de evolução variou de um a 72 meses (média: 29,5. Três pacientes apresentaram hematoma cervical necessitando drenagem cirúrgica. Dois pacientes (1,92% tiveram acidente vascular cerebral do mesmo lado da endarterectomia no pós-operatório e outros dois durante o seguimento. Dois pacientes faleceram em decorrência da cirurgia (1,92%. Os resultados desta série, comparados com a literatura, permitem concluir que a endarterectomia é uma forma segura de tratamento para as estenoses carotídeas moderadas e graves.Cervical carotid stenosis is one of the main causes of ischemic stroke. Carotid endarterectomy is a safe procedure for treatment of moderate and severe symptomatic and asymptomatic carotid stenosis. Regional anesthesia allows neurological evaluation of the patient during the surgery. We reviewed the results of 104 patients operated on at our institution under regional anesthesia during the period of April 1996 and May 2002. 64 patients were symptomatic (61.54% and 40 asymptomatic (38.46%. All patients had carotid stenosis over 70%. The patients

  14. Indoor Localization for Optimized Ambient Assisted Living Services

    DEFF Research Database (Denmark)

    Mitev, Miroslav; Mihovska, Albena Dimitrova; Poulkov, Vladimir

    Indoor localization is very critical for the provision of Ambient Assisted Living (AAL) services, such as e-Health, smart home, etc. The success of deploying a real-time localization system depends on selecting the right performance characteristics. Bluetooth Low Energy (BLE) is a technology, which...

  15. Optimization of precision localization microscopy using CMOS camera technology

    Science.gov (United States)

    Fullerton, Stephanie; Bennett, Keith; Toda, Eiji; Takahashi, Teruo

    2012-02-01

    Light microscopy imaging is being transformed by the application of computational methods that permit the detection of spatial features below the optical diffraction limit. Successful localization microscopy (STORM, dSTORM, PALM, PhILM, etc.) relies on the precise position detection of fluorescence emitted by single molecules using highly sensitive cameras with rapid acquisition speeds. Electron multiplying CCD (EM-CCD) cameras are the current standard detector for these applications. Here, we challenge the notion that EM-CCD cameras are the best choice for precision localization microscopy and demonstrate, through simulated and experimental data, that certain CMOS detector technology achieves better localization precision of single molecule fluorophores. It is well-established that localization precision is limited by system noise. Our findings show that the two overlooked noise sources relevant for precision localization microscopy are the shot noise of the background light in the sample and the excess noise from electron multiplication in EM-CCD cameras. At low light conditions (CCD cameras are the preferred detector. However, in practical applications, optical background noise is significant, creating conditions where CMOS performs better than EM-CCD. Furthermore, the excess noise of EM-CCD is equivalent to reducing the information content of each photon detected which, in localization microscopy, reduces the precision of the localization. Thus, new CMOS technology with 100fps, super resolution precision localization microscopy.

  16. Improved quantum-behaved particle swarm optimization with local search strategy

    Directory of Open Access Journals (Sweden)

    Maolong Xi

    2017-03-01

    Full Text Available Quantum-behaved particle swarm optimization, which was motivated by analysis of particle swarm optimization and quantum system, has shown compared performance in finding the optimal solutions for many optimization problems to other evolutionary algorithms. To address the problem of premature, a local search strategy is proposed to improve the performance of quantum-behaved particle swarm optimization. In proposed local search strategy, a super particle is presented which is a collection body of randomly selected particles’ dimension information in the swarm. The selected probability of particles in swarm is different and determined by their fitness values. To minimization problems, the fitness value of one particle is smaller; the selected probability is more and will contribute more information in constructing the super particle. In addition, in order to investigate the influence on algorithm performance with different local search space, four methods of computing the local search radius are applied in local search strategy and propose four variants of local search quantum-behaved particle swarm optimization. Empirical studies on a suite of well-known benchmark functions are undertaken in order to make an overall performance comparison among the proposed methods and other quantum-behaved particle swarm optimization. The simulation results show that the proposed quantum-behaved particle swarm optimization variants have better advantages over the original quantum-behaved particle swarm optimization.

  17. Optimal Local Dimming for LC Image Formation With Controllable Backlighting

    DEFF Research Database (Denmark)

    Shu, Xiao; Wu, Xiaolin; Forchhammer, Søren

    2013-01-01

    Light emitting diode (LED)-backlit liquid crystal displays (LCDs) hold the promise of improving image quality while reducing the energy consumption with signal-dependent local dimming. However, most existing local dimming algorithms are mostly motivated by simple implementation, and they often lack...... concern for visual quality. To fully realize the potential of LED-backlit LCDs and reduce the artifacts that often occur in current systems, we propose a novel local dimming technique that can achieve the theoretical highest fidelity of intensity reproduction in either $\\ell_{1}$ or $\\ell_{2}$ metrics...

  18. Supplemental pulpal anesthesia for mandibular teeth

    Directory of Open Access Journals (Sweden)

    Thangavel Boopathi

    2013-01-01

    Full Text Available Clinical pulpal anesthesia is dependent on the interaction of three major factors. (1 the dentist (2 the patient and (3 local anesthesia. Many patients fear endodontic treatment due to a concern about pain. Although pain treatment is well managed in many endodontic patients, there exists a group of patients who do not receive adequate local anesthesia. The purpose of this review article is to discuss the possible reasons for pulpal anesthetic failures and also to focus on the measures for developing effective approaches for the same.

  19. Efeitos cardiovasculares da anestesia local com vasoconstritor durante exodontia em coronariopatas Cardiovascular effects of local anesthesia with vasoconstrictor during dental extraction in coronary patients

    OpenAIRE

    Valeria C. L. S. Conrado; Januário de Andrade; Angelis,Gabriella A. M. C. de; Ana Carolina P. de Andrade; Lilia Timerman; Andrade,Mercedes M.; Moreira,Dalmo R.; Amanda G. M. R. Sousa; J. Eduardo M. R. Sousa; Piegas, Leopoldo S

    2007-01-01

    OBJETIVO: Avaliar a ocorrência de variáveis detectoras de isquemia miocárdica, durante ou após o tratamento odontológico, sob anestesia com vasoconstritor (adrenalina). MÉTODOS: Foram incluídos 54 pacientes coronariopatas submetidos a exodontia sob anestesia local com ou sem vasoconstritor, divididos em dois grupos (sorteio por envelope): grupo I, composto por 27 que receberam anestésico com vasoconstritor; e grupo II, composto por 27 que receberam anestésico sem vasoconstritor. Todos os paci...

  20. 腹股沟疝手术中的局部麻醉应用分析%The Analysis of Local Anesthesia Application in Surgery Treatment of Inguinal Hernia

    Institute of Scientific and Technical Information of China (English)

    张凯

    2015-01-01

    Objective The local anesthesia application in surgery treatment of inguinal hernia is to be analyzed. Methods Choose 32 inguinal hernia patients who are treated in hospital from October 2013 to November 2014 and separate them into study group and control group according to their hospitalization sequence.Patients in study group are given local anesthesia treatment; while patients in control group are given epidural anesthesia treatment,and then compare treatment efficacy of the two groups. Results The result shows that the anesthesia taking-effect time and anesthesia lasting time, and operation timein study group are much more favorable than control group,there is a clinical treatment efficacy differential between the two groups, and such a differential has statistic value(P < 0.05). Besides, patients’ complication incidence and il ness recurrence in study group are less than patients in control group;there is a clinical treatment efficacy differential between the two groups, and such a differential has statistic value(P<0.05). Conclusion Local anesthesia treatment is of efficacy in treatment of inguinal hernia, the anesthesia taking-effect time is fast and over-lasting, and complication incidence of local anesthesia treatment is quite few;thus, it is quite worthwhile to be promoted clinical y.%目的探讨腹股沟疝手术中的局部麻醉应用分析。方法选取2013年10月~2014年11月我院接诊的32例腹股沟疝手术患者,按照入院的先后顺序分为两组,实验组和对照组,实验组采用局部麻醉,对照组采用硬膜外麻醉,观察两组患者的治疗效果。结果实验组患者的麻醉起效时间、麻醉持续时间、手术时间明显优于对照组,差异显著,有统计学意义(P<0.05);实验组患者的并发症的发生率、复发率明显低于对照组,差异显著,有统计学意义(P<0.05)。结论腹股沟疝手术应用局部麻醉的效果显著,麻醉起效快、麻醉时间

  1. OPTIMIZING LOCALIZATION ROUTE USING PARTICLE SWARM-A GENETIC APPROACH

    Directory of Open Access Journals (Sweden)

    L. Lakshmanan

    2014-01-01

    Full Text Available One of the most key problems in wireless sensor networks is finding optimal algorithms for sending packets from source node to destination node. Several algorithms exist in literature, since some are in vital role other may not. Since WSN focus on low power consumption during packet transmission and receiving, finally we adopt by merging swarm particle based algorithm with genetic approach. Initially we order the nodes based on their energy criterion and then focusing towards node path; this can be done using Proactive route algorithm for finding optimal path between Source-Destination (S-D nodes. Fast processing and pre traversal can be done using selective flooding approach and results are in genetic. We have improved our results with high accuracy and optimality in rendering routes.

  2. Local-in-Time Adjoint-Based Method for Optimal Control/Design Optimization of Unsteady Compressible Flows

    Science.gov (United States)

    Yamaleev, N. K.; Diskin, B.; Nielsen, E. J.

    2009-01-01

    .We study local-in-time adjoint-based methods for minimization of ow matching functionals subject to the 2-D unsteady compressible Euler equations. The key idea of the local-in-time method is to construct a very accurate approximation of the global-in-time adjoint equations and the corresponding sensitivity derivative by using only local information available on each time subinterval. In contrast to conventional time-dependent adjoint-based optimization methods which require backward-in-time integration of the adjoint equations over the entire time interval, the local-in-time method solves local adjoint equations sequentially over each time subinterval. Since each subinterval contains relatively few time steps, the storage cost of the local-in-time method is much lower than that of the global adjoint formulation, thus making the time-dependent optimization feasible for practical applications. The paper presents a detailed comparison of the local- and global-in-time adjoint-based methods for minimization of a tracking functional governed by the Euler equations describing the ow around a circular bump. Our numerical results show that the local-in-time method converges to the same optimal solution obtained with the global counterpart, while drastically reducing the memory cost as compared to the global-in-time adjoint formulation.

  3. Optimal reconstruction of a pure qubit state with local measurements

    CERN Document Server

    Bagán, E; Monras, A; Muñoz-Tàpia, R

    2003-01-01

    We analyse the reconstruction of an unknown pure qubit state. We derive the optimal guess that can be inferred from any set of measurements on N identical copies of the system with the fidelity as a figure of merit. We study in detail the estimation process with individual von Neumann measurements and demonstrate that they are very competitive as compared to (complicated) collective measurements. We compute the expressions of the fidelity for large $N$ and show that individual measurement schemes can perform optimally in the asymptotic regime.

  4. 局部麻醉下疝环充填式无张力疝修补术治疗腹股沟疝%Under local anesthesia hernia ring without tension hernia repair filling type surgical treatment the groin hernia

    Institute of Scientific and Technical Information of China (English)

    李旭; 邢壮杰

    2012-01-01

    目的 评价应用局部麻醉下疝环充填式无张力疝修补术治疗腹股沟疝的临床价值.方法 回顾性分析256例腹股沟疝在局部麻醉下行疝环充填式无张力疝修补术患者的临床资料.结果 所有患者手术均顺利完成,麻醉效果满意,无明显疼痛与不适感.无一例使用止痛药,仅1例出现尿潴留,2例切口脂肪液化,经对症处理后痊愈.术后随访无复发.结论 局部麻醉下疝环充填式无张力疝修补术安全可靠,操作简便,符合人体解剖结构,对无法耐受硬膜外麻醉的患者,是一种理想选择.%Objective To evaluate the way of under local anesthesia hernia ring without tension hernia repair filling type surgical treatment the groin hernia surgery value of clinical application.Methods The clinical data of 256 cases were analyzed retrospectively for inguinal hernia in local anesthesia downside hernia ring filling type without tension hernia repair.Results All patients were recovered,under local anesthesia hernia ring without tension filling type hernia repair operation convenient operation,postoperative pain were light,the recurrence rate was low,less complications.Only 2 cases appeared the liquefaction of fat,1 case appeared urinary retention.Follow-up so far without recurrence.Conclusion Local anesthesia hernia ring without tension hernia method is safe and rehable,simple operation,and complex human anatomy,it is a kind of ideal choice to the ones who can't tolerate epidural anesthesia patients.

  5. Global Local Structural Optimization of Transportation Aircraft Wings

    NARCIS (Netherlands)

    Ciampa, P.D.; Nagel, B.; Van Tooren, M.J.L.

    2010-01-01

    The study presents a multilevel optimization methodology for the preliminary structural design of transportation aircraft wings. A global level is defined by taking into account the primary wing structural components (i.e., ribs, spars and skin) which are explicitly modeled by shell layered finite e

  6. Total energy global optimizations using non orthogonal localized orbitals

    CERN Document Server

    Kim, J; Galli, G; Kim, Jeongnim; Mauri, Francesco; Galli, Giulia

    1994-01-01

    An energy functional for orbital based $O(N)$ calculations is proposed, which depends on a number of non orthogonal, localized orbitals larger than the number of occupied states in the system, and on a parameter, the electronic chemical potential, determining the number of electrons. We show that the minimization of the functional with respect to overlapping localized orbitals can be performed so as to attain directly the ground state energy, without being trapped at local minima. The present approach overcomes the multiple minima problem present within the original formulation of orbital based $O(N)$ methods; it therefore makes it possible to perform $O(N)$ calculations for an arbitrary system, without including any information about the system bonding properties in the construction of the input wavefunctions. Furthermore, while retaining the same computational cost as the original approach, our formulation allows one to improve the variational estimate of the ground state energy, and the energy conservation...

  7. Topology optimization of fail-safe structures using a simplified local damage model

    DEFF Research Database (Denmark)

    Jansen, Miche; Lombaert, Geert; Schevenels, Mattias;

    2014-01-01

    Topology optimization of mechanical structures often leads to efficient designs which resemble statically determinate structures. These economical structures are especially vulnerable to local loss of stiffness due to material failure. This paper therefore addresses local failure of continuum...... with a fixed shape. The damage scenarios are taken into account by means of a minimax formulation of the optimization problem which minimizes the worst case performance.The detrimental influence of local failure on the nominal design is demonstrated in two representative examples: a cantilever beam optimized...

  8. A Parallel Global-Local Mixed Evolutionary Algorithm for Multimodal Function Optimization Based on Domain Decomposition

    Institute of Scientific and Technical Information of China (English)

    Wu Zhi-jian; Tang Zhi-long; Kang Li-shan

    2003-01-01

    This paper presents a parallel two level evolutionary algorithm based on domain decomposition for solving function optimization problem containing multiple solutions.By combining the characteristics of the global search and local search in each sub-domain, the former enables individual to draw closer to each optirma and keeps the diversity of individuals, while the latter selects local optimal solutions known as latent solutions in sub-domain. In the end, by selecting the global optimal solutions from latent solutions in each sub-domain, we can discover all the optimal solutions easily and quickly.

  9. Optimization of anesthesia protocol for resting-state fMRI in mice based on differential effects of anesthetics on functional connectivity patterns.

    Science.gov (United States)

    Grandjean, Joanes; Schroeter, Aileen; Batata, Imene; Rudin, Markus

    2014-11-15

    Resting state-fMRI (rs-fMRI) in mice allows studying mechanisms underlying functional connectivity (FC) as well as alterations of FC occurring in murine models of neurological diseases. Mouse fMRI experiments are typically carried out under anesthesia to minimize animal movement and potential distress during examination. Yet, anesthesia inevitably affects FC patterns. Such effects have to be understood for proper interpretation of data. We have compared the influence of four commonly used anesthetics on rs-fMRI. Rs-fMRI data acquired under isoflurane, propofol, and urethane presented similar patterns when accounting for anesthesia depth. FC maps displayed bilateral correlation with respect to cortical seeds, but no significant inter-hemispheric striatal connectivity. In contrast, for medetomidine, we detected bilateral striatal but compromised inter-hemispheric cortical connectivity. The spatiotemporal patterns of the rs-fMRI signal have been rationalized considering anesthesia depth and pharmacodynamic properties of the anesthetics. Our results bridge the results from different studies from the burgeoning field of mouse rs-fMRI and offer a framework for understanding the influences of anesthetics on FC patterns. Utilizing this information, we suggest the combined use of medetomidine and isoflurane representing the two proposed classes of anesthetics; the combination of low doses of the two anesthetics retained strong correlations both within cortical and subcortical structures, without the potential seizure-inducing effects of medetomidine, rendering this regimen an attractive anesthesia for rs-fMRI in mice.

  10. Efeitos do uso da adrenalina na anestesia local odontológica em portador de coronariopatia Effects of epinephrine in local dental anesthesia in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Ricardo Simões Neves

    2007-05-01

    Full Text Available FUNDAMENTO: A literatura é controversa no que se refere ao uso de vasoconstritores para anestesia local em cardiopatas, havendo preocupação com a indução de descompensação cardíaca. OBJETIVO: Avaliar parâmetros eletrocardiográficos e de pressão arterial durante procedimento odontológico restaurador sob anestesia local com e sem vasoconstritor em portadores de doença arterial coronária. MÉTODOS: Neste estudo foram avaliados 62 pacientes. As idades variaram de 39 a 80 anos (média de 58,7 + 8,8 anos, sendo 51 pacientes (82,3% do sexo masculino. Do total de pacientes, 30 foram randomizados para receber anestesia com lidocaína 2% com adrenalina (grupo LCA e os demais para lidocaína 2% sem vasoconstritor (grupo LSA. Todos foram submetidos a monitorização ambulatorial da pressão arterial e eletrocardiografia dinâmica por 24 horas. Foram considerados três períodos: 1 basal (registros obtidos durante os 60 minutos que antecederam o procedimento; 2 procedimento (registros obtidos desde o início da anestesia até o final do procedimento e 3 das 24 horas. RESULTADOS: Houve elevação da pressão arterial do período basal para o procedimento nos dois grupos quando analisados separadamente; quando confrontados, não apresentaram diferença entre si. A freqüência cardíaca não se alterou nos dois grupos. Depressão do segmento ST > 1 mm não ocorreu durante os períodos basal e procedimento. Arritmias em número superior a 10 por hora estiveram presentes durante o procedimento em sete pacientes (12,5%, sendo quatro (13,8% do grupo que recebeu anestesia sem adrenalina e três (11,1% do grupo com adrenalina. CONCLUSÃO: Não houve diferença em relação a comportamento da pressão arterial, freqüência cardíaca, evidência de isquemia e arritmias entre os grupos. O uso de vasoconstritor mostrou-se seguro dentro dos limites do estudo.BACKGROUND: The use of vasoconstrictors for local anesthesia in patients with coronary heart

  11. 日间手术中心复合局部麻醉下腰骶部筋膜脂肪疝的治疗%Treatment of lumbar sacral fascial hernia under local anesthesia in ambulatory operations

    Institute of Scientific and Technical Information of China (English)

    陈荣恒; 谭家驹; 甄作均; 范国勇; 郭健童; 欧国昌

    2014-01-01

    Objective To investigate and analyse the experiences of surgical treatment of lumbosacral lipocele under combined local anesthesia in ambulatory surgery center (ASC).Methods A total of 33 cases patients with lumbosacral lipocele who accepted a new surgical treatment in ASC of our hospital from October 201 2 to July 201 3 were enrolled and retrospectively analyzed.The hernia expanding plus contents resection were applied.The topical compound anesthesia of lidocaine cream and topical infiltration anesthesia with ropivacaine were used.Results All operations were successfully completed under the combined local anesthesia.No operation-related complication was observed.All patients were followed up for 6 months.Positive effects were achieved with an efficacy rate of 93.94%.Conclusions Lumbosacral lipocele can be successfully cured under combined local anesthesia in ASC.As a safe and reliable method,it can also reduce the hospitalization time and save medical costs.%目的:探讨分析日间手术中心(ambulatory surgery center,ASC)复合局部麻醉下腰骶部筋膜脂肪疝的手术治疗体会。方法回顾性分析2012年10月至2013年7月,佛山市第一人民医院ASC接收手术治疗腰骶部筋膜脂肪疝患者33例的临床资料。手术方式:疝囊口扩大+内容物切除术。麻醉方式:复方利多卡因乳膏表面麻醉+哌卡因局部浸润麻醉。结果本组患者均在复合局部麻醉下顺利完成手术治疗,术中、术后无手术相关并发症发生。术后随访6个月,手术疗效价:优良率为93.94%。结论 ACS复合局部麻醉下手术治疗腰骶部筋膜脂肪疝疗效确切、安全可靠,减少了患者在院时间,节省了医疗成本。

  12. Optimized Flight Path for Localization Using Line of Bearing

    Science.gov (United States)

    2015-03-26

    speed and angular velocity of heading angle will be considered. MATLAB / Simulink is used for solving the optimal control problem. Among the many...from real-world data can be compared to the result of the MATLAB / Simulink simulation predictions for future flight tests can be made. 6 1.6 Thesis...targeting. In addition, the specific process of the algorithm is explained using a sample result using MATLAB / Simulink . Sensitivity of the result and

  13. Application of lichtenstein repair in elderly patients with inguinal hernia under local anesthesia%局麻下李金斯坦疝修补术在老年人腹股沟疝病人中的应用

    Institute of Scientific and Technical Information of China (English)

    汪陵生; 姚时伟; 左贵泽

    2013-01-01

    Objective:To research the applied value of Lichtenstein repair in elderly patients with inguinal hernia under local anesthe -sia.Methods:Retrospective analysis of 43 cases clinical data of Lichtenstein repair in elderly patients over age 65 with inguinal hernia under local anesthesia from Dec .2010 to Dec.2012.Results:43 cases elderly patients over age 65 with inguinal hernia were implemen-ted by Lichtenstein repair under local anesthesia .Postoperative patients with rapid recovery ,light pain,low cost,etc.Conclusion:The ap-plication of Lichtenstein repair in elderly patients with inguinal hernia under local anesthesia was safe ,simple,effective,affordable and so on.It might be worth the clinical promotion .%目的:研究局麻下李金斯坦疝修补术在老年人腹股沟疝病人中的应用价值。方法:回顾性分析我院2010年12月~2012年12月开展的43例65岁以上老年人腹股沟疝施行局麻下李金斯坦疝修补术的临床资料。结果:43例65岁以上老年人腹股沟疝均在局麻下施行了李金斯坦疝修补术,术后病人具有恢复快、疼痛轻、费用低等特点。结论:局麻下李金斯坦疝修补术在老年腹股沟疝病人中的应用具有安全、简单、有效、经济等优点,并且值得临床推广。

  14. Measurement and Optimization of Local Coupling from RHIC BPM Data

    CERN Document Server

    Calaga, Rama; Bai, Mei; Fischer, Wolfram; Franchi, Andrea; Tomas, Rogelio

    2005-01-01

    Global coupling in RHIC is routinely corrected by using three skew quadrupole families to minimize the tune split. In this paper we aim to re-optimize the coupling at top energy by minimizing resonance driving terms and the C-matrix in two steps: 1. Find the best configuration of the three skew quadrupole families and 2. Identify locations with coupling sources by inspection of the driving terms and the C-matrix around the ring. The measurements of resonance terms and C-matrix are presented.

  15. Global Optimization, Local Adaptation, and the Role of Growth in Distribution Networks

    Science.gov (United States)

    Ronellenfitsch, Henrik; Katifori, Eleni

    2016-09-01

    Highly optimized complex transport networks serve crucial functions in many man-made and natural systems such as power grids and plant or animal vasculature. Often, the relevant optimization functional is nonconvex and characterized by many local extrema. In general, finding the global, or nearly global optimum is difficult. In biological systems, it is believed that such an optimal state is slowly achieved through natural selection. However, general coarse grained models for flow networks with local positive feedback rules for the vessel conductivity typically get trapped in low efficiency, local minima. In this work we show how the growth of the underlying tissue, coupled to the dynamical equations for network development, can drive the system to a dramatically improved optimal state. This general model provides a surprisingly simple explanation for the appearance of highly optimized transport networks in biology such as leaf and animal vasculature.

  16. Parameter optimization of controllable local degree of freedom for reducing vibration of flexible manipulator

    Institute of Scientific and Technical Information of China (English)

    Bian Yushu; Gao Zhihui

    2013-01-01

    Parameter optimization of the controllable local degree of freedom is studied for reducing vibration of the flexible manipulator at the lowest possible cost.The controllable local degrees of freedom are suggested and introduced to the topological structure of the flexible manipulator,and used as an effective way to alleviate vibration through dynamic coupling.Parameters introduced by the controllable local degrees of freedom are analyzed and their influences on vibration reduction are investigated.A strategy to optimize these parameters is put forward and the corresponding optimization method is suggested based on Particle Swarm Optimization (PSO).Simulations are conducted and results of case studies confirm that the proposed optimization method is effective in reducing vibration of the flexible manipulator at the lowest possible cost.

  17. Global optimization, local adaptation and the role of growth in distribution networks

    CERN Document Server

    Ronellenfitsch, Henrik

    2016-01-01

    Highly-optimized complex transport networks serve crucial functions in many man-made and natural systems such as power grids and plant or animal vasculature. Often, the relevant optimization functional is non-convex and characterized by many local extrema. In general, finding the global, or nearly global optimum is difficult. In biological systems, it is believed that natural selection slowly guides the network towards an optimized state. However, general coarse grained models for flow networks with local positive feedback rules for the vessel conductivity typically get trapped in low efficiency, local minima. In this work we show how the growth of the underlying tissue, coupled to the dynamical equations for network development, can drive the system to a dramatically improved optimal state. This general model provides a surprisingly simple explanation for the appearance of highly optimized transport networks in biology such as leaf and animal vasculature.

  18. Gradient-only approaches to avoid spurious local minima in unconstrained optimization

    CSIR Research Space (South Africa)

    Wilke, DN

    2013-06-01

    Full Text Available local minima, are artifacts of the numerical strategies used and should not influence the solution to the optimization problem. Although the discontinuities imply that the gradient field is not defined everywhere, the gradient field associated...

  19. Anesthesia information management systems.

    Science.gov (United States)

    Williams, Joe R

    2005-06-01

    Documentation is the last component of anesthesia patient management to be affected by technology. Anesthesia information management systems (AIMS) have been introduced in a limited number of practice sites. The automated systems provide unbiased reporting of most patient information. This results in improved patient care and possible medical legal advantages. AIMS also allow anesthesia departments to monitor their business related activity.

  20. [Unilateral spinal anesthesia : Literature review and recommendations].

    Science.gov (United States)

    Büttner, B; Mansur, A; Bauer, M; Hinz, J; Bergmann, I

    2016-11-01

    Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis. Until now, spinal anesthesia has been considered unsuitable for this, not only because of the high incidence of intraoperative hypotension and postoperative urinary retention but also because of the prolonged postoperative stay before home discharge. This is not the case with unilateral spinal anesthesia: motor function returns rapidly, the incidence of urinary retention is extremely low, and patients are usually eligible for home discharge sooner than after bilateral spinal anesthesia or general anesthesia. The success of the technique depends on a number of factors. In addition to the local anesthetic, its concentration and dose, and the baricity of the injected solution, the shape of the spinal needle, the injection speed, the patient's position during injection, and the time the patient remains in this position after injection are equally important parameters. A number of intrathecally applied adjuvant drugs are used to give a more intense and/or longer-lasting block. For this review, we collated the published data on unilateral spinal anesthesia from journals with an impact factor greater than 1.0 and defined an optimized method for performing the technique. In order to achieve an exclusively unilateral block one should use 0.5 % hyperbaric bupivacaine injected at a rate of 0.33 ml/min or slower. During the injection and the following 20 min the patient should

  1. Single-lung ventilation in pediatric anesthesia.

    Science.gov (United States)

    Choudhry, Dinesh K

    2005-12-01

    Single-lung ventilation is requested for an increasing spectrum of surgical procedures in infants and children. A clear understanding of the physiology of single-lung ventilation, the techniques of lung separation, and the technical skill necessary to apply these techniques are essential for an anesthesiologist practicing thoracic anesthesia. This article focuses on various devices available for single-lung ventilation in the pediatric age group, the relevant respiratory physiology, and the strategies that optimize oxygenation during one-lung anesthesia.

  2. Fast Quadratic Local Meta-Models for Evolutionary Optimization of Anguilliform Swimmers

    OpenAIRE

    Kern, Stefan; Hansen, Nikolaus; Koumoutsakos, Petros

    2004-01-01

    International audience; We combine second order local regression meta-models with the Covariance Matrix Adaptation Evolution Strategy in order to enhance its efficiency in the optimization of computationally expensive problems. Computationally intensive direct numerical simulations of an anguilliform swimmer provide the testbed for the optimization. We propose two concepts to reduce the computational cost of the meta-model building. The novel versions of the local meta-model assisted Evolutio...

  3. On topology optimization of acoustic metamaterial lattices for locally resonant bandgaps of flexural waves

    CERN Document Server

    Hedayatrasa, Saeid; Uddin, Mohammad

    2016-01-01

    Optimized topology of bi-material acoustic metamaterial lattice plates is studied for maximized locally resonant bandgap of flexural guided waves. Optimized layout of the two relatively stiff and compliant material phases in the design domain is explored, free from any restrictions on the topology and shape of the relevant domains. Multiobjective optimization is performed through which maximized effective stiffness or minimized overall mass of the bandgap topology is additionally ensured. Extreme and selected intermediate optimized topologies of Pareto fronts are presented and their bandgap efficiencies and effective stiffness are compared. The bi-material constitution of selected topologies are further altered and modal band structure of resultant multilateral and porous designs are evaluated. Novel, core-shell like, locally resonant bandgaps are introduced. It is shown that how the bandgap efficiency and structural mass and/or stiffness can be optimized through optimized microstructural design of the matrix...

  4. Parameter Selection and Performance Comparison of Particle Swarm Optimization in Sensor Networks Localization.

    Science.gov (United States)

    Cui, Huanqing; Shu, Minglei; Song, Min; Wang, Yinglong

    2017-03-01

    Localization is a key technology in wireless sensor networks. Faced with the challenges of the sensors' memory, computational constraints, and limited energy, particle swarm optimization has been widely applied in the localization of wireless sensor networks, demonstrating better performance than other optimization methods. In particle swarm optimization-based localization algorithms, the variants and parameters should be chosen elaborately to achieve the best performance. However, there is a lack of guidance on how to choose these variants and parameters. Further, there is no comprehensive performance comparison among particle swarm optimization algorithms. The main contribution of this paper is three-fold. First, it surveys the popular particle swarm optimization variants and particle swarm optimization-based localization algorithms for wireless sensor networks. Secondly, it presents parameter selection of nine particle swarm optimization variants and six types of swarm topologies by extensive simulations. Thirdly, it comprehensively compares the performance of these algorithms. The results show that the particle swarm optimization with constriction coefficient using ring topology outperforms other variants and swarm topologies, and it performs better than the second-order cone programming algorithm.

  5. Damage approach: A new method for topology optimization with local stress constraints

    DEFF Research Database (Denmark)

    Verbart, Alexander; Langelaar, Matthijs; van Keulen, Fred

    2016-01-01

    In this paper, we propose a new method for topology optimization with local stress constraints. In this method, material in which a stress constraint is violated is considered as damaged. Since damaged material will contribute less to the overall performance of the structure, the optimizer will p...

  6. Parameter Selection and Performance Comparison of Particle Swarm Optimization in Sensor Networks Localization

    Directory of Open Access Journals (Sweden)

    Huanqing Cui

    2017-03-01

    Full Text Available Localization is a key technology in wireless sensor networks. Faced with the challenges of the sensors’ memory, computational constraints, and limited energy, particle swarm optimization has been widely applied in the localization of wireless sensor networks, demonstrating better performance than other optimization methods. In particle swarm optimization-based localization algorithms, the variants and parameters should be chosen elaborately to achieve the best performance. However, there is a lack of guidance on how to choose these variants and parameters. Further, there is no comprehensive performance comparison among particle swarm optimization algorithms. The main contribution of this paper is three-fold. First, it surveys the popular particle swarm optimization variants and particle swarm optimization-based localization algorithms for wireless sensor networks. Secondly, it presents parameter selection of nine particle swarm optimization variants and six types of swarm topologies by extensive simulations. Thirdly, it comprehensively compares the performance of these algorithms. The results show that the particle swarm optimization with constriction coefficient using ring topology outperforms other variants and swarm topologies, and it performs better than the second-order cone programming algorithm.

  7. Parameter Selection and Performance Comparison of Particle Swarm Optimization in Sensor Networks Localization

    Science.gov (United States)

    Cui, Huanqing; Shu, Minglei; Song, Min; Wang, Yinglong

    2017-01-01

    Localization is a key technology in wireless sensor networks. Faced with the challenges of the sensors’ memory, computational constraints, and limited energy, particle swarm optimization has been widely applied in the localization of wireless sensor networks, demonstrating better performance than other optimization methods. In particle swarm optimization-based localization algorithms, the variants and parameters should be chosen elaborately to achieve the best performance. However, there is a lack of guidance on how to choose these variants and parameters. Further, there is no comprehensive performance comparison among particle swarm optimization algorithms. The main contribution of this paper is three-fold. First, it surveys the popular particle swarm optimization variants and particle swarm optimization-based localization algorithms for wireless sensor networks. Secondly, it presents parameter selection of nine particle swarm optimization variants and six types of swarm topologies by extensive simulations. Thirdly, it comprehensively compares the performance of these algorithms. The results show that the particle swarm optimization with constriction coefficient using ring topology outperforms other variants and swarm topologies, and it performs better than the second-order cone programming algorithm. PMID:28257060

  8. Portfolio Optimization under Local-Stochastic Volatility: Coefficient Taylor Series Approximations & Implied Sharpe Ratio

    OpenAIRE

    Matthew Lorig; Ronnie Sircar

    2015-01-01

    We study the finite horizon Merton portfolio optimization problem in a general local-stochastic volatility setting. Using model coefficient expansion techniques, we derive approximations for the both the value function and the optimal investment strategy. We also analyze the `implied Sharpe ratio' and derive a series approximation for this quantity. The zeroth-order approximation of the value function and optimal investment strategy correspond to those obtained by Merton (1969) when the risky...

  9. SURVEY ON CLINICAL STUDY OF COMPOUND ACUPUNCTURE ANESTHESIA IN RESENT 10 YEARS IN CHINA

    Institute of Scientific and Technical Information of China (English)

    秦必光; 胡北喜; 等

    2002-01-01

    In the present paper,the authors make a review on the progresses of acupuncture anesthesia(AA) from (1)historical development,(2)research on acupuncture combined with local anesthesia;(3)research on acupuncture combined with epidural anesthesia;and (4)research on acupuncture combined with general anesthesia.Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definits analyesic effect and many advantages,and should be investigated further.

  10. 氯普鲁卡因在乳牙拔除中的疗效分析%Clinical study of local anesthesia with chlorprocaine hydrochloride in children tooth extracion

    Institute of Scientific and Technical Information of China (English)

    王莉; 周赟

    2015-01-01

    目的::观察盐酸氯普鲁卡因在儿童乳牙拔除中的麻醉效果。方法:将120例乳牙滞留但牙不松动的患儿随机分为2组,实验组以2%盐酸氯普鲁卡因局部麻醉,对照组以2%利多卡因局部麻醉。比较两组药物麻醉良好率的差异。结果:实验组麻醉良好率80.3%对照组麻醉良好率79.7%,差异不具统计学意义(P>0.05)。结论:在乳牙拔除中盐酸氯普鲁卡因麻醉效果与利多卡因一样。%Objective: To evaluate the efficacy of local anesthesia with chlorprocaine hydrochloride in children tooth extracion. Methods: 120 retained deciduous teeth without loosening were randomly divided into test group (local anesthesia with chlorprocaine hydrochloride), and control group(with lidocaine). Their effective rate were observed. Results: The effective rate was 80.3% in test group and 79.7% in control group, the difference was not significant (P>0.05). Conclusion:Local anesthesia with chlorprocaine hydrochloride may be applied to extract retained deciduous tooth.

  11. Analysis of local anesthesia used in Lichtenstein unstressing hernia plastic operation in 54 patients with inguinal hernia%局部麻醉下老年人腹股沟疝Lichtenstein无张力修补术54例体会

    Institute of Scientific and Technical Information of China (English)

    徐福祥; 陈文军; 樊盛军; 胡海涛

    2012-01-01

    目的 对局部麻醉下行Lichtenstein无张力疝修补术治疗老年人腹股沟疝的疗效进行评价.方法 对54例老年腹人股沟疝患者在局部麻醉下行Lichtenstein无张力疝修补术的术中以及术后等情况进行随访观察.结果 54例患者术中都获得良好的麻醉效果,术后恢复快,并发症少.52例患者获得随访,随访时间12 ~ 48 m,无复发.结论 局部麻醉下Lichtenstein无张力疝修补术,是一种对老年人身体机能干扰小、并发症少、恢复快、易于掌握的理想方法.%Objective To evaluate the effect of Lichtenstien unstressing hernia plastic operation for inguinal hernia with local anesthesia. Methods The clinical data of 54 patients with inguinal hernia, which underwent Lichtenstien unstressing hernia plastic operation with local anesthesia, were analyzed. Results All patients underwent good anaesthesia, and recovered quickly with low expense. Fifty-two patients receiving follow-up from 12 to 48 months did not show recrudescence. Conclusion Unstressing hernia plastic operation under local anesthesia is one ideal method for inguinal hernia with few complications with low expense, and could be easily used.

  12. Approximating the Expansion Profile and Almost Optimal Local Graph Clustering

    CERN Document Server

    Gharan, Shayan Oveis

    2012-01-01

    Spectral partitioning is a simple, nearly-linear time, algorithm to find sparse cuts, and the Cheeger inequalities provide a worst-case guarantee for the quality of the approximation found by the algorithm. Local graph partitioning algorithms [ST08,ACL06,AP09] run in time that is nearly linear in the size of the output set, and their approximation guarantee is worse than the guarantee provided by the Cheeger inequalities by a polylogarithmic $\\log^{\\Omega(1)} n$ factor. It has been a long standing open problem to design a local graph clustering algorithm with an approximation guarantee close to the guarantee of the Cheeger inequalities and with a running time nearly linear in the size of the output. In this paper we solve this problem; we design an algorithm with the same guarantee (up to a constant factor) as the Cheeger inequality, that runs in time slightly super linear in the size of the output. This is the first sublinear (in the size of the input) time algorithm with almost the same guarantee as the Che...

  13. Role of intraseptal anesthesia for pain-free dental treatment

    Directory of Open Access Journals (Sweden)

    G Gazal

    2016-01-01

    Full Text Available Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003, and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine, and intraosseous injection (2% lidocaine are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia.

  14. A PHASE 1 DOSE OPTIMIZATION STUDY OF ABP-700 WITH OPIATES AND/OR MIDAZOLAM PRE-MEDICATION IN HEALTHY ADULT VOLUNTEERS TARGETING INDUCTION OF GENERAL ANESTHESIA

    NARCIS (Netherlands)

    Meier, Sascha; Absalom, Anthony; Sweeney, Steven; Campagna, Jason; Marota, John; Struys, Michel

    2016-01-01

    INTRODUCTION: ABP-700 is a novel, second-generation metabolically labile etomidate analogue in development for procedural sedation and general anesthesia . Pre-clinical and Phase I studies show minimal hemodynamic and respiratory depression, no adrenocortical suppression, and rapid emergence from

  15. A PHASE 1 DOSE OPTIMIZATION STUDY OF ABP-700 WITH OPIATES AND/OR MIDAZOLAM PRE-MEDICATION IN HEALTHY ADULT VOLUNTEERS TARGETING INDUCTION OF GENERAL ANESTHESIA

    NARCIS (Netherlands)

    Meier, Sascha; Absalom, Anthony; Sweeney, Steven; Campagna, Jason; Marota, John; Struys, Michel

    2016-01-01

    INTRODUCTION: ABP-700 is a novel, second-generation metabolically labile etomidate analogue in development for procedural sedation and general anesthesia . Pre-clinical and Phase I studies show minimal hemodynamic and respiratory depression, no adrenocortical suppression, and rapid emergence from se

  16. [Automated anesthesia record system].

    Science.gov (United States)

    Zhu, Tao; Liu, Jin

    2005-12-01

    Based on Client/Server architecture, a software of automated anesthesia record system running under Windows operation system and networks has been developed and programmed with Microsoft Visual C++ 6.0, Visual Basic 6.0 and SQL Server. The system can deal with patient's information throughout the anesthesia. It can collect and integrate the data from several kinds of medical equipment such as monitor, infusion pump and anesthesia machine automatically and real-time. After that, the system presents the anesthesia sheets automatically. The record system makes the anesthesia record more accurate and integral and can raise the anesthesiologist's working efficiency.

  17. Experience of treatment of 58 cases of tension-free hernia repair under local anesthesia%局麻下无张力疝修补术58例治疗体会

    Institute of Scientific and Technical Information of China (English)

    侯培华

    2014-01-01

    目的:总结在局部麻醉下行无张力疝修补手术治疗腹股沟疝的临床经验。方法:对58例腹股沟疝患者在局麻下行无张力疝修补手术的临床资料进行分析。结果:局部麻醉下镇痛效果满意,手术时间30~50分钟,平均住院5.5天,术后阴囊血肿2例,术后疼痛2例,异物感1例,尿潴留1例,随访6个月~3年无复发病例。结论:局部麻醉下行腹股沟疝修补术具有手术操作简便、恢复快、术后痛苦小、并发症降低等优点,适合在基层医院推广开展。%Objective:To summarize the clinical experience of tension-free hernia repair under local anesthesia for inguinal hernia.Methods:We analyzed the clinical data of 58 cases with tension-free hernia repair under local anesthesia for inguinal hernia.Results:Analgesia effect with local anesthesia was satisfactory.The operation time was 30 to 50 minutes.The average hospitalization time was 5.5 days.After operation,2 cases had hematoma of scrotum,2 cases had pain,1 case had foreign body sensation,and 1 case had urinary retention.Follow up of 6 months to 3 years,there was no recurrence.Conclusion:Inguinal hernia repair with local anesthesia has many advantages,such as simple operation,quick recovery,less complications and so on.It is suitable for promotion in basic hospital.

  18. Optimal volume of local anaesthetic for the adductor canal block

    DEFF Research Database (Denmark)

    Jæger, P.; Jenstrup, M. T.; Lund, J.;

    2015-01-01

    Background: Theoretically, the ideal volume of local anaesthetic for adductor canal block (ACB) would ensure sufficient filling ofthe canal and avoid proximal spread to the femoral triangle. In this dose-finding study, we aimed to investigate the minimaleffective volume for an ACB needed to fill...... the adductor canal distally in at least 95% of patients (ED95). Methods: We performed a blinded trial, enrolling 40 healthy men. All subjects received an ACB with lidocaine 1%. Volumes wereassigned sequentially to the subjects using the continual reassessment method followed by Bayesian analysis to determine...... theED95. Distal filling of the adductor canal was assessed by magnetic resonance imaging (primary outcome). Secondary outcomeswere the effect of volume on proximal spread to the femoral triangle (also assessed by magnetic resonance imaging), quadricepsmuscle weakness (decrease by ≥25% from baseline...

  19. Optimalization of Beacon Selection for Localization in Wireless AD-HOC Networks

    Directory of Open Access Journals (Sweden)

    Martin Matula

    2008-01-01

    Full Text Available In this paper we engage in optimalization of convenient beacons for localization position of a node in the ad-hoc network. An algorithm designed by us localizes position of moving or static node by RSS (Received Signal Strength method and trilateration. At first, localization of unknown node runs by combination of all beacons. Than optimalizating algorithmreduces the number of beacons (and repeats localization, while only three left. Its reduction is based on highest levels of received signal strength. It is only when signals are from the nearest beacons. Position localizating exactness is statistically interpreted from all localization by beacons combination and its repeating.

  20. OPTIMAL ERROR ESTIMATES OF THE PARTITION OF UNITY METHOD WITH LOCAL POLYNOMIAL APPROXIMATION SPACES

    Institute of Scientific and Technical Information of China (English)

    Yun-qing Huang; Wei Li; Fang Su

    2006-01-01

    In this paper, we provide a theoretical analysis of the partition of unity finite element method(PUFEM), which belongs to the family of meshfree methods. The usual error analysis only shows the order of error estimate to the same as the local approximations[12].Using standard linear finite element base functions as partition of unity and polynomials as local approximation space, in 1-d case, we derive optimal order error estimates for PUFEM interpolants. Our analysis show that the error estimate is of one order higher than the local approximations. The interpolation error estimates yield optimal error estimates for PUFEM solutions of elliptic boundary value problems.

  1. Topology Optimization of Periodic Microstructures with a Penalization of Highly Localized Buckling Modes

    DEFF Research Database (Denmark)

    Neves, Miguel M.; Sigmund, Ole; Bendsøe, Martin P.

    2002-01-01

    The problem of determining highly localized buckling modes in perfectly periodic cellular microstructures of infinite extent is addressed. A double scale asymptotic technique is applied to the linearized stability problem for a periodic structure built from linearly elastic microstructures...... to design materials with optimal elastic properties that are less prone to localized instability in the form of local buckling modes at the scale of the micro structure. Copyright (C) 2002 John Wiley Sons, Ltd....

  2. Is local participation always optimal for sustainable action? The costs of consensus-building in Local Agenda 21.

    Science.gov (United States)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-11-15

    Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits. Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable action in the future.

  3. The effects of local anesthesia and epidural anesthesia on immune function in patients undergoing benign breast tumor surgery%局部浸润麻醉和硬膜外麻醉对乳腺良性肿瘤切除患者免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    季蒙; 陶军; 王庆利; 黎笔熙

    2013-01-01

    Objective To investigate the effects of local anesthesia and epidural anesthesia on immune function in patients undergoing benign breast tumor surgery.Methods 62 patients undergoing benign breast tumor surgery were selected and divided into two groups,local anesthesia group (n =31),epidural anesthesia group (n=31).Peripheral vein blood was obtained before anaesthesia(T1),at 30 rain(T2),60 min (T3)and 90 min(T4)during anaesthesia for detecting CD3+,CD4+,CD8+,and natural killer cells by flow cytometry,IL-12,IFN-γ,IL-4,TNF-α by ELISA,lgG,lgA,lgM by immunodiffusion.Results In epidural anesthesia group,the level of lgG,lgA and lgM at T1 reduced compared with those at T0(P<0.05).There were significant different in the level of lgG,lgA and lgM at T1 between two groups(P<0.05).In epidural anesthesia group,at T2 and T3,CD4+ increased and natural killer cells decreased significantly compared with those at T1 (P<0.05).In local anesthesia group,the level of IL-12,IFN-γ and TNF-α at T3 increased compared with those at T0(P<0.05).There were significant different in the level of IL-12,IFN-γ and TNF-α at T3 between two groups(P<0.05).Meanwhile,there were significant different in the level of TNF-α at T2 between two groups(P<0.05).Conclusion This study indicates that local anesthesia has less effects on immune function than that of epidural anesthesia in patients undergoing benign breast tumor surgery.%目的 比较局部浸润麻醉和硬膜外麻醉对乳腺良性肿瘤切除患者免疫功能的影响.方法 将入选的62例行乳腺良性肿瘤切除患者随机分成硬膜外麻醉组和局部浸润麻醉组各31例,分别测定麻醉前(T0)及麻醉后30 min(T1)、60 min(T2)及90 min(T3)的血清T细胞亚群自然杀伤细胞、免疫蛋白浓度以及细胞因子浓度,并对测定结果进行统计学比较.结果 硬膜外麻醉组在T1时的lgG、lgA及lgM水平均较T0明显降低(P<0.05),且在T1时硬膜外麻醉组的lgG、lgA及lgM水平也

  4. Subcritical transition scenarios via linear and nonlinear localized optimal perturbations in plane Poiseuille flow

    Science.gov (United States)

    Farano, Mirko; Cherubini, Stefania; Robinet, Jean-Christophe; De Palma, Pietro

    2016-12-01

    Subcritical transition in plane Poiseuille flow is investigated by means of a Lagrange-multiplier direct-adjoint optimization procedure with the aim of finding localized three-dimensional perturbations optimally growing in a given time interval (target time). Space localization of these optimal perturbations (OPs) is achieved by choosing as objective function either a p-norm (with p\\gg 1) of the perturbation energy density in a linear framework; or the classical (1-norm) perturbation energy, including nonlinear effects. This work aims at analyzing the structure of linear and nonlinear localized OPs for Poiseuille flow, and comparing their transition thresholds and scenarios. The nonlinear optimization approach provides three types of solutions: a weakly nonlinear, a hairpin-like and a highly nonlinear optimal perturbation, depending on the value of the initial energy and the target time. The former shows localization only in the wall-normal direction, whereas the latter appears much more localized and breaks the spanwise symmetry found at lower target times. Both solutions show spanwise inclined vortices and large values of the streamwise component of velocity already at the initial time. On the other hand, p-norm optimal perturbations, although being strongly localized in space, keep a shape similar to linear 1-norm optimal perturbations, showing streamwise-aligned vortices characterized by low values of the streamwise velocity component. When used for initializing direct numerical simulations, in most of the cases nonlinear OPs provide the most efficient route to transition in terms of time to transition and initial energy, even when they are less localized in space than the p-norm OP. The p-norm OP follows a transition path similar to the oblique transition scenario, with slightly oscillating streaks which saturate and eventually experience secondary instability. On the other hand, the nonlinear OP rapidly forms large-amplitude bent streaks and skips the phases

  5. An adaptive image denoising method based on local parameters optimization

    Indian Academy of Sciences (India)

    Hari Om; Mantosh Biswas

    2014-08-01

    In image denoising algorithms, the noise is handled by either modifying term-by-term, i.e., individual pixels or block-by-block, i.e., group of pixels, using suitable shrinkage factor and threshold function. The shrinkage factor is generally a function of threshold and some other characteristics of the neighbouring pixels of the pixel to be thresholded (denoised). The threshold is determined in terms of the noise variance present in the image and its size. The VisuShrink, SureShrink, and NeighShrink methods are important denoising methods that provide good results. The first two, i.e., VisuShrink and SureShrink methods follow term-by-term approach, i.e., modify the individual pixel and the third one, i.e., NeighShrink and its variants: ModiNeighShrink, IIDMWD, and IAWDMBMC, follow block-by-block approach, i.e., modify the pixels in groups, in order to remove the noise. The VisuShrink, SureShrink, and NeighShrink methods however do not give very good visual quality because they remove too many coefficients due to their high threshold values. In this paper, we propose an image denoising method that uses the local parameters of the neighbouring coefficients of the pixel to be denoised in the noisy image. In our method, we propose two new shrinkage factors and the threshold at each decomposition level, which lead to better visual quality. We also establish the relationship between both the shrinkage factors. We compare the performance of our method with that of the VisuShrink and NeighShrink including various variants. Simulation results show that our proposed method has high peak signal-to-noise ratio and good visual quality of the image as compared to the traditional methods:Weiner filter, VisuShrink, SureShrink, NeighBlock, NeighShrink, ModiNeighShrink, LAWML, IIDMWT, and IAWDMBNC methods.

  6. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    Science.gov (United States)

    Tetzlaff, John E; Vargo, John J; Maurer, Walter

    2014-06-01

    Anesthesia services are increasingly being requested for gastrointestinal (GI) endoscopy procedures. The preparation of the patients is different from the traditional operating room practice. The responsibility to optimize comorbid conditions is also unclear. The anesthetic techniques are unique to the procedures, as are the likely events that require intervention by the anesthesia team. The postprocedure care is also unique. The future needs for anesthesia services in GI endoscopy suite are likely to expand with further developments of the technology.

  7. [Seeing more : Technical innovations in regional anesthesia].

    Science.gov (United States)

    Wiesmann, T; Steinfeldt, T; Volk, T; Schwemmer, U; Kessler, P; Wulf, H

    2014-11-01

    Visualization and verification are key factors since the implementation of ultrasound-guided regional anesthesia. This article reviews and discusses newer technical innovations in regional anesthesia with regard to optimization of needle guidance, improvements in needle visibility, technical improvements in ultrasound techniques and innovative technologies in regional anesthesia. Clinically available applications are presented as well as experimental tools and techniques with a potential for clinical implementation in the future. Mechanical needle guides are used to improve alignment of needle axis and ultrasound beam axis. Compound imaging technology improves needle visibility in steep needle insertion angles and is already implemented in daily clinical practice. Sonoelastography improves tissue discrimination and detection of small amounts of fluids. Benefits of 3D and 4D ultrasound in regional anesthesia are discussed as well as experimental tools for tissue discrimination, such as optical reflection spectrophotometry.

  8. [Systematic recording of perioperative events associated with anesthesia as quality indicator in ambulatory anesthesia].

    Science.gov (United States)

    García-Aguado, R; Vivó Benlloch, M; Arcusa Mon, M J; Peiró Alós, C; Zaragoza Fernández, C; Castaño Conesa, S; Grau Real, F

    2000-03-01

    To analyze the quality of several anesthetic techniques used for major outpatient surgery in our hospital, by quantifying for each the relative risk (RR) of adverse events during anesthesia and in the postoperative period. One thousand seventeen patients who underwent surgery between 18 May 1998 and 23 October 1998 were studied retrospectively. The mean age of the patients was 52.27 +/- 24.65 yr; 44.18% were ASA I, 40.56% were ASA II, 14.56% ASA III and 0.67% ASA IV. Mean time of surgery was 33 +/- 16.49 min and mean recovery time until discharge was 77.3 +/- 93.4 min. Admission was necessary for 0.6% of the patients and re-admission for 0.3%. General anesthesia was used with 19%, anesthetic monitoring with 17%, regional anesthesia (including peribulbar) with 46% and local anesthesia plus sedation with 16.6%. In 95% of the cases, no adverse events occurred during anesthesia; in 94.8% no such events occurred during the early recovery period. During surgery and postoperative recovery, intradural anesthesia was associated with significantly greater RR of adverse events in comparison with general anesthesia (6.6 and 2.2 respectively) and in comparison with monitored anesthesia (7.2 and 3.3). No differences in RR were found between general anesthesia and monitored anesthesia. Problems were slight to moderate in severity and mainly related to nausea and vomiting (2%). Recording perioperative events permits evaluation of the quality of anesthesic procedures. Intradural anesthesia is associated with more complications.

  9. Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia: A prospective clinical trial.

    Science.gov (United States)

    Lee, Sook Young; Yoo, Ji Young; Kim, Jong Yeop; Kim, Dae Hee; Lee, Jung Dong; Rho, Go Un; Park, Hyungbae; Park, Sung Yong

    2016-06-01

    Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled. The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC50 and EC95) for preventing cough was determined using the isotonic regression method with a bootstrapping approach, following the Dixon up-and-down method. Recovery profiles and hemodynamic values after anesthesia were compared between patients with cough and patients without cough.EC50 and EC95 of remifentanil was 1.670 ng/mL [95% confidence interval (95% CI) 1.393-1.806] and 2.275 ng/mL (95% CI 1.950-2.263), respectively. There were no differences in recovery profiles and hemodynamic values after anesthesia between patients with/without cough. No patients suffered respiratory complications during the emergence period.Remifentanil can be a safe and reliable method of cough prevention during emergence from sevoflurane anesthesia after thoracic surgery requiring DLT. EC50 and EC95 of remifentanil that suppresses coughing is 1.670 and 2.275 ng/mL, respectively.

  10. Robotics and regional anesthesia.

    Science.gov (United States)

    Wehbe, Mohamad; Giacalone, Marilu; Hemmerling, Thomas M

    2014-10-01

    Robots in regional anesthesia are used as a tool to automate the performance of regional techniques reducing the anesthesiologist's workload and improving patient care. The purpose of this review is to show the latest findings in robotic regional anesthesia. The literature separates robots in anesthesia into two groups: pharmacological robots and manual robots. Pharmacological robots are mainly closed-loop systems that help in the titration of anesthetic drugs to patients undergoing surgery. Manual robots are mechanical robots that are used to support or replace the manual gestures performed by anesthesiologists. Although in the last decade researchers have focused on the development of decision support systems and closed-loop systems, more recent evidence supports the concept that robots can also be useful in performing regional anesthesia techniques. Robots can improve the performance and safety in regional anesthesia. In this review, we present the developments made in robotic and automated regional anesthesia, and discuss the current state of research in this field.

  11. CAN FRACTIONATED SPINAL ANESTHESIA BE AN ECONOMICAL ALTERNATIVE TECHNIQUE TO COMBINED SPINAL - EPIDURAL ANESTHESIA??

    Directory of Open Access Journals (Sweden)

    Sunitha

    2015-01-01

    Full Text Available NTRODUCTION : Central neuraxial blockade holds a very good place in anesthesia for surgical procedures on abdomen and lower limbs 1 . We have spinal anesthesia with rapid onset of action with precipitous hypotension , on the other hand we have epidural anesthesia with gradual onset of action with graded fall in BP and ability to prolong anesthesia for required duration and to provide post - operative analgesia. Combination of these two techniques can be of benefit in the form of rapid onset of action by spinal anesthesia and prolonging the duration of anesthesia by epidural. 2 , 3 This combined technique appears to be demanding higher cost when compared to either of them 4 , 5 and also associated with technical difficulties a nd catheter related problems. Fractionated spinal anesthesia (FSA 6 , 7 where local anesthetic is injected into subarachnoid space in fractions with time gap along with opioids like morphine 5 , 8 , 9 will not only reduce the degree of hypotension 10 , 11 but al so provides prolonged duration of anesthesia. 12 , 13 Addition of morphine will take care of postoperative analgesia and this technique is devoid of complications related to the catheters like kinking , infections , difficulty in insertion , blockade etc

  12. Anesthesia information management systems

    OpenAIRE

    Feri Štivan; Janez Benedik; Tomaž Lužar

    2014-01-01

    Introduction: The use of anesthesia information management systems (AIMS) is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia...

  13. 局麻下行无张力腹股沟疝修补术治疗体会%Clinical Experience of Local Anesthesia in Tension-free Inguinal Hernia Repair

    Institute of Scientific and Technical Information of China (English)

    郑新; 邢壮杰; 李润生; 赵晖; 郝国强; 邓芝徽

    2015-01-01

    目的总结局麻下无张力疝修补术治疗腹股沟疝的经验。方法对110例腹股沟疝无张力修补术中疼痛情况、术后早期疼痛、下床活动、进食、排尿及住院时间等情况进行观察。结果局麻下无张力疝修补术手术适应症宽,手术平均时间为55min,住院平均时间为4d,术中麻醉效果好,术后进食早,疼痛轻,无尿潴留发生。结论该治疗方法是一种麻醉风险小、术后恢复快、并发症少、复发率低。%Objective To experience the experience of treating inguinal hernia with tension free hernia repair under anesthesia.Methods 110 cases of inguinal hernia tension free repair,pain,early postoperative pain,get out of bed,eating,urination and hospital stay were observed.Results Under local anesthesia without tension hernia repair wide indications,the average operation time is 55,the average hospitalization time was 4 days,anesthetic ef ect is good,postoperative eating early,less pain and no urinary retention occur ed.Conclusion This method is one of the ideal methods for low risk of anesthesia,quick recovery,less complications,low recur ence rate.

  14. 局部麻醉下李金斯坦平片改良修补腹股沟疝的研究%Study on Lichtenstein improvement repair of inguinal hernia under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    张勇; 李旋; 杨传青; 林德新; 曾岳岳

    2016-01-01

    Objective To Study Lichtenstein improvement repair of inguinal hernia under local anesthesia. Methods With 2% lidocaine hydrochloride 15ml and 2. 5% bupivacaine hydrochloride 15ml and 0.9% saline 30ml and 0.3 mg epinephrine were mixed to 60ml, the line of surgical incision marking distance for each 1 ~ 1.5cm taken as a injection point in local infiltration anesthesia. When anesthesia succeeded, continued to deal with the hernia sac, then using the Lichtenstein mesh implantation to strengthen posterior wall of spermatic cord or enhance the tension, of femoral canal, and the Lichtenstein mesh improvement repair of inguinal hernia and other surgery methods, including Rutkow, Kugel, M-Kugel, PHS, and TEP. To observe the index. changes in hospitalization time, cost, postoperative recurrence and postoperative chronic pain. Results In our hospital in inguinal hernia repair operation method contrast, the improvement repair used Lichtenstein mesh under local anesthesia, hospitalization time and cost was lower than that of other surgical methods (P<0.05), postoperative recurrence and chronic pain were low, there was no significant difference. Conclusions Lichtenstein mesh of improvement repair under local anesthesia can cover the site of all the hernia in the groin region, which has the advantages of shorter hospital stay, lower cost, less postoperative pain and low recurrence probability. In the basic hospital can be implemented, it is worthy of clinical promotion.%目的:回顾性分析局部麻醉下应用李金斯坦( Lichtenstein)平片改良修补腹股沟疝的临床效果。方法以2%盐酸利多卡因15 ml+2.5%盐酸布比卡因15 ml+0.9%生理盐水30 ml+肾上腺素0.3 mg混合总量约60 ml,手术切口标记线上每距离1~1.5 cm处作分点局部浸润麻醉。麻醉达成后处理好疝囊,再将李金斯坦平片置入加强精索后壁或增强股管张力,并观察本院经李金斯坦平片改良修补腹股沟疝和其他

  15. Optimal local dimming for LED-backlit LCD displays via linear programming

    DEFF Research Database (Denmark)

    Shu, Xiao; Wu, Xiaolin; Forchhammer, Søren

    2012-01-01

    LED-backlit LCD displays hold the promise of improving the image quality while reducing the energy consumption with signal-dependent local dimming. To fully realize such potentials we propose a novel local dimming technique that jointly optimizes the intensities of LED backlights...... and the attenuations of LCD pixels. The objective is to minimize the distortion in luminance reproduction due to the leakage of LCD and the coarse granularity of the LED lights. The optimization problem is formulated as one of linear programming, and both exact and approximate algorithms are proposed. Simulation...

  16. Local Optimization and Adversarial Consideration:Agent Skills in Everest Simulation Team

    Institute of Scientific and Technical Information of China (English)

    顾洋; 崔立辉; 刘俊峰; 王庆林

    2004-01-01

    Skilled individual agents are firm basis of a strong soccer team. The skills available to Everest 2002 agents include kicking, dribbling, forwarding, ball interception and tackling. These intermediate sub goals are implemented by a combination of local optimization which hopes to determine the optimal primitive action from a local perspective and adversarial consideration which takes into account opponents and limitations imposed by simulation environment. Everest 2002 RoboCup simulation teams, building on 11 skilled agents and an on-line coach, won the 2nd place in RoboCup 2002 simulation league.

  17. [Correction of the mental status during ketamine anesthesia].

    Science.gov (United States)

    Vorob'ev, A A; Shpilenia, L S; Zobin, M L

    1987-03-01

    Possibilities of pharmacological correction of the patient's mental state while performing Ketamin anesthesia were studied. The optimal results were obtained by the complex of Seduxen prior to and Pyracetam after anesthesia. It considerably reduced the frequency and degree of hallucinative--illusional disturbances and simultaneously markedly accelerated the restoration of the disturbed consciousness.

  18. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  19. Optimizing Data Locality for Fork/Join Programs Using Constrained Work Stealing

    Energy Technology Data Exchange (ETDEWEB)

    Lifflander, Jonathan; Krishnamoorthy, Sriram; Kale, Laxmikant

    2014-11-16

    We present an approach to improving data locality across different phases of fork/join programs scheduled using work stealing. The approach consists of: (1) user-specified and automated approaches to constructing a steal tree, the schedule of steal operations and (2) constrained work stealing algorithms that constrain the actions of the scheduler to mirror a given steal tree. These are combined to construct work stealing schedules that maximize data locality across computation phases while ensuring load balance within each phase. These algorithms are also used to demonstrate dynamic coarsening, an optimization to improve spatial locality and sequential overheads by combining many finer-grained tasks into coarser tasks while ensuring sufficient concurrency for locality-optimized load balance. Implementation and evaluation in Cilk demonstrate performance improvements of up to 2.5x on 80 cores. We also demonstrate that dynamic coarsening can combine the performance benefits of coarse task specification with the adaptability of finer tasks.

  20. Small-tip-angle spokes pulse design using interleaved greedy and local optimization methods.

    Science.gov (United States)

    Grissom, William A; Khalighi, Mohammad-Mehdi; Sacolick, Laura I; Rutt, Brian K; Vogel, Mika W

    2012-11-01

    Current spokes pulse design methods can be grouped into methods based either on sparse approximation or on iterative local (gradient descent-based) optimization of the transverse-plane spatial frequency locations visited by the spokes. These two classes of methods have complementary strengths and weaknesses: sparse approximation-based methods perform an efficient search over a large swath of candidate spatial frequency locations but most are incompatible with off-resonance compensation, multifrequency designs, and target phase relaxation, while local methods can accommodate off-resonance and target phase relaxation but are sensitive to initialization and suboptimal local cost function minima. This article introduces a method that interleaves local iterations, which optimize the radiofrequency pulses, target phase patterns, and spatial frequency locations, with a greedy method to choose new locations. Simulations and experiments at 3 and 7 T show that the method consistently produces single- and multifrequency spokes pulses with lower flip angle inhomogeneity compared to current methods.

  1. Inverse-problem approach for particle digital holography: accurate location based on local optimization.

    Science.gov (United States)

    Soulez, Ferréol; Denis, Loïc; Fournier, Corinne; Thiébaut, Eric; Goepfert, Charles

    2007-04-01

    We propose a microparticle localization scheme in digital holography. Most conventional digital holography methods are based on Fresnel transform and present several problems such as twin-image noise, border effects, and other effects. To avoid these difficulties, we propose an inverse-problem approach, which yields the optimal particle set that best models the observed hologram image. We resolve this global optimization problem by conventional particle detection followed by a local refinement for each particle. Results for both simulated and real digital holograms show strong improvement in the localization of the particles, particularly along the depth dimension. In our simulations, the position precision is > or =1 microm rms. Our results also show that the localization precision does not deteriorate for particles near the edge of the field of view.

  2. Phase-Field Relaxation of Topology Optimization with Local Stress Constraints

    DEFF Research Database (Denmark)

    Stainko, Roman; Burger, Martin

    2006-01-01

    We introduce a new relaxation scheme for structural topology optimization problems with local stress constraints based on a phase-field method. In the basic formulation we have a PDE-constrained optimization problem, where the finite element and design analysis are solved simultaneously...... parameter decreases to zero. A major advantage of this kind of relaxation opposed to standard approaches is a uniform constraint qualification that is satisfied for any positive value of the penalization parameter. The relaxation scheme yields a large-scale optimization problem with a high number of linear...

  3. A class of optimal tests for symmetry based on local Edgeworth approximations

    CERN Document Server

    Cassart, Delphine; Paindaveine, Davy; 10.3150/10-BEJ298

    2011-01-01

    The objective of this paper is to provide, for the problem of univariate symmetry (with respect to specified or unspecified location), a concept of optimality, and to construct tests achieving such optimality. This requires embedding symmetry into adequate families of asymmetric (local) alternatives. We construct such families by considering non-Gaussian generalizations of classical first-order Edgeworth expansions indexed by a measure of skewness such that (i) location, scale and skewness play well-separated roles (diagonality of the corresponding information matrices) and (ii) the classical tests based on the Pearson--Fisher coefficient of skewness are optimal in the vicinity of Gaussian densities.

  4. DESTINATION MARKETING STRATEGY IN BALI THROUGH OPTIMIZING THE POTENTIAL OF LOCAL PRODUCTS

    OpenAIRE

    I Gusti Ayu Oka Suryawardani; Agung Suryawan Wiranatha; Petr, Christine

    2014-01-01

    This study was designed to study destination marketing strategy in Bali through optimizing the potential of local products. Seventy nine of hotel managers were interviewed based on cluster sampling method to gain their point of view. The results show that destination must build their images around unique attributes that provide them sustainable competitive advantage including its attraction which should be designed to meet the needs of the target market and should be served by local produc...

  5. FY08 LDRD Final Report LOCAL: Locality-Optimizing Caching Algorithms and Layouts

    Energy Technology Data Exchange (ETDEWEB)

    Lindstrom, P

    2009-02-27

    This project investigated layout and compression techniques for large, unstructured simulation data to reduce bandwidth requirements and latency in simulation I/O and subsequent post-processing, e.g. data analysis and visualization. The main goal was to eliminate the data-transfer bottleneck - for example, from disk to memory and from central processing unit to graphics processing unit - through coherent data access and by trading underutilized compute power for effective bandwidth and storage. This was accomplished by (1) designing algorithms that both enforce and exploit compactness and locality in unstructured data, and (2) adapting offline computations to a novel stream processing framework that supports pipelining and low-latency sequential access to compressed data. This report summarizes the techniques developed and results achieved, and includes references to publications that elaborate on the technical details of these methods.

  6. Use of local or epidural anesthesia in inguinal hernia repair: a randomized trial%局部麻醉和硬膜外麻醉在腹股沟疝无张力修补术中的对照研究

    Institute of Scientific and Technical Information of China (English)

    杨斌; 梁明娟; 张育超; 陈双

    2008-01-01

    目的 探讨局部麻醉和硬膜外麻醉下行腹股沟疝修补术的疗效与安全性. 方法 2004年1月至2006年12月我院收治的269例腹股沟疝患者,按数字表法随机分为两组,143例采用局部浸润麻醉,126例采用硬膜外麻醉,比较分析两组临床资料. 结果 局部麻醉组在手术(加麻醉)时间、下床时间、住院天数及费用方面均明显少于硬膜外麻醉组(P0.05).两组患者的伤口及阴囊并发症发生率差异无统计学意义(P>0.05).硬膜外麻醉组术中平均动脉压下降,术后恶心、呕吐、尿潴留发生率显著高于局部麻醉组(P0.05). 结论 局部麻醉下行腹股沟疝修补手术简单、安全、经济、可靠,是更为理想的麻醉方式.%Objective To investigate the efficacy and safety of local anesthesia and epidural anesthesia in tension-free repair of inguinal hernia. Methods Between January 2004 and December 2006, 269 patients underwent inguinal hernia repair were randomly divided into two groups, receiving local anesthesia (143 cases) and epidural anesthesia (126 cases). The clinical data from the two groups were analyzed retrospectively. Results The operation time, ambulation time, length of hospital stay and cost of hospitalization in local anesthesia group were significantly less than those in epidural anesthesia group( P < 0. 05 ). No significant differences were found in intra-operative use of ancillary sedation drugs, postoperative recovery situation, pain scores and operation-correlated complications between the two groups. The occurrence of postoperative anaesthetic complication rate was also significantly lower in local anesthesia group (P < 0. 05 ). One case of recurrence occurred in each group during postoperative follow-up period. Conclusion Tension-free inguinal hernia repair under local anesthesia is a simple, safe, economical, effective procedure and superior to epidural anesthesia.

  7. Alkalinized lidocaine versus lidocaine gel as local anesthesia prior to intra-vesical botulinum toxin (BoNTA) injections: A prospective, single center, randomized, double-blind, parallel group trial of efficacy and morbidity.

    Science.gov (United States)

    Nambiar, Arjun K; Younis, Ayman; Khan, Zainab A; Hildrup, Iona; Emery, Simon J; Lucas, Malcolm G

    2016-04-01

    To assess the efficacy and morbidity of alkalinized lidocaine solution compared to lidocaine gel for intra-vesical anesthesia during botulinum toxin (BoNTA) injections in a statistically powered, prospective, parallel group, double-blind randomized controlled trial. Fifty-four patients of either sex were randomized to receive either alkalinized lidocaine (AL) solution (10 ml 8.4% sodium bicarbonate + 20 ml 2% lidocaine solution + 22 ml sterile Aquagel®) or lidocaine gel (LG) (22 ml standard 2% lidocaine gel Instillagel® + 30 ml 0.9% normal saline solution). Primary outcome was average pain (assessed by 100 mm visual analog score) felt during intra-vesical BoNTA injections performed at least 20 min after instillation. Secondary outcome was the rate of adverse events. Of 60 randomized patients 54 received the allocated intervention and were analyzed. Mean pain score in the AL group was 17.11 mm (95%CI 8.65-25.57 mm) and in the LG group was 19.53 mm (95%CI 13.03-26.03mm) with no significant difference between the groups. Cost of interventional medication in the AL group was almost double that of the LG group. No adverse events were attributable to local anesthetic instillation in either group. Alkalinized lidocaine solution is not superior to lidocaine gel for anesthesia during intra-vesical BoNTA injections, and the higher cost precludes its use over lidocaine gel at our centre. We have used the results of this study to adapt our local protocol for BoNTA injections and continue to use lidocaine gel as the local anesthetic of choice. Neurourol. Urodynam. 35:522-527, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  8. The clinical pathway of tension-free inguinal hernia repair under local anesthesia%局部麻醉下腹股沟疝无张力修补术临床路径及其应用

    Institute of Scientific and Technical Information of China (English)

    石华伟; 汤汉林; 姜海平; 祁应才; 李新军

    2014-01-01

    Objective To explore the clinical pathway of tension-free inguinal hernia repair under local anesthesia.Methods The clinical pathway of tension-free inguinal hernia repair was set up under local anesthesia.Time of hospitalization stay,hospitalization costs and complications were observed in 56 cases.Results There were totally 56 cases with 54 cases (96.4%)who completed the clinical pathway and 2 cases were withdrawal.Time of hospitalization stay was shortened and the costs were reduced in the cases with clinical pathway.Fourteen cases had postoperative short-term complications without recurrence after treatment.Conclusions The clinical pathway of tension-free inguinal hernia repair under local anesthesia is easy to operate,which can significantly shorten the time of hospitalization,reduce the medical costs,and reduce the patient and social burdens.%目的:探讨局部麻醉下腹股沟疝无张力修补术的临床路径及其应用。方法观察局部麻醉下腹股沟疝无张力修补术临床路径的56例患者住院时间、住院各项费用及并发症情况。结果进入临床路径56例患者中,54例完成临床路径,2例退出,完成率为96.4%;纳入临床路径的患者住院时间明显缩短,各项费用显著降低;有14例患者出现术后近期并发症,无复发。结论局部麻醉下腹股沟疝无张力修补术临床路径操作简单,能明显缩短住院时间、降低住院医疗成本,减轻患者和社会负担,值得推广。

  9. 应用局麻无张力疝修补术治疗复发性腹股沟疝34例%Tension-free herniorrhaphy operated under local anesthesia on 34 cases of recurrent inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    王立成; 姚秀霞

    2008-01-01

    Objective Analyse what we saw in the operation of inguinal hernia surgery to know the causes of recurrence, carry out tension-free herniorrhaphy for recurrent inguinal hernia by local anesthesia in practice.Methods The clinical data of tension-free herniorrhaphy carried out under local anesthesia in 34 cases of recurrent inguinal hernia patients from Jan-2006 to Jan-2008 were analyzed retrospectively. The procedures include 32 classical herniorrhaphy (13 Bassini,s method, and 9 Ferguson,s method, 7 Halsted,s method, 3 Schouldice,s method), 2 cases were tension-free herniorrhaphy.Results All patients were cured, complications occurred in 5 cases , 4 scrotal edema and 1 scrotal hematomas, in postoperative follow-up survey of 0.5-2 years ,34 cases were no recurrence.Conclusions To achieve the desired effect of recurrent herniorrhaphy and low recurrence rate, we should take full account of the cause of recurrence in the operation, take individual choice of surgical methods and repair materials, standardized technical operations. In our experience, the application of local anesthesia tension-free herniorrhaphy is safe and effective.%目的 通过手术所见分析腹股沟疝术后复发的病因, 总结局麻无张力疝修补术治疗复发性腹股沟疝的临床经验.方法 回顾性分析和总结2006年1月至2008年1月收治复发性腹股沟疝患者34例(经典疝修补术后复发疝患者32例, 其中Bassini 13例,Ferguson 9例, Halsted 7例,Schouldice 3例;无张力疝修补术后复发2例)行局麻无张力疝修补的临床资料.结果 全组均治愈出院,术后阴囊水肿4例,阴囊血肿1例,随访6个月~2年无复发病例.结论 要达到理想的复发疝修补效果和低复发率,应充分考虑复发的病因,术中进行分析,合理选择修补材料和个体化手术方法,规范技术操作,应用局麻无张力疝修补术是一种理想术式.

  10. Perioperative nursing of totally extraperitoneal laparoscopic hernia repair under local anesthesia%局麻下腹腔镜完全腹膜外疝修补术的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    宋赛花; 张小琴; 倪春华

    2011-01-01

    Objective To summarize perioperative nursing experience of totally extraperi-toneal laparoscopic hernia repair under local anesthesia. Methods The effect of perioperative nursing on 26 cases with inguinal hernia treated by totally extraperitoneal laparoscopic hernia repair under local anesthesia from January 2009 to January 2010 was observed. Results All cases were operated successfully. The average postoperative stay was 2.4(1 -4) days. Most complications included 2 cases of subcutancous emphysema. There were no complications of hematoma/seroma, persistent nervous pain, wound infection, mesh infection after operations, and urinary retentio. All patients were followed up for 8 (3~15) months, and there were no recurrence. Conclusion Totally extraperitoneal laparoscopic hernia repair under local anesthesia is safe and effective for inguinal hernia with advantages of less pain, quick recovery and, lower operation cost, which can be easily accepted by both patients and surgeons. It can obviously reduce the nursing workload, but mental nursing is also very important.%目的 总结局麻下腹腔镜完全腹膜外疝修补术(TEP)的围手术期护理经验.方法对2009年1月-2010年1月采用局麻完成的26例(28例次)TEP患者进行围手术期护理观察.结果所有患者均治愈,术后平均住院2.4d,主要并发症为皮下气肿2例,术后未出现血肿/血清肿、持续性神经性疼痛、切口感染、补片感染及尿潴留,术后平均随访8个月未见复发病例.结论局麻下腹腔镜完全腹膜外疝修补术安全可靠,术后疼痛轻,恢复更快,术后恢复体力活动早,可以明显降低手术费用,易被患者及外科医生接受,明显减少了护理工作量,但心理护理非常重要.

  11. Application of local anesthesia for tension-free inguinal hernia repair%局部麻醉在腹股沟疝无张力修补术的应用

    Institute of Scientific and Technical Information of China (English)

    乔世铭; 彭健

    2011-01-01

    Objective To compare the outcomes of tension-free inguinal hernia repair under local anesthesia and epidural blockade. Methods A total of 120 case was operated for tension-free hernioplasty with mesh-plug made of PP,of whom 60 cases were given local anesthesia(group A) and the other 60 cases were treated with epidural blockade. The operation time, postoperative time staying in bed,wound pain, urine retention, satisfactory rate for anesthesia and medical costs were recorded and compared between two groups. Results Compared to group B, group A had shorter operation time,shorter postoperative time staying in bed, less postoperative complications such as retention of urine, and lower medical costs. Conclusion Tension-free inguinal hernia neoplasty under local anaethesia has the advantages of simple procedure, well toleration, minimal invasion, low risk of complications, shorter hospital stay and low medical costs.%目的 比较局部麻醉和硬膜外麻醉下行腹股沟疝无张力修补术的效果.方法 120例腹股沟疝无张力修补患者随机均分为局部麻醉(A组)和硬膜外麻醉(B组)两组,对两组的手术时间、术后下床活动时间、术后伤口疼痛、术后尿潴留、麻醉满意率和住院费用等进行比较研究.结果 A组在手术时间、术后下床活动时间、术后尿潴留、住院费用等方面均优于B组(P<0.05).结论 局部麻醉下施行无张力疝修补术具有操作简单、患者痛苦小、恢复快、手术并发症少、住院时间短及住院费用低等优点.

  12. 局麻下补片修补术治疗腹股沟疝36例临床观察%Clinical Observation of Local Anesthesia Patch Repair of Inguinal Hernia in 36 Cases

    Institute of Scientific and Technical Information of China (English)

    吴宜平

    2016-01-01

    目的:观察并分析局麻下补片修补术治疗腹股沟疝的效果。方法将我院在2006年8月~2013年8月收治的72例腹股沟疝患者分为观察组和对照组,每组36例,对照组予以常规修补术治疗,观察组采用局麻下补片修补术治疗,对两组患者治疗效果进行比较。结果两组患者手术顺利,观察组的手术时间更短,术后24小时所有患者均可下床自由活动,观察组患者的治疗效果优于对照组,治疗有效率更高,不良反应和并发症发生率更低,但这2年的复发率更低,P <0.05,差异具有统计学意义。结论临床上采用局麻下补片修补术治疗腹股沟疝效果更好。%Objective To observe and analyze the patch repair under local anesthesia effect for the treatment of inguinal hernia. Methods 72 patients with inguinal hernia were divided into observation group and control group the hospital fom August 2006 to August 2013, 36 cases in each group, control group routine repair treatment, observation group was treated with patch repair under local anesthesia, to compare the effect of two groups of patients. Results Two groups of patients with surgery goes well, the observation group of shorter operation time, postoperative 24 hours free all of the patients are under the bed, the curative effect of observation group of patients is better than that of control group, the treatment efficiency is higher, lower incidence of adverse reactions and complications, but these two years of lower recurrence rate, P<0.05, significant difference, statistically significant. Conclusion Using the patch repair under local anesthesia clinical treatment of inguinal hernia is better, worthy of promotion of use.

  13. Local anesthesia downlink evaluation of the clinical effect of small incision repairing inguinal hernia%局麻下行小切口修补腹股沟疝的临床效果评价

    Institute of Scientific and Technical Information of China (English)

    孔明友

    2014-01-01

    Objective: To explore small incision under local anesthesia inguinal hernia clinical results.Methods: September 2011 to September 2013 in our hospital 88 cases of inguinal hernia patients for the study were randomly divided into a control group and treatment group and control group 44 cases treated with conventional surgery, the treatment group 44 cases given small incision under local anesthesia for inguinal hernia repair treatment, compared two groups of clinical effect.Results: Compared with the control group, the treatment group operative time and postoperative recovery was excellent, signiifcant differences between two groups, with statistical signiifcance (P <0.05).Conclusion:Small incision under local anesthesia for inguinal hernia repair rapid postoperative recovery, the exact clinical effect, therefore, worthy of clinical application.%目的:探讨局麻下行小切口修补腹股沟疝的临床效果。方法:选取2011年9月至2013年9月收治的88例腹股沟疝患者为研究对象,将其随机分为对照组和治疗组,对照组44例给予常规手术治疗,治疗组44例给予局麻下行小切口修补腹股沟疝治疗,对比两组临床治疗效果。结果:与对照组相比,治疗组手术时间以及术后恢复明显较优,两组对比差异明显,具有统计学意义(P<0.05)。结论:局麻下行小切口修补腹股沟疝术后恢复快,临床效果确切,因此,值得临床推广应用。

  14. Design Optimization of Laminated Composite Structures with Many Local Strength Criteria

    DEFF Research Database (Denmark)

    Lund, Erik

    2012-01-01

    This paper presents different strategies for handling very many local strength criteria in structural optimization of laminated composites. Global strength measures using Kreisselmeier-Steinhauser or p-norm functions are introduced for patch-wise parameterizations, and the efficiency of the methods...

  15. Mouse anesthesia and analgesia.

    Science.gov (United States)

    Adams, Sean; Pacharinsak, Cholawat

    2015-03-02

    Providing anesthesia and analgesia for mouse subjects is a common and critical practice in the laboratory setting. These practices are necessary for performing invasive procedures, achieving prolonged immobility for sensitive imaging modalities (magnetic resonance imaging for instance), and providing intra- and post-procedural pain relief. In addition to facilitating the procedures performed by the investigator, the provision of anesthesia and analgesia is crucial for the preservation of animal welfare and for humane treatment of animals used in research. Furthermore, anesthesia and analgesia are important components of animal use protocols reviewed by Institutional Animal Care and Use Committees, requiring careful consideration and planning for the particular animal model. In this article, we provide technical outlines for the investigator covering the provision of anesthesia by two routes (injectable and inhalant), guidelines for monitoring anesthesia, current techniques for recognition of pain, and considerations for administering preventative analgesia. Copyright © 2015 John Wiley & Sons, Inc.

  16. Hooke–Jeeves Method-used Local Search in a Hybrid Global Optimization Algorithm

    Directory of Open Access Journals (Sweden)

    V. D. Sulimov

    2014-01-01

    Full Text Available Modern methods for optimization investigation of complex systems are based on development and updating the mathematical models of systems because of solving the appropriate inverse problems. Input data desirable for solution are obtained from the analysis of experimentally defined consecutive characteristics for a system or a process. Causal characteristics are the sought ones to which equation coefficients of mathematical models of object, limit conditions, etc. belong. The optimization approach is one of the main ones to solve the inverse problems. In the main case it is necessary to find a global extremum of not everywhere differentiable criterion function. Global optimization methods are widely used in problems of identification and computation diagnosis system as well as in optimal control, computing to-mography, image restoration, teaching the neuron networks, other intelligence technologies. Increasingly complicated systems of optimization observed during last decades lead to more complicated mathematical models, thereby making solution of appropriate extreme problems significantly more difficult. A great deal of practical applications may have the problem con-ditions, which can restrict modeling. As a consequence, in inverse problems the criterion functions can be not everywhere differentiable and noisy. Available noise means that calculat-ing the derivatives is difficult and unreliable. It results in using the optimization methods without calculating the derivatives.An efficiency of deterministic algorithms of global optimization is significantly restrict-ed by their dependence on the extreme problem dimension. When the number of variables is large they use the stochastic global optimization algorithms. As stochastic algorithms yield too expensive solutions, so this drawback restricts their applications. Developing hybrid algo-rithms that combine a stochastic algorithm for scanning the variable space with deterministic local search

  17. Particle swarm optimization and its application in MEG source localization using single time sliced data

    Science.gov (United States)

    Lin, Juan; Liu, Chenglian; Guo, Yongning

    2014-10-01

    The estimation of neural active sources from the magnetoencephalography (MEG) data is a very critical issue for both clinical neurology and brain functions research. A widely accepted source-modeling technique for MEG involves calculating a set of equivalent current dipoles (ECDs). Depth in the brain is one of difficulties in MEG source localization. Particle swarm optimization(PSO) is widely used to solve various optimization problems. In this paper we discuss its ability and robustness to find the global optimum in different depths of the brain when using single equivalent current dipole (sECD) model and single time sliced data. The results show that PSO is an effective global optimization to MEG source localization when given one dipole in different depths.

  18. 局部及静脉联合用药超前镇痛对椎管内麻醉穿刺的影响%Effect of preemptive analgesia with local and intravenous medication on intraspinal anesthesia puncture

    Institute of Scientific and Technical Information of China (English)

    李中云; 陆健君; 杨焱焰; 文建乾; 牙耀; 刘文伟; 甘立书

    2013-01-01

    Objective To investigate the effect of preemptive analgesia with local and intravenous medication on the analgesic effect during puncture procedure, the degree of satisfaction for anesthesia puncture posture, and the one-time success rate of anesthesia puncture. Methods Eighty patients of elective inguinal hernia (aged 36~60 years old, weighted 48~75 kg), classified as ASA Ⅰ ~ Ⅱ, were divided into the observation Group (group A, n=40) and the control group (C, n= 40) by a randomized single-blind method. Patients of group A were given 2% lidocaine twice immediately on the spinal anesthesia puncture point and 2 cm2 skin surface around, followed by injection of 10 mg Dezocine intravenously. Patients of group C were given saline instead of lidocaine, followed by equal amount of saline solution injected intravenously. Pain scores at the puncture of local anesthesia (T1) and during spinal anesthesia puncture procedure (T2), postural changes during anesthesia puncture (movement), one-time success rate of anesthesia puncture, patient satisfaction and side effects (dizziness, nausea, vomiting) were recorded. Results Compared with group C, VAS scores of group A significantly decreased at T1 and T2 (P0.05). Conclusion Preemptive analgesia with local and intravenous medication is effective to relieve stress, anxiety and pain during spinal anesthesia, with good body position, high one-time success rate, and high patient satisfaction.%目的 探讨局部及静脉联合用药超前镇痛对椎管内麻醉穿刺过程临床镇痛效果、麻醉体位配合的满意度、麻醉穿刺一次成功率的影响.方法 择期行腹股沟疝修补术的患者80例,年龄36~60岁,体重48~75kg,ASA分级Ⅰ~Ⅱ级,采用随机数字表法,将其随机分为两组各40例.A组患者人室后立即在椎管内麻醉穿刺点为中心2cm2的皮肤范围内用2%利多卡因均匀的涂布两遍,开放静脉通路后静注地佐辛10 mg,C组穿刺点及静脉用等量生理盐水.

  19. Notions of local controllability and optimal feedforward control for quantum systems

    Energy Technology Data Exchange (ETDEWEB)

    Chakrabarti, Raj, E-mail: rchakra@purdue.edu [School of Chemical Engineering, Purdue University, West Lafayette, IN 47907 (United States)

    2011-05-06

    Local controllability is an essential concept for regulation and control of time-varying nonlinear dynamical systems; in the classical control logic it is at the foundation of neighboring optimal feedback and feedforward control. We introduce notions of local controllability suited to feedforward control of classical input disturbances in bilinear quantum systems evolving on projective spaces and Lie groups. Tests for local controllability based on a Gramian matrix analogous to the nonlinear local controllability Gramian, which allow assessment of which trajectories can be regulated by perturbative feedforward in the presence of classical input noise, are presented. These notions explicitly incorporate system bilinearity and the geometry of quantum states into the definition of local controllability of quantum systems. Associated feedforward strategies are described.

  20. Localization of WSN using Distributed Particle Swarm Optimization algorithm with precise references

    Science.gov (United States)

    Janapati, Ravi Chander; Balaswamy, Ch.; Soundararajan, K.

    2016-08-01

    Localization is the key research area in Wireless Sensor Networks. Finding the exact position of the node is known as localization. Different algorithms have been proposed. Here we consider a cooperative localization algorithm with censoring schemes using Crammer Rao Bound (CRB). This censoring scheme can improve the positioning accuracy and reduces computation complexity, traffic and latency. Particle swarm optimization (PSO) is a population based search algorithm based on the swarm intelligence like social behavior of birds, bees or a school of fishes. To improve the algorithm efficiency and localization precision, this paper presents an objective function based on the normal distribution of ranging error and a method of obtaining the search space of particles. In this paper Distributed localization algorithm PSO with CRB is proposed. Proposed method shows better results in terms of position accuracy, latency and complexity.

  1. [History of anesthesia : "From narcosis to perioperative homeostasis"].

    Science.gov (United States)

    Petermann, H; Goerig, M

    2016-10-01

    In the western World 16 October 1846 is often called "Ether Day", marking the beginning of anesthesia. Before that date, for physicians there was only a struggle against pain. In the following 170 years all fields of general anesthesia as well as regional and local anesthesia were continuously developed. Pharmacological developments and technical innovations made this evolution possible. The complexity of this field of medicine requires a specialist: the anesthesiologist, whose selection of the most suitable form of anesthesia for the patient makes the surgical intervention painless. In addition, the history of anesthesia was characterized by personalities who were responsible for the progress of this medical field. Anesthesia is one part of the discipline of anesthesiology, which also includes resuscitation, intensive care medicine, emergency medicine and pain therapy.

  2. OPTIMAL CONTROL OF THE FLEXIBLE LINK MANIPULATOR WITH CONTROLLABLE LOCAL DEGREES OF FREEDOM

    Institute of Scientific and Technical Information of China (English)

    BIAN Yushu; YUN Chao; GAO Zhihui

    2008-01-01

    Although flexible manipulators own many potential advantages, one of their major disadvantages is the deterioration of the end-effector accuracy due to the flexibility. Therefore, how to reduce vibration is a significant problem. Inspired by the observation on the motion behaviors of animals, a new idea of decreasing motion deflection of the flexible manipulator is suggested. The concept of controllable local degrees of freedom is proposed and analyzed. By way of optimizing local motion provided by the controllable local degrees of freedom, the end-effector deflection of the flexible manipulator can be effectively decreased through dynamic coupling. The corresponding optimal method for vibration control of the flexible manipulator is put forward. The kinematic simulation is carried ant on a three-link flexible manipulator The corresponding results verify the feasibility of this method.

  3. 应用无痛口腔局麻注射仪注射硬化剂治疗舌前腺囊肿的效果评定%The Use of the WAND Painless Oral Local Anesthesia Unit to Hardener Local Injection in the Patient with Mucocele of the Glands of Blandin-Nuhn

    Institute of Scientific and Technical Information of China (English)

    孙海鹏; 汤剑明; 黄盛兴; 张国志

    2012-01-01

    目的:评价应用The WAND无痛口腔局麻注射仪囊腔内注射硬化剂治疗舌前腺囊肿的临床效果.方法:实验组使用The WAND进行舌前腺囊肿囊腔内注射5%鱼肝油酸钠或4%碘酊,对照组使用传统针管式手动注射5%鱼肝油酸钠或4%碘酊.评定相应实验方法的治愈率和注射时疼痛程度.结果:无论是5%鱼肝油酸钠还是4%碘酊,使用无痛注射仪注射无痛效果明显好于传统注射器注射,用t检验分析具有高度显著性差异;使用无痛注射仪注射治愈率明显好于传统注射器注射,用x2检验分析具有高度显著性差异.结论:应用无痛口腔局麻注射仪注射硬化剂治疗舌前腺囊肿明显优于传统针管式手动注射治疗效果,治愈率提高,疼痛减轻.%To evaluate the hardener local injection effect of the painless oral local anesthesia unit in the treatment of Mucocele of the Glands of Blandin-Nuhn. Methods: The patients were divided into four groups randomly. Two groups were used the painless oral local anesthesia unit to inject 5% cod liver oil sodium or 4 % iodine into the mucoceles. Two groups were used traditional manual syringe to inject 5% cod liver oil sodium or 4% iodine into the mucoceles. The cure rate and the corresponding injection pain were assessed. Results: Whether it was 5% cod liver oil sodium or 4% iodine, by using the painless oral local anesthesia unit, the pain in local injection was statistical less than traditional manual syringe and the cure rate was statistical higher than traditional manual syringe. Conclusion: The painless oral local anesthesia unit is superior to the traditional manual syringe in the hardener local injection in the patient with Mucocele of the Glands of Blandin-Nuhn. It can improve the cure rate and reduce the injection pain.

  4. Análise de custos entre a raquianestesia e a anestesia venosa com propofol associada ao bloqueio perianal local em operações anorretais Cost analysis between spinal and venous anesthesia with propofol associated with local perianal block in anorectal procedures

    Directory of Open Access Journals (Sweden)

    Paulo Gustavo Kotze

    2009-09-01

    Full Text Available RACIONAL: Atualmente cerca de 90% das operações anorretais podem ser realizadas em regime ambulatorial. A técnica anestésica é fator fundamental na busca de menor tempo de internamento e redução de custos nestes procedimentos. Não há consenso na literatura sobre qual o melhor tipo de anestesia para essas operações. OBJETIVO: Comparar os custos da técnica de raquianestesia com bupivacaína 0,5% isobárica com a técnica de anestesia venosa com propofol associada ao bloqueio perianal local com lidocaína a 2% e bupivacaína 0,5% (anestesia combinada em pacientes submetidos a operações anorretais. MÉTODOS: Foram analisados dados de 99 pacientes submetidos à operações anorretais, divididos em dois grupos: grupo I (raquianestesia, composto por 50 pacientes e grupo II (anestesia combinada, composto por 49 pacientes. Foram estudados os procedimentos cirúrgicos, tempo de procedimento anestésico-cirúrgico, tempo de internamento e custos globais de cada paciente. RESULTADOS: Não houve diferença estatística significativa entre os grupos estudados em relação ao tipo de procedimento cirúrgico, sexo, idade e complicações. O tempo médio do procedimento anestésico-cirúrgico, no grupo I foi de 53,1 minutos e de 44,08 minutos no grupo II (P=0,034. O tempo médio de internamento foi de 19,68 horas no grupo I e de 7,08 horas no grupo II (PBACKGROUND: Approximately ninety percent of anorectal surgical procedures are performed in ambulatory basis. The choice of a proper anesthetic technique is important to achieve shorter hospital stay and low costs. There's no evidence in the literature that an ideal type of anesthesia for these procedures exists. AIM: To compare the costs of patients operated with spinal anesthesia (0,5% bupivacaine with combined anesthesia (propofol and local perineal block with 2% lidocaine and 0,5% bupivacaine in anorectal surgical procedures. METHODS: Data from 99 patients submitted to anorectal operations were

  5. A Local and Global Search Combined Particle Swarm Optimization Algorithm and Its Convergence Analysis

    Directory of Open Access Journals (Sweden)

    Weitian Lin

    2014-01-01

    Full Text Available Particle swarm optimization algorithm (PSOA is an advantage optimization tool. However, it has a tendency to get stuck in a near optimal solution especially for middle and large size problems and it is difficult to improve solution accuracy by fine-tuning parameters. According to the insufficiency, this paper researches the local and global search combine particle swarm algorithm (LGSCPSOA, and its convergence and obtains its convergence qualification. At the same time, it is tested with a set of 8 benchmark continuous functions and compared their optimization results with original particle swarm algorithm (OPSOA. Experimental results indicate that the LGSCPSOA improves the search performance especially on the middle and large size benchmark functions significantly.

  6. A note on eigenfrequency sensitivities and structural eigenfrequency optimization based on local sub-domain frequencies

    DEFF Research Database (Denmark)

    Pedersen, Pauli; Pedersen, Niels Leergaard

    2014-01-01

    result has many applications. It is therefore presented before specific use in optimization examples. The engineering approach of fully stressed design is a practical tool with a theoretical foundation. The analog approach to structural eigenfrequency optimization is presented here with its theoretical...... foundation. A numerical heuristic redesign procedure is proposed and illustrated with examples. For the ideal case, an optimality criterion is fulfilled if the design have the same sub-domain frequency (local Rayleigh quotient). Sensitivity analysis shows an important relation between squared system...... on the derived optimality condition. The design that maximize a frequency depend on the total amount of available material and on a necessary interpolation as illustrated by different design cases.In this note we have assumed a linear and conservative eigenvalue problem without multiple eigenvalues. The presence...

  7. 局麻下应用3DMax补片前入路修补腹股沟疝30例%3DMax Mesh tension free inguinal hernia repair by anterior approach under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    姚胜; 李基业; 费阳; 刘飞德

    2012-01-01

    目的 探讨在局部麻醉下应用前入路置入3DMax补片施行腹股沟疝无张力修补术的可行性及优越性.方法 回顾性分析2008年12月至2010年12月,在局部麻醉下施行的3DMax补片的无张力腹股沟疝修补术30例,对患者手术时间、手术方式、术后镇痛药应用、术后并发症、术后住院天数进行综合分析.结果 30例患者均成功施行局麻下腹膜前3DMax补片置入术,手术时间平均(63.1 ±2.6) min.术后即可进食水,无尿潴留.术后无痛或轻微疼痛患者23例,中度疼痛6例,重度疼痛1例.30例伤口均一期愈合,2例发生皮下淤血,2例发生补片上方少量血清肿,1例患者大腿内侧皮肤感觉麻木,4个月后好转.3例患者下蹲时腹股沟区有异物感,1~5个月后消失.30例患者均获得随访,平均(11±7)个月,无复发.结论 局麻前入路应用3DMax补片覆盖耻骨肌孔修补腹股沟疝是一种安全有效、创伤轻的方法,能提高多发疝的术中诊断,避免遗漏疝的发生.%Objective To assess Bard3DMax Mesh pre-formed Knitted Polypropylene tension free hernia repair under local anesthesia. Methods Bard 3DMax Mesh was used for inguinal hernia repair in 30 cases under local anesthesia at our department. Results Hernia was successfully repaired in all cases using Bard 3DMax Mesh from the myopectineal orifice through anterior approach under local anesthesia.The mean operation time was (63.1 ± 2.6) min.All cases were able to drink and eat immediately after surgery,there was no postoperative urinary retention.Postoperative pain-free or mild pain was reported in 23 cases,moderate pain in 6,severe pain in only one.Wound healed by first intention in all 30 cases.Two cases suffered from subcutaneous ecchymosis,a seroma above the patch was observed in 2 cases.A inner thigh numb was complained in one case,which subsided 4 months later.Three patients complained below groin area foreign body sensation which disappeared after 1 -5 months

  8. Comparação entre duas soluções modificadas de lidocaína para uso em anestesia local na blefaroplastia Comparison of two modified lidocaine solutions for local anesthesia in blepharoplasty

    Directory of Open Access Journals (Sweden)

    2009-04-01

    Full Text Available OBJETIVO: Comparar a dor causada pela injeção de solução de lidocaína 2% e epinefrina 1:100.000 com a injeção de solução de lidocaína 2% e epinefrina 1:100.000 tamponada com bicarbonato sódico 8,4% na proporção de 9:1 durante a realização de anestesia local em pacientes a serem submetidos a blefaroplastia superior bilateral. MÉTODOS: Estudo prospectivo duplo-cego, onde 25 pacientes foram submetidos a blefaroplastia superior, sob anestesia local. Cada pálpebra recebia uma das duas soluções anestésicas modificadas definidas por sorteio realizado por um dos pesquisadores que não participava do procedimento cirúrgico. Foram observadas as alterações na frequência cardíaca, pressão arterial sistêmica e saturação de oxigênio, comparadas aos índices de base do próprio paciente, obtidas previamente no início do procedimento. Ao término das aplicações, solicitava-se ao paciente uma nota (de 0 a 4 referente a dor. RESULTADOS: Apenas dois parâmetros (frequência cardíaca e saturação de O2 apresentaram diferença estatisticamente significativa durante a aplicação das duas soluções. CONCLUSÃO: Não houve diferença estatisticamente significativa entre a sensação de dor causada pela injeção de solução de lidocaína 2% e epinefrina 1:100.000 com a aplicação da mesma solução tamponada com bicarbonato sódico 8,4% na proporção de 9:1, em pacientes submetidos a blefaroplastia superior bilateral.PURPOSE: To compare pain on injection of two modified anesthetic lidocaine solutions for use in upper blepharoplasty: 2% lidocaine with 1:100,000 epinephrine, and 2% lidocaine with 1:100,000 epinephrine buffered 9:1 with 8.4% sodium bicarbonate. METHODS: In this prospective, double-masked study, 25 consecutive patients undergoing upper blepharoplasty were submitted to the anesthesic procedure. Each eyelid received one of two modified lidocaine solutions. Heart rate, systemic arterial pressure and oxygen saturation

  9. Optimal neighbor graph-based orthogonal tensor locality preserving projection for image recognition

    Science.gov (United States)

    Yuan, Sen; Mao, Xia

    2016-11-01

    As a typical multilinear dimensionality reduction (DR) method, tensor locality preserving projection (TLPP) has been successfully applied in many practical problems. However, TLPP depends mainly on preserving its local neighbor graph which often suffers from the following issues: (1) the neighbor graph is constructed with the Euclidean distance which fails to consider the relationships among different coordinates for tensor data; (2) the affinity matrix only focuses on the local structure information of samples while ignoring the existing label information; (3) the projection matrices are nonorthogonal, thus it is difficult to preserve the local manifold structure. To address these problems, a multilinear DR algorithm called optimal neighbor graph-based orthogonal tensor locality preserving projection (OG-OTLPP) is proposed. In OG-OTLPP, an optimal neighbor graph is first built according to tensor distance. Then the affinity matrix of data is defined by utilizing both the label information and the intrinsic local geometric properties of the data. Finally, in order to improve the manifold preserving ability, an efficient and stable scheme is designed to iteratively learn the orthogonal projections. We evaluate the proposed algorithm by applying it to image recognition. The experimental results on five public image databases demonstrate the effectiveness of our algorithm.

  10. RDEL: Restart Differential Evolution algorithm with Local Search Mutation for global numerical optimization

    Directory of Open Access Journals (Sweden)

    Ali Wagdy Mohamed

    2014-11-01

    Full Text Available In this paper, a novel version of Differential Evolution (DE algorithm based on a couple of local search mutation and a restart mechanism for solving global numerical optimization problems over continuous space is presented. The proposed algorithm is named as Restart Differential Evolution algorithm with Local Search Mutation (RDEL. In RDEL, inspired by Particle Swarm Optimization (PSO, a novel local mutation rule based on the position of the best and the worst individuals among the entire population of a particular generation is introduced. The novel local mutation scheme is joined with the basic mutation rule through a linear decreasing function. The proposed local mutation scheme is proven to enhance local search tendency of the basic DE and speed up the convergence. Furthermore, a restart mechanism based on random mutation scheme and a modified Breeder Genetic Algorithm (BGA mutation scheme is combined to avoid stagnation and/or premature convergence. Additionally, an exponent increased crossover probability rule and a uniform scaling factors of DE are introduced to promote the diversity of the population and to improve the search process, respectively. The performance of RDEL is investigated and compared with basic differential evolution, and state-of-the-art parameter adaptive differential evolution variants. It is discovered that the proposed modifications significantly improve the performance of DE in terms of quality of solution, efficiency and robustness.

  11. Benders decomposition for discrete material optimization in laminate design with local failure criteria

    DEFF Research Database (Denmark)

    Munoz, Eduardo; Stolpe, Mathias; Bendsøe, Martin P.

    2009-01-01

    We study the problem of designing a minimum compliance (or weight) composite laminate. The optimization is made by selecting, out of a set of candidate materials, the materials that will be used in the building process of a laminated structure. The material candidate set is given as data of the d......We study the problem of designing a minimum compliance (or weight) composite laminate. The optimization is made by selecting, out of a set of candidate materials, the materials that will be used in the building process of a laminated structure. The material candidate set is given as data...... a generalized Benders Decomposition technique, a global optimization technique for mixed-integer optimization. The method, under certain conditions, solves optimization problems to global optimum and allows us to solve larger problems. The technique solves the optimization problem iteratively, where at each...... iteration, a local linear approximation of the objective function and the feasible set are included in a mixed integer linear program, called the relaxed master problem. The approximations are obtained by solving one analysis problem and one adjoint problem. The process continues, until the optimal value...

  12. 局麻下行小切口修补腹股沟疝的临床观察%Clinical Observation of Inguinal Hernia Repair With Minimal Access Surgery Under Local Anesthesia

    Institute of Scientific and Technical Information of China (English)

    祁青华

    2014-01-01

    目的:分析局麻下行小切口修补腹股沟疝的疗效。方法将92例腹股沟疝患者随机分为研究组和对照组各46例,分别给予局麻下小切口修补术及传统疝修补术,分析两组治疗效果。结果研究组手术时间、术中出血量、住院时间、术后疼痛评分和并发症发生率均显著优于对照组。结论局麻下行小切口修补腹股沟疝临床疗效显著,操作简单,创伤小,有利于患者较快康复。%Objective To analyze the clinical effect of small incision of inguinal hernia repair operation under local anesthesia. Methods 92 cases inguinal hernia patients were divided into study group and control group, 46 in each group. They were applied in small incision repair and traditional hernia repair operation respectively. The clinical effect of two groups were compared. Results The operative time, blood loss, hospital stay, postoperative pain scores and complication rates were significantly better than the control group. Conclusion Small incision under local anesthesia used in inguinal hernia repair operation is effective.

  13. 音乐疗法对局部麻醉乳腺手术患者焦虑的干预效果%Intervention effect of music therapy on anxiety in patients with local anesthesia in breast operation

    Institute of Scientific and Technical Information of China (English)

    苏丽琼

    2015-01-01

    目的:观察音乐疗法对局部麻醉乳腺手术患者焦虑的干预效果。方法:将100例局部麻醉手术患者分为对照组和观察组,对观察组患者进行音乐干预,采用汉密尔顿焦虑量表进行焦虑程度测定,并监测血压和心率的变化。结果:与对照组相比,观察组患者的焦虑程度有所降低,血压和心率也有所下降(P﹤0.05)。结论:音乐疗法能有效干预局部麻醉手术患者的焦虑心理。%Objective To observe the effect of music therapy on anxiety intervention in patients with local anesthesia in breast opera-tion. Method 100 patients with local anesthesia operation were divided into two groups,music therapy was implemented in the experiment group,the patients' anxiety level was determined by Hamilton anxiety scale,the changes of blood pressure and heart rate was also moni-tored. Results Compared with the control group,the anxiety level of the experiment group decreased,blood pressure and heart rate was also declined( P﹤0. 05). Conclusion The music therapy can effectively intervene patients's anxiety.

  14. Comparison of the efficacy and safety of 2% lidocaine HCl with different epinephrine concentration for local anesthesia in participants undergoing surgical extraction of impacted mandibular third molars: A multicenter, randomized, double-blind, crossover, phase IV trial.

    Science.gov (United States)

    Karm, Myong-Hwan; Park, Fiona Daye; Kang, Moonkyu; Kim, Hyun Jeong; Kang, Jeong Wan; Kim, Seungoh; Kim, Yong-Deok; Kim, Cheul-Hong; Seo, Kwang-Suk; Kwon, Kyung-Hwan; Kim, Chul-Hwan; Lee, Jung-Woo; Hong, Sung-Woon; Lim, Mi Hyoung; Nam, Seung Kwan; Cho, Jae Min

    2017-05-01

    The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in 2 separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analog scale pain scores obtained immediately after surgical extraction were primarily evaluated for the 2 groups receiving different epinephrine concentrations. Visual analog scale pain scores were obtained 2, 4, and 6 hours after administering an anesthetic. Onset and duration of analgesia, onset of pain, intraoperative bleeding, operator's and participant's overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the 2 groups. There were no statistically significant differences between the 2 groups in any measurements except hemodynamic factors (P >.05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine (P ≤.01). The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted

  15. Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

    Directory of Open Access Journals (Sweden)

    Chetana Sachin Makade

    2014-01-01

    Full Text Available Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student′s t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%. Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01 during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective.

  16. Exploring the relationship between vibrational mode locality and coupling using constrained optimization

    Science.gov (United States)

    Molina, Andrew; Smereka, Peter; Zimmerman, Paul M.

    2016-03-01

    The use of alternate coordinate systems as a means to improve the efficiency and accuracy of anharmonic vibrational structure analysis has seen renewed interest in recent years. While normal modes (which diagonalize the mass-weighted Hessian matrix) are a typical choice, the delocalized nature of this basis makes it less optimal when anharmonicity is in play. When a set of modes is not designed to treat anharmonicity, anharmonic effects will contribute to inter-mode coupling in an uncontrolled fashion. These effects can be mitigated by introducing locality, but this comes at its own cost of potentially large second-order coupling terms. Herein, a method is described which partially localizes vibrations to connect the fully delocalized and fully localized limits. This allows a balance between the treatment of harmonic and anharmonic coupling, which minimizes the error that arises from neglected coupling terms. Partially localized modes are investigated for a range of model systems including a tetramer of hydrogen fluoride, water dimer, ethene, diphenylethane, and stilbene. Generally, partial localization reaches ˜75% of maximal locality while introducing less than ˜30% of the harmonic coupling of the fully localized system. Furthermore, partial localization produces mode pairs that are spatially separated and thus weakly coupled to one another. It is likely that this property can be exploited in the creation of model Hamiltonians that omit the coupling parameters of the distant (and therefore uncoupled) pairs.

  17. Raquianestesia contínua com altas doses de anestésicos locais Raquianestesia continua con altas dosis de anestésicos locales Continuous spinal anesthesia with high dose of local anesthetics

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2010-10-01

    éteres intermediarios (catéter por fuera de la aguja y por su baja incidencia de cefalea y síntomas neurológicos, la técnica ha venido ganando credibilidad. El objetivo de este caso es relatar la posible seguridad del uso del nuevo catéter con una gran dosis de bupivacaína hiperbárica al 0,5% con glucosa al 1,6% asociada a la lidocaína al 2% hiperbárica y con glucosa al 1,6%. RELATO DEL CASO: Paciente masculino, de 78 años, 85 kg, 168 cm, estado físico ASA III, hipertenso, con coronariopatía e insuficiencia renal crónica. Candidato a cirugía de voluminosas hernias inguinales bilateral y umbilical, siendo sometido durante una semana a neumoperitoneo para crear espacio. Posteriormente a la venoclisis con catéter 18G, monitorización con cardioscopio, presión arterial no invasiva y oximetria de pulso, fue sedado con 1 mg de midazolam y fentanil 100 µg por vía venosa y colocado en decúbito lateral izquierdo. Sometido a la raquianestesia continua por vía mediana en L3-L4, y conjunto de aguja cortante 27G con catéter 22G. La dosis total de anestésico utilizada en el procedimiento fue 25 mg de bupivacaína al 0,5% (hiperbárica con glucosa al 1,6% y 160 mg de lidocaína al 2% (hiperbárica con glucosa al 1,6% y morfina (100 µg. Paciente con seguimiento hasta el 30º día sin quejidos neurológicos. CONCLUSIONES: Recientemente, la mala distribución del anestésico local a través de microcatéter, se atribuyó a una causa del síndrome de cola de caballo. Este relato de caso mostró que, con la administración de altas dosis de anestésicos hiperbáricos a través del nuevo catéter, no hubo una mala distribución ni el riesgo de síndrome de cola de caballoBACKGROUND AND OBJECTIVES: Better control of the level, intensity, and duration of spinal analgesia represents the greatest advantages of continuous spinal anesthesia. With the advent of intermediate catheters (over-the-needle catheter and its low incidence of headaches and neurological symptoms, the technique has

  18. [Anesthesia for ambulatory patients].

    Science.gov (United States)

    Landauer, B

    1975-11-13

    The specific problems of outpatient anesthesia are discussed with respect to the patient's condition, the anesthesist's qualification and pharmacological properties of anesthetics used. Methohexitone seems to be the best choice for induction. Problems may arise from the use of Propanidid, Ketamin and Diazepam. Nitrousoxide and Enflurane are a suitable completion. Endotracheal intubation, if needed, is facilitated by Suxamethonium, which is rapidly eliminated. Practical aspects of timing, premedication, induction, maintenance and ending of anesthesia are pointed out. After 1-2 hours the patient can be allowed to leave the hospital accompanied by a responsible person. Driving a car is not recommended before 24 hours have elapsed since anesthesia.

  19. 局部麻醉下腹膜前间隙无张力疝修补160例%Preperitoneal tension-free hernia repair under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨飖

    2014-01-01

    目的:总结局部麻醉下腹膜前间隙无张力疝修补术的临床应用价值。方法回顾性分析2011年10月至2014年3月,同济大学医学院附属东方医院在局部麻醉下行开放式腹膜前间隙无张力疝修补术的腹股沟疝患者160例。结果本组患者手术过程顺利,手术时间30~65 min,平均(50±3)min;术后2~6 h下床活动;住院时间1~3 d。术后出现尿潴留12例,阴囊水肿9例,切口疼痛8例,经物理治疗后疼痛缓解。随访1~12个月,复发5例,经二次手术治愈。结论局部麻醉下腹膜前间隙无张力疝修补术是安全可行的,麻醉效果满意,并发症少,复发率低,精准的手术操作是腹股沟疝修补术成功的关键。%Objective To summarize the value of local anesthesia for tension-free inguinal hernia repair.Methods From October 201 1 to March 201 4,a retrospective analysis was performed to 1 60 cases of inguinal hernia who received preperitoneal tension-free hernia repair under local anesthesia in Shanghai Dongfang Hospital.Results The operating time for these patients was 35 to 60 minutes (mean of 50 ± 3 minutes);patients return to physical activity in 2 to 6 hours after operations;the length of stay was 1 to 3 days.Postoperative urinary retention occurred in 1 2 cases,scrotal seroma in 9 cases;8 patients found incisional pain which improved by physical therapy.With a follow-up of 1 to 1 2 months,5 patients had recurrences,and reoperation were performed to them.Conclusion Preperitoneal tension-free hernia repair under local anesthesia is a safe and effective procedure,has satisfactory anesthesia effect,less complications and low recurrence rate.However,accurate operation is the key to a successful inguinal herniorrhaphy.

  20. Nuevos procedimientos en anestesia local en odontología: el sistema Injex® New proceedings in dental anesthesia: the Injex® system

    Directory of Open Access Journals (Sweden)

    C Fernández-Canedo

    2004-06-01

    Full Text Available Una de las circunstancias que han contribuido al desarrollo de la odontología en los últimos tiempos ha sido la mejora en las técnicas anestésicas. Sin embargo, el uso de la aguja en la mayor parte de los sistemas de anestesia dental, a pesar de ser un sistema casi indoloro, constituye un problema por la gran cantidad de pacientes que presentan fobias a la misma. Este hecho empeora cuando las poblaciones que han de ser tratadas son niños o pacientes especiales. En esta revisión bibliográfica se exponen las ventajas e inconvenientes de las técnicas anestésicas sin aguja, y se describe un nuevo sistema aparecido en el mercado español, el sistema Injex®.In the recent years, the improvement of anesthesics methods have been one of the circunstances who had contributed to the development of Odontology. In the other hand, sometimes is an important problem the employrnent of the needle in the most of anethesisc systems, because many patients present fobic situations when the needle is employed. This situation is worst when children or handicapped patients have to be treated. In this review, the advantages and mistakes of dental anesthesia without needle is exposed, and a new method developed, called Injex® is presented.

  1. Comparing the Selected Transfer Functions and Local Optimization Methods for Neural Network Flood Runoff Forecast

    Directory of Open Access Journals (Sweden)

    Petr Maca

    2014-01-01

    Full Text Available The presented paper aims to analyze the influence of the selection of transfer function and training algorithms on neural network flood runoff forecast. Nine of the most significant flood events, caused by the extreme rainfall, were selected from 10 years of measurement on small headwater catchment in the Czech Republic, and flood runoff forecast was investigated using the extensive set of multilayer perceptrons with one hidden layer of neurons. The analyzed artificial neural network models with 11 different activation functions in hidden layer were trained using 7 local optimization algorithms. The results show that the Levenberg-Marquardt algorithm was superior compared to the remaining tested local optimization methods. When comparing the 11 nonlinear transfer functions, used in hidden layer neurons, the RootSig function was superior compared to the rest of analyzed activation functions.

  2. Block Locally Optimal Preconditioned Eigenvalue Xolvers (BLOPEX) in hypre and PETSc

    CERN Document Server

    Knyazev, A V; Lashuk, I; Ovtchinnikov, E E

    2007-01-01

    We describe our software package Block Locally Optimal Preconditioned Eigenvalue Xolvers (BLOPEX) publicly released recently. BLOPEX is available as a stand-alone serial library, as an external package to PETSc (``Portable, Extensible Toolkit for Scientific Computation'', a general purpose suite of tools for the scalable solution of partial differential equations and related problems developed by Argonne National Laboratory), and is also built into {\\it hypre} (``High Performance Preconditioners'', scalable linear solvers package developed by Lawrence Livermore National Laboratory). The present BLOPEX release includes only one solver--the Locally Optimal Block Preconditioned Conjugate Gradient (LOBPCG) method for symmetric eigenvalue problems. {\\it hypre} provides users with advanced high-quality parallel preconditioners for linear systems, in particular, with domain decomposition and multigrid preconditioners. With BLOPEX, the same preconditioners can now be efficiently used for symmetric eigenvalue problems...

  3. A Particle Swarm Optimization-Based Approach with Local Search for Predicting Protein Folding.

    Science.gov (United States)

    Yang, Cheng-Hong; Lin, Yu-Shiun; Chuang, Li-Yeh; Chang, Hsueh-Wei

    2017-03-13

    The hydrophobic-polar (HP) model is commonly used for predicting protein folding structures and hydrophobic interactions. This study developed a particle swarm optimization (PSO)-based algorithm combined with local search algorithms; specifically, the high exploration PSO (HEPSO) algorithm (which can execute global search processes) was combined with three local search algorithms (hill-climbing algorithm, greedy algorithm, and Tabu table), yielding the proposed HE-L-PSO algorithm. By using 20 known protein structures, we evaluated the performance of the HE-L-PSO algorithm in predicting protein folding in the HP model. The proposed HE-L-PSO algorithm exhibited favorable performance in predicting both short and long amino acid sequences with high reproducibility and stability, compared with seven reported algorithms. The HE-L-PSO algorithm yielded optimal solutions for all predicted protein folding structures. All HE-L-PSO-predicted protein folding structures possessed a hydrophobic core that is similar to normal protein folding.

  4. Meningitis after spinal anesthesia

    National Research Council Canada - National Science Library

    Mouchrif, Issam; Berdaii, Adnane; Labib, Ismail; Harrandou, Moustapha

    2016-01-01

    Meningitis is a rare but serious complication of epidural and spinal anesthesia. Bacterial meningitis is mainly caused by Gram-positive cocci, implying an exogenous contamination which suggests a lack of asepsis...

  5. Pediatric anesthesia and neurotoxicity

    DEFF Research Database (Denmark)

    Disma, Nicola; Hansen, Tom G.

    2016-01-01

    Many studies have demonstrated a neurodegenerative effect of anesthetic drugs in cubs and young animals, raising the concern that similar effects can happen in children, and that the administration of anesthesia in young children undergoing surgical or diagnostic procedures may cause long- Term...... neurocognitive impairment. Thus, several epidemiological studies have been performed with the aim to find a possible association between early anesthesia exposure and poor long- Term outcome, like learning disabilities or worse school grading and two prospective trials are currently running, the GAS...... and the PANDA study. Interim results from the GAS study, which compared infants undergoing general and regional anesthesia for hernia repair, have demonstrated that a single exposure of about one hour of anesthesia does not affect the neurological outcome at 2 years of age. Nowadays, most of the knowledge...

  6. Anesthesia information management systems

    Directory of Open Access Journals (Sweden)

    Feri Štivan

    2014-08-01

    Full Text Available Introduction: The use of anesthesia information management systems (AIMS is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia record on malpractice exposure.Conclusions: The experience reported by departments using AIMS indicates that these systems are useful for managing malpractice risk. AIMS can enhance the efficiency and effectiveness of preoperative, intraoperative, and post-operative anesthesia care. However, AIMS are able to increase the quality of care and improve operating room efficiency only with careful planning, installation, and customization. Strengths, weaknesses, opportunities and threats (SWOT analysis performed for AIMS could help departments in making better decisions when implementing AIMS.

  7. 86例老年患者局麻下行无张力疝修补术临床体会%Clinical Experience of 86 Cases of Elderly Patients with Tension-free Hernia Repair Under Local Anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈建光; 范楚; 郑昊

    2015-01-01

    目的总结65岁以上老年患者局部麻醉下施行无张力疝修补术治疗腹股沟疝的临床经验。方法对86例老年腹股沟疝患者临床资料进行回顾性分析。结果麻醉效果满意,手术时间40~70min,术后24h内可以下床活动,平均住院时间7.6d,术后65-year-old )under local anaethesia.Methods The clinical data of eighty-six inguinal hernia neoplasty of aged patients were reviewed.Results Most of the patients tolerated wel to local anaesthesia.The mean operation time was 40~70 minutes.The patients restored the out-of-bed activity within 24 hours.The mean hospitalized duration was 7.6 days.The postoperative complication rate,such as urinary retention,was 4%.There was no recur ence in our fol ow-up during 1 month to 2 years.Conclusion Under local anesthesia, tension free hernia repair has the advantages of simple operation, less pain, rapid recovery, less complications and shorter hospital stay.

  8. Portfolio optimization using local linear regression ensembles in RapidMiner

    OpenAIRE

    Gabor Nagy; Gergo Barta; Tamas Henk

    2015-01-01

    In this paper we implement a Local Linear Regression Ensemble Committee (LOLREC) to predict 1-day-ahead returns of 453 assets form the S&P500. The estimates and the historical returns of the committees are used to compute the weights of the portfolio from the 453 stock. The proposed method outperforms benchmark portfolio selection strategies that optimize the growth rate of the capital. We investigate the effect of algorithm parameter m: the number of selected stocks on achieved average annua...

  9. A theory of local learning, the learning channel, and the optimality of backpropagation.

    Science.gov (United States)

    Baldi, Pierre; Sadowski, Peter

    2016-11-01

    In a physical neural system, where storage and processing are intimately intertwined, the rules for adjusting the synaptic weights can only depend on variables that are available locally, such as the activity of the pre- and post-synaptic neurons, resulting in local learning rules. A systematic framework for studying the space of local learning rules is obtained by first specifying the nature of the local variables, and then the functional form that ties them together into each learning rule. Such a framework enables also the systematic discovery of new learning rules and exploration of relationships between learning rules and group symmetries. We study polynomial local learning rules stratified by their degree and analyze their behavior and capabilities in both linear and non-linear units and networks. Stacking local learning rules in deep feedforward networks leads to deep local learning. While deep local learning can learn interesting representations, it cannot learn complex input-output functions, even when targets are available for the top layer. Learning complex input-output functions requires local deep learning where target information is communicated to the deep layers through a backward learning channel. The nature of the communicated information about the targets and the structure of the learning channel partition the space of learning algorithms. For any learning algorithm, the capacity of the learning channel can be defined as the number of bits provided about the error gradient per weight, divided by the number of required operations per weight. We estimate the capacity associated with several learning algorithms and show that backpropagation outperforms them by simultaneously maximizing the information rate and minimizing the computational cost. This result is also shown to be true for recurrent networks, by unfolding them in time. The theory clarifies the concept of Hebbian learning, establishes the power and limitations of local learning rules

  10. Advances in pediatric anesthesia.

    Science.gov (United States)

    Burns, L S

    1997-03-01

    Advances in many aspects of pediatric anesthesia have resulted in a significant reduction in morbidity and mortality in children. Research and development have created vast improvements in pharmacology. Sophisticated monitoring and improvements in equipment evolved from advances made in scientific technology. Recognition of the psychological needs of children of all ages likely has reduced the incidence of lasting psychological effects after hospitalization. Finally, these important advances have made pediatric anesthesia a safer and more compassionate specialty.

  11. Awareness under general anesthesia.

    Science.gov (United States)

    Bischoff, Petra; Rundshagen, Ingrid

    2011-01-01

    Awareness while under general anesthesia, and the later recall of what happened during surgery, can be experienced by patients as horrific events that leave lasting mental trauma behind. Patients may have both auditory and tactile perception, potentially accompanied by feelings of helplessness, inability to move, pain, and panic ranging to an acute fear of death. For some patients, the experience of awareness under anesthesia has no sequelae; for others, however, it can lead to the development of post-traumatic stress disorder, consisting of complex psychopathological phenomena such as anxiety, insomnia, nightmares, irritability, and depression possibly leading to suicidality. The literature on the subject was selectively reviewed. In the absence of risk factors awareness phenomena occur in one to two per 1000 operations under general anesthesia (0.1% to 0.2%) and are thus classed as an occasionally occurring critical event. In children, the risk of such phenomena occurring is 8 to 10 times higher. These phenomena are due to an inadequate depth of anesthesia with incomplete unconsciousness. They can be promoted by a number of risk factors that are either patient-related (ASA class III or above, medication abuse), surgery-related (Caesarean section, emergency procedures, surgery at night), or anesthesia-related (anesthesia without benzodiazepines, use of muscle relaxants). Strategies for avoiding awareness phenomena under anesthesia include the training of staff to know about the problem and, specifically, the use of benzodiazepines, the avoidance of muscle relaxants if possible, and shielding the patient from excessive noise. EEG monitoring is effective but provides no guarantee against awareness. If awareness under anesthesia occurs despite these measures, the patient must be given expert, interdisciplinary treatment as soon after the event as possible in order to minimize its potential sequelae.

  12. Optimal sensor placement for maximum area coverage (MAC) for damage localization in composite structures

    Science.gov (United States)

    Thiene, M.; Sharif Khodaei, Z.; Aliabadi, M. H.

    2016-09-01

    In this paper an optimal sensor placement algorithm for attaining the maximum area coverage (MAC) within a sensor network is presented. The proposed novel approach takes into account physical properties of Lamb wave propagation (attenuation profile, direction dependant group velocity due to material anisotropy) and geometrical complexities (boundary reflections, presence of openings) of the structure. A feature of the proposed optimization approach lies in the fact that it is independent of characteristics of the damage detection algorithm (e.g. probability of detection) making it readily up-scalable to large complex composite structures such as aircraft stiffened composite panel. The proposed fitness function (MAC) is independent of damage parameters (type, severity, location). Statistical analysis carried out shows that the proposed optimum sensor network with MAC results in high probability of damage localization. Genetic algorithm is coupled with the fitness function to provide an efficient optimization strategy.

  13. SU-E-J-130: Automating Liver Segmentation Via Combined Global and Local Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Li, Dengwang; Wang, Jie [College of Physics and Electronics, Shandong Normal University, Jinan, Shandong (China); Kapp, Daniel S.; Xing, Lei [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: The aim of this work is to develop a robust algorithm for accurate segmentation of liver with special attention paid to the problems with fuzzy edges and tumor. Methods: 200 CT images were collected from radiotherapy treatment planning system. 150 datasets are selected as the panel data for shape dictionary and parameters estimation. The remaining 50 datasets were used as test images. In our study liver segmentation was formulated as optimization process of implicit function. The liver region was optimized via local and global optimization during iterations. Our method consists five steps: 1)The livers from the panel data were segmented manually by physicians, and then We estimated the parameters of GMM (Gaussian mixture model) and MRF (Markov random field). Shape dictionary was built by utilizing the 3D liver shapes. 2)The outlines of chest and abdomen were located according to rib structure in the input images, and the liver region was initialized based on GMM. 3)The liver shape for each 2D slice was adjusted using MRF within the neighborhood of liver edge for local optimization. 4)The 3D liver shape was corrected by employing SSR (sparse shape representation) based on liver shape dictionary for global optimization. Furthermore, H-PSO(Hybrid Particle Swarm Optimization) was employed to solve the SSR equation. 5)The corrected 3D liver was divided into 2D slices as input data of the third step. The iteration was repeated within the local optimization and global optimization until it satisfied the suspension conditions (maximum iterations and changing rate). Results: The experiments indicated that our method performed well even for the CT images with fuzzy edge and tumors. Comparing with physician delineated results, the segmentation accuracy with the 50 test datasets (VOE, volume overlap percentage) was on average 91%–95%. Conclusion: The proposed automatic segmentation method provides a sensible technique for segmentation of CT images. This work is

  14. An optimized ensemble local mean decomposition method for fault detection of mechanical components

    Science.gov (United States)

    Zhang, Chao; Li, Zhixiong; Hu, Chao; Chen, Shuai; Wang, Jianguo; Zhang, Xiaogang

    2017-03-01

    Mechanical transmission systems have been widely adopted in most of industrial applications, and issues related to the maintenance of these systems have attracted considerable attention in the past few decades. The recently developed ensemble local mean decomposition (ELMD) method shows satisfactory performance in fault detection of mechanical components for preventing catastrophic failures and reducing maintenance costs. However, the performance of ELMD often heavily depends on proper selection of its model parameters. To this end, this paper proposes an optimized ensemble local mean decomposition (OELMD) method to determinate an optimum set of ELMD parameters for vibration signal analysis. In OELMD, an error index termed the relative root-mean-square error (Relative RMSE) is used to evaluate the decomposition performance of ELMD with a certain amplitude of the added white noise. Once a maximum Relative RMSE, corresponding to an optimal noise amplitude, is determined, OELMD then identifies optimal noise bandwidth and ensemble number based on the Relative RMSE and signal-to-noise ratio (SNR), respectively. Thus, all three critical parameters of ELMD (i.e. noise amplitude and bandwidth, and ensemble number) are optimized by OELMD. The effectiveness of OELMD was evaluated using experimental vibration signals measured from three different mechanical components (i.e. the rolling bearing, gear and diesel engine) under faulty operation conditions.

  15. GWO-LPWSN: Grey Wolf Optimization Algorithm for Node Localization Problem in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    R. Rajakumar

    2017-01-01

    Full Text Available Seyedali Mirjalili et al. (2014 introduced a completely unique metaheuristic technique particularly grey wolf optimization (GWO. This algorithm mimics the social behavior of grey wolves whereas it follows the leadership hierarchy and attacking strategy. The rising issue in wireless sensor network (WSN is localization problem. The objective of this problem is to search out the geographical position of unknown nodes with the help of anchor nodes in WSN. In this work, GWO algorithm is incorporated to spot the correct position of unknown nodes, so as to handle the node localization problem. The proposed work is implemented using MATLAB 8.2 whereas nodes are deployed in a random location within the desired network area. The parameters like computation time, percentage of localized node, and minimum localization error measures are utilized to analyse the potency of GWO rule with other variants of metaheuristics algorithms such as particle swarm optimization (PSO and modified bat algorithm (MBA. The observed results convey that the GWO provides promising results compared to the PSO and MBA in terms of the quick convergence rate and success rate.

  16. DOA Estimation for Local Scattered CDMA Signals by Particle Swarm Optimization

    Directory of Open Access Journals (Sweden)

    Jhih-Chung Chang

    2012-03-01

    Full Text Available This paper deals with the direction-of-arrival (DOA estimation of local scattered code-division multiple access (CDMA signals based on a particle swarm optimization (PSO search. For conventional spectral searching estimators with local scattering, the searching complexity and estimating accuracy strictly depend on the number of search grids used during the search. In order to obtain high-resolution and accurate DOA estimation, a smaller grid size is needed. This is time consuming and it is unclear how to determine the required number of search grids. In this paper, a modified PSO is presented to reduce the required search grids for the conventional spectral searching estimator with the effects of local scattering. Finally, several computer simulations are provided for illustration and comparison.

  17. DOA estimation for local scattered CDMA signals by particle swarm optimization.

    Science.gov (United States)

    Chang, Jhih-Chung

    2012-01-01

    This paper deals with the direction-of-arrival (DOA) estimation of local scattered code-division multiple access (CDMA) signals based on a particle swarm optimization (PSO) search. For conventional spectral searching estimators with local scattering, the searching complexity and estimating accuracy strictly depend on the number of search grids used during the search. In order to obtain high-resolution and accurate DOA estimation, a smaller grid size is needed. This is time consuming and it is unclear how to determine the required number of search grids. In this paper, a modified PSO is presented to reduce the required search grids for the conventional spectral searching estimator with the effects of local scattering. Finally, several computer simulations are provided for illustration and comparison.

  18. Matrix Completion Optimization for Localization in Wireless Sensor Networks for Intelligent IoT

    Directory of Open Access Journals (Sweden)

    Thu L. N. Nguyen

    2016-05-01

    Full Text Available Localization in wireless sensor networks (WSNs is one of the primary functions of the intelligent Internet of Things (IoT that offers automatically discoverable services, while the localization accuracy is a key issue to evaluate the quality of those services. In this paper, we develop a framework to solve the Euclidean distance matrix completion problem, which is an important technical problem for distance-based localization in WSNs. The sensor network localization problem is described as a low-rank dimensional Euclidean distance completion problem with known nodes. The task is to find the sensor locations through recovery of missing entries of a squared distance matrix when the dimension of the data is small compared to the number of data points. We solve a relaxation optimization problem using a modification of Newton’s method, where the cost function depends on the squared distance matrix. The solution obtained in our scheme achieves a lower complexity and can perform better if we use it as an initial guess for an interactive local search of other higher precision localization scheme. Simulation results show the effectiveness of our approach.

  19. Matrix Completion Optimization for Localization in Wireless Sensor Networks for Intelligent IoT.

    Science.gov (United States)

    Nguyen, Thu L N; Shin, Yoan

    2016-05-18

    Localization in wireless sensor networks (WSNs) is one of the primary functions of the intelligent Internet of Things (IoT) that offers automatically discoverable services, while the localization accuracy is a key issue to evaluate the quality of those services. In this paper, we develop a framework to solve the Euclidean distance matrix completion problem, which is an important technical problem for distance-based localization in WSNs. The sensor network localization problem is described as a low-rank dimensional Euclidean distance completion problem with known nodes. The task is to find the sensor locations through recovery of missing entries of a squared distance matrix when the dimension of the data is small compared to the number of data points. We solve a relaxation optimization problem using a modification of Newton's method, where the cost function depends on the squared distance matrix. The solution obtained in our scheme achieves a lower complexity and can perform better if we use it as an initial guess for an interactive local search of other higher precision localization scheme. Simulation results show the effectiveness of our approach.

  20. THE POTENTIAL OF INFORMATION AND COMMUNICATIONS TECHNOLOGICAL IN THE OPTIMIZATION OF LOCAL GOVERNMENT FUNCTIONING IN RUSSIA

    Directory of Open Access Journals (Sweden)

    Виктор Павлович Ляхов

    2014-05-01

    Full Text Available The shift to a new type of relations in the system of “community-state” with regard to informational and network nature of modern society seemed to be the most important strategic course in the realization of modernization project in Russia. On this ground the article deals with the opportunities of local government system optimization through the active implementation of informational and communication technologies into state authorities and local government activity.The purpose of e-municipality is the reduction of informational inequality level, the transparency and increase of local authorities controllability by society, engaging general community in governing process.It is necessary to cope with the problem of creating and realizing the strategy of the shift from the closed style of performance to the open one by the active development of informational and communication technologies and their implementation into the performance of local government.As a required and compulsory mechanism we suggest monitoring municipal management efficiency as well as legal determining and differentiating of functions, powers and liabilities of local authorities’ structures.The informational component of modernization process in Russia will enable to attain a new level of communicative management activity of local authorities as well as the monitoring of its results.DOI: http://dx.doi.org/10.12731/2218-7405-2013-10-41

  1. Anesthesia awareness: narrative review of psychological sequelae, treatment, and incidence.

    Science.gov (United States)

    Bruchas, Robin R; Kent, Christopher D; Wilson, Hilary D; Domino, Karen B

    2011-09-01

    Awareness during general anesthesia occurs when patients recall events or sensations during their surgeries, although the patients should have been unconscious at the time. Anesthesiologists are cognizant of this phenomenon, but few discussions occur outside the discipline. This narrative review summarizes the patient recollections, psychological sequelae, treatment and follow-up of psychological consequences, as well as incidence and etiology of awareness during general anesthesia. Recalled memories include noises, conversations, images, mental processes, feelings of pain and/or paralysis. Psychological consequences include anxiety, flashbacks, and posttraumatic stress disorder diagnosis. Limited discussion for therapeutic treatment after an anesthesia awareness experience exists. The incidence of anesthesia awareness ranges from 0.1 to 0.2% (e.g., 1-2/1000 patients). Increased recognition of awareness during general anesthesia within the psychological/counseling community, with additional research focusing on optimal therapeutic treatment, will improve the care of these patients.

  2. DESTINATION MARKETING STRATEGY IN BALI THROUGH OPTIMIZING THE POTENTIAL OF LOCAL PRODUCTS

    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Oka Suryawardani

    2014-03-01

    Full Text Available This study was designed to study destination marketing strategy in Bali through optimizing the potential of local products. Seventy nine of hotel managers were interviewed based on cluster sampling method to gain their point of view. The results show that destination must build their images around unique attributes that provide them sustainable competitive advantage including its attraction which should be designed to meet the needs of the target market and should be served by local products. The results also show that hotel managers thought that foreign tourists always preferred imported products, meanwhile previous statistical results indicate that foreign tourists significantly look for local products. There is a need to encourage hotel managers to change their perception and attitude about local and imported products. In fact, hoteliers expressed willingness to use local products as long as these meet the quality standard. As tourism involves four types of activities, namely something to see, something to do, something to buy, something to learn, destination product development could be focused in the above activities through offering foreign tourist, such as to stay in hotels, homestays or villas owned by Balinese; to eat in restaurants owned by Balinese by choosing the authentic local foods that are using local meat, seafood and vegetables, exotic local fruits and beverages; and to buy products that are produced by the Balinese. By promoting vacation on the real Balinese atmosphere such as stay in accommodations owned by the Balinese supported by the authenticity of local Balinese foods, fruits and beverages, these will strengthen the local economy, so the benefit of tourism development can be more beneficial to the local Balinese. The results suggests that destination management related to improvement of service and hospitality are really important through improvement of human resource by giving training to their employees, educate

  3. Regional anesthesia in faciomaxillary and oral surgery

    Directory of Open Access Journals (Sweden)

    Manimaran Kanakaraj

    2012-01-01

    Full Text Available Faciomaxillary and oral surgical procedures are frequently done under local anesthesia. Only few techniques are used widely in these areas in spite of the numerous blocks available. Knowledge about these techniques could encourage use of these techniques for the benefit of patients and operators′ comfort. Leaving aside the commonly used intraoral anesthetic technique by faciomaxillary and dental surgeons, focus is given on regional blocks of extraoral route, like maxillary block, mandibular block, superficial cervical plexus block, forehead and scalp block, trigeminal nerve block, sphenopalatine nerve block, and they are discussed with their indications and technical details involved in administering them. Advantages of using the regional blocks over general anesthesia and multiple pricks include reduced dosage and number of needle pricks. Pediatric considerations like prolonged duration of anesthesia and wider area of action for regional blocks warrant that they should be used with caution.

  4. Pharmacokinetics of levobupivacaine following infant spinal anesthesia.

    Science.gov (United States)

    Frawley, Geoff; Hallett, Ben; Velkov, Tony; Bjorksten, Andrew

    2016-06-01

    Infant spinal anesthesia with levobupivacaine has been promoted as a technique to reduce both the risk of postoperative apnea and exposure to volatile anesthesia. There is, however, no pharmacokinetic data to support the currently recommended doses. Our aim was to determine whether infant levobupivacaine spinal anesthesia is associated with plasma concentrations consistent with a low risk of local anesthetic systemic toxicity. This was an open-label pharmacokinetic safety and tolerability study of levobupivacaine spinal anesthesia in infants spinal anesthetic with levobupivacaine 1 mg·kg(-1) in the left lateral position. Spinal anesthesia was successful in 25 (86.2%) of 29 infants (postmenstrual age 36-52 weeks; weight 2.2-4.7 kg). The median (IQR) total venous levobupivacaine plasma concentrations was 0.33 (0.25-0.42) μg·ml(-1) and unbound venous levobupivacaine was 19.5 (14.5-38) ng·ml(-1) . Median protein binding was 93.5 (91.4-96%). Alpha-1 acid glycoprotein concentrations were 0.25 (0.17-0.37) g·l(-1) and albumin concentrations were 29 (24-32) g·l(-1) . Total plasma concentrations and unbound (free) concentration of levobupivacaine were consistently lower than concentrations reported in cases of pediatric local anesthetic toxicity. In a small number of infants requiring a repeat spinal of 1 mg·kg(-1) was also associated with acceptable total and free concentrations. We conclude that levobupivacaine at 1 mg·kg(-1) is associated with no systemic side effects in infants receiving awake spinal anesthesia. © 2016 John Wiley & Sons Ltd.

  5. The Optimization of the Local Public Policies’ Development Process Through Modeling And Simulation

    Directory of Open Access Journals (Sweden)

    Minodora URSĂCESCU

    2012-06-01

    Full Text Available The local public policies development in Romania represents an empirically realized measure, the strategic management practices in this domain not being based on a scientific instrument capable to anticipate and evaluate the results of implementing a local public policy in a logic of needs-policies-effects type. Beginning from this motivation, the purpose of the paper resides in the reconceptualization of the public policies process on functioning principles of the dynamic systems with inverse connection, by means of mathematical modeling and techniques simulation. Therefore, the research is oriented in the direction of developing an optimization method for the local public policies development process, using as instruments the mathematical modeling and the techniques simulation. The research’s main results are on the one side constituted by generating a new process concept of the local public policies, and on the other side by proposing the conceptual model of a complex software product which will permit the parameterized modeling in a virtual environment of these policies development process. The informatic product’s finality resides in modeling and simulating each local public policy type, taking into account the respective policy’s characteristics, but also the value of their appliance environment parameters in a certain moment.

  6. Risk management in anesthesia.

    Science.gov (United States)

    Cabrini, L; Levati, A

    2009-11-01

    Anesthesia is considered a leading discipline in the field of patient safety. Nevertheless, complications still occur and can be devastating. A substantial portion of anesthesia-related adverse events are preventable since risk factors can be detected and eliminated. Risk management (RM) in anesthesia includes preventive and remedial measures to minimize patient anesthesia-related morbidity and mortality. RM involves all aspects of anesthesia care. Classically, the following four steps are needed to prevent critical incidents or to learn from them: (1) detection of problems, (2) assessment, (3) implementation of solutions, and (4) verification of effectiveness. Problems and solutions can be identified into the fields of structures, processes and personnel. Authoritative agencies like the World Health Organization, the World Federation of Societies of Anesthesiologists, the Section and Board of Anesthesiology of the European Union of Medical Specialties and the Italian Scientific Society of Anesthesiologists (Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva SIAARTI) have proposed initiatives addressing safety in the operating room. The central role of a well-trained, constantly present anesthesiologist and the usefulness of checklists have been highlighted. Cost cutting and production pressure in medical care are potential threats to safety. A shared knowledge of the best standards of care and of the potential consequences of unscrupulous actions could make the daily management of conflicting interests easier. A correctly applied RM can be a powerful, highly beneficial aid to our practice.

  7. Recent advances in topical anesthesia

    Science.gov (United States)

    2016-01-01

    Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain. PMID:28879311

  8. Optimization of the sources in local hyperthermia using a combined finite element-genetic algorithm method.

    Science.gov (United States)

    Siauve, N; Nicolas, L; Vollaire, C; Marchal, C

    2004-12-01

    This article describes an optimization process specially designed for local and regional hyperthermia in order to achieve the desired specific absorption rate in the patient. It is based on a genetic algorithm coupled to a finite element formulation. The optimization method is applied to real human organs meshes assembled from computerized tomography scans. A 3D finite element formulation is used to calculate the electromagnetic field in the patient, achieved by radiofrequency or microwave sources. Space discretization is performed using incomplete first order edge elements. The sparse complex symmetric matrix equation is solved using a conjugate gradient solver with potential projection pre-conditionning. The formulation is validated by comparison of calculated specific absorption rate distributions in a phantom to temperature measurements. A genetic algorithm is used to optimize the specific absorption rate distribution to predict the phases and amplitudes of the sources leading to the best focalization. The objective function is defined as the specific absorption rate ratio in the tumour and healthy tissues. Several constraints, regarding the specific absorption rate in tumour and the total power in the patient, may be prescribed. Results obtained with two types of applicators (waveguides and annular phased array) are presented and show the faculties of the developed optimization process.

  9. Effective mass density based topology optimization of locally resonant acoustic metamaterials for bandgap maximization

    Science.gov (United States)

    Yang, Xiong Wei; Lee, Joong Seok; Kim, Yoon Young

    2016-11-01

    Because effective material properties are essential concepts in the analyses of wave phenomena in metamaterials, they may also be utilized in the optimal design of metamaterials. In this work, we propose a topology optimization method directly using the Effective Mass Density (EMD) concept to maximize the first bandgaps of two-dimensional solid Locally Resonant Acoustic Metamaterials (LRAMs). When the first bandgap is characterized by the negative EMD, the bandgap maximization can be formulated efficiently as a topology optimization problem to broaden the frequency zone of the negative EMD values. In this work, EMD is calculated by considering the macroscopic isotropy of LRAMs in the long wavelength limit. To facilitate the analytical sensitivity analysis, we propose an elaborate calculation scheme of EMD. A sensitivity averaging technique is also suggested to guarantee the macroscopically isotropic behavior of the LRAMs. In the present study, the coating layer interfacing the core and the matrix of a ternary LRAM is chosen as the design region because it significantly influences the bandgap. By considering several numerical examples, the validity of this method is verified, and the effects of the mass constraint ratios on the optimized results are also investigated.

  10. Optimization of a Localized Air Conditioning System Using Thermoelectric Coolers for Commercial Vehicles

    Science.gov (United States)

    Wan, Qiushi; Deng, Yadong; Su, Chuqi; Wang, Yiping

    2016-11-01

    To improve the thermal comfort and energy saving of commercial vehicles, an auxiliary air conditioning (AC) system has been constructed. Several distributed components using thermoelectric coolers were applied in a localized AC system to adjust the microclimate around the driver only. A computational fluid dynamics model of a commercial vehicle cabin with a driver was built, the temperature field of the cabin investigated, and the thermal comfort analyzed. Based on the results of the simulations, the temperature around the cold side of the thermoelectric coolers is discussed and optimized by means of the response surface methodology and a multiobjective genetic algorithm. To validate the simulation and optimization results, a bench test was carried out; the results obtained from the simulation showed good agreement with the experimental results.

  11. Reliability based topology optimization for continuum structures with local failure constraints

    DEFF Research Database (Denmark)

    Luo, Yangjun; Zhou, Mingdong; Wang, Michael Yu

    2014-01-01

    -related) target performance constraints. In order to overcome the stress singularity phenomenon caused by the combined stress and reliability constraints, a reduction strategy on target reliability index is proposed and utilized together with the ε-relaxation approach. Meanwhile, an enhanced aggregation method......This paper presents an effective method for stress constrained topology optimization problems under load and material uncertainties. Based on the Performance Measure Approach (PMA), the optimization problem is formulated as to minimize the objective function under a large number of (stress...... is employed to aggregate the selected active constraints using a general K–S function, which avoids expensive computational cost from the large-scale nature of local failure constraints. Several numerical examples are given to demonstrate the validity of the present method....

  12. Speedup of optimization-based approach to local backlight dimming of HDR displays

    DEFF Research Database (Denmark)

    Burini, Nino; Nadernejad, Ehsan; Korhonen, Jari

    2012-01-01

    Local backlight dimming in Liquid Crystal Displays (LCD) is a technique for reducing power consumption and simultaneously increasing contrast ratio to provide a High Dynamic Range (HDR) image reproduction. Several backlight dimming algorithms exist with focus on reducing power consumption, while...... also be beneficial in conjunction with other approaches, such as an algorithm based on gradient descent, also presented here. All the proposals have been compared against other known approaches on simulated edge- and direct-lit displays, and the results show that the optimal distortion level can...

  13. Local Bifurcations and Optimal Theory in a Delayed Predator-Prey Model with Threshold Prey Harvesting

    Science.gov (United States)

    Tankam, Israel; Tchinda Mouofo, Plaire; Mendy, Abdoulaye; Lam, Mountaga; Tewa, Jean Jules; Bowong, Samuel

    2015-06-01

    We investigate the effects of time delay and piecewise-linear threshold policy harvesting for a delayed predator-prey model. It is the first time that Holling response function of type III and the present threshold policy harvesting are associated with time delay. The trajectories of our delayed system are bounded; the stability of each equilibrium is analyzed with and without delay; there are local bifurcations as saddle-node bifurcation and Hopf bifurcation; optimal harvesting is also investigated. Numerical simulations are provided in order to illustrate each result.

  14. PlayNCool: Opportunistic Network Coding for Local Optimization of Routing in Wireless Mesh Networks

    DEFF Research Database (Denmark)

    Pahlevani, Peyman; Roetter, Daniel Enrique Lucani; Pedersen, Morten Videbæk;

    2013-01-01

    This paper introduces PlayNCool, an opportunistic protocol with local optimization based on network coding to increase the throughput of a wireless mesh network (WMN). PlayNCool aims to enhance current routing protocols by (i) allowing random linear network coding transmissions end-to-end, (ii...... in large scale mesh networks. We show that PlayNCool can provide gains of more than 3x in individual links, which translates into a large end-to-end throughput improvement, and that it provides higher gains when more nodes in the network contend for the channel at the MAC layer, making it particularly...... relevant for dense mesh networks....

  15. Anesthesia methods used by anesthetic specialists for circumcision cases

    Science.gov (United States)

    Altaş, Cafer; Küçükosman, Gamze; Yurtlu, Bülent S.; Okyay, Rahşan D.; Aydın, Bengü G.; Pişkin, Özcan; Çimencan, Murat; Ayoğlu, Hilal; Hancı, Volkan; Özkoçak-Turan, Işıl

    2017-01-01

    Objectives: To examine the anesthesiologist’s choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions. These questions included demographic data, methods of anesthesia for circumcision, postoperative analgesia methods, and monitoring methods. Results: The data were obtained from 206 anesthesiologists who agreed to participate in the survey. Circumcision was performed most frequently in the age group of 3-6 years old. It was found that 47% of routine preoperative laboratory tests were coagulation parameters and complete blood count tests. The most common method of anesthesia was laryngeal mask. The frequency of administration of regional anesthesia was 37.4%, and caudal block was more preferable. Bupivacaine as a local anesthetic in regional anesthesia and midazolam and ketamine were the most preferred agents in sedoanalgesia. During regional anesthesia, ultrasound was most often used by anesthesiologists (31.6%). Conclusion: Ambulatory anesthesia protocols, which are also needed in circumcision, can be improved with international recommendation, and these protocols could be conformed as sociocultural structure in societies. This study should be regarded as a preliminary study to attract attention on anesthesia techniques in circumcision. PMID:28042634

  16. Recent advances and perspectives in topical oral anesthesia.

    Science.gov (United States)

    Franz-Montan, Michelle; Ribeiro, Lígia Nunes de Morais; Volpato, Maria Cristina; Cereda, Cintia Maria Saia; Groppo, Francisco Carlos; Tofoli, Giovana Randomille; de Araújo, Daniele Ribeiro; Santi, Patrizia; Padula, Cristina; de Paula, Eneida

    2017-05-01

    Topical anesthesia is widely used in dentistry to reduce pain caused by needle insertion and injection of the anesthetic. However, successful anesthesia is not always achieved using the formulations that are currently commercially available. As a result, local anesthesia is still one of the procedures that is most feared by dental patients. Drug delivery systems (DDSs) provide ways of improving the efficacy of topical agents. Areas covered: An overview of the structure and permeability of oral mucosa is given, followed by a review of DDSs designed for dental topical anesthesia and their related clinical trials. Chemical approaches to enhance permeation and anesthesia efficacy, or to promote superficial anesthesia, include nanostructured carriers (liposomes, cyclodextrins, polymeric nanoparticle systems, solid lipid nanoparticles, and nanostructured lipid carriers) and different pharmaceutical dosage forms (patches, bio- and mucoadhesive systems, and hydrogels). Physical methods include pre-cooling, vibration, iontophoresis, and microneedle arrays. Expert opinion: The combination of different chemical and physical methods is an attractive option for effective topical anesthesia in oral mucosa. This comprehensive review should provide the readers with the most relevant options currently available to assist pain-free dental anesthesia. The findings should be considered for future clinical trials.

  17. Nanoplasmonics simulations at the basis set limit through completeness-optimized, local numerical basis sets

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Tuomas P., E-mail: tuomas.rossi@alumni.aalto.fi; Sakko, Arto; Puska, Martti J. [COMP Centre of Excellence, Department of Applied Physics, Aalto University School of Science, P.O. Box 11100, FI-00076 Aalto (Finland); Lehtola, Susi, E-mail: susi.lehtola@alumni.helsinki.fi [COMP Centre of Excellence, Department of Applied Physics, Aalto University School of Science, P.O. Box 11100, FI-00076 Aalto (Finland); Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Nieminen, Risto M. [COMP Centre of Excellence, Department of Applied Physics, Aalto University School of Science, P.O. Box 11100, FI-00076 Aalto (Finland); Dean’s Office, Aalto University School of Science, P.O. Box 11000, FI-00076 Aalto (Finland)

    2015-03-07

    We present an approach for generating local numerical basis sets of improving accuracy for first-principles nanoplasmonics simulations within time-dependent density functional theory. The method is demonstrated for copper, silver, and gold nanoparticles that are of experimental interest but computationally demanding due to the semi-core d-electrons that affect their plasmonic response. The basis sets are constructed by augmenting numerical atomic orbital basis sets by truncated Gaussian-type orbitals generated by the completeness-optimization scheme, which is applied to the photoabsorption spectra of homoatomic metal atom dimers. We obtain basis sets of improving accuracy up to the complete basis set limit and demonstrate that the performance of the basis sets transfers to simulations of larger nanoparticles and nanoalloys as well as to calculations with various exchange-correlation functionals. This work promotes the use of the local basis set approach of controllable accuracy in first-principles nanoplasmonics simulations and beyond.

  18. NEURAXIAL ANESTHESIA and OBESITY

    Directory of Open Access Journals (Sweden)

    Aynur sahin

    2013-09-01

    Full Text Available Obesity is one of the serious condition that commonly effects health in modern age. It was reported that obesity was three-fold increased in the last three decades. According to the statement by World Health Organisation in 2005, 700 million people will be estimated obese in 2015. While neuraxial anesthesia is a commonly used technique in the worldwide, the process may have difficulties in obese patients. In this review, the pathophysiological changes and challenges in neuraxial anesthesia procedure in obesity were assessed with current literatures. [J Contemp Med 2013; 3(3.000: 234-236

  19. Regional anesthesia techniques for ambulatory orthopedic surgery.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2012-02-03

    PURPOSE OF REVIEW: The purpose of this review is to present advances in the use of regional anesthetic techniques in ambulatory orthopedic surgery. New findings regarding the use of both neuraxial anesthesia and peripheral nerve block are discussed. RECENT FINDINGS: Neuraxial anesthesia: The use of short-acting local anesthetic agents such as mepivacaine, 2-chloroprocaine, and articaine permits rapid onset intrathecal anesthesia with early recovery profiles. Advantages and limitations of these agents are discussed.Peripheral nerve block: Peripheral nerve blocks in limb surgery have the potential to transform this patient cohort into a truly ambulatory, self-caring group. Recent trends and evidence regarding the benefits of regional anesthesia techniques are presented.Continuous perineural catheters permit extension of improved perioperative analgesia into the ambulatory home setting. The role and reported safety of continuous catheters are discussed. SUMMARY: In summary, shorter acting, neuraxial, local anesthetic agents, specific to the expected duration of surgery, may provide superior recovery profiles in the ambulatory setting. A trend towards more peripheral and selective nerve blocks exists. The infrapatellar block is a promising technique to provide analgesia following knee arthroscopy. Improved analgesia seen in the perioperative period can be safely and effectively extended to the postoperative period with the use of perineural catheters.

  20. Evaluation of the efficacy and safety of a lidocaine and tetracaine (7%/7%) cream for induction of local dermal anesthesia for facial soft tissue augmentation with hyaluronic Acid.

    Science.gov (United States)

    Cohen, Joel L; Gold, Michael H

    2014-10-01

    Injection of dermal fillers for soft tissue augmentation is a minimally invasive cosmetic procedure with growing popularity. However, patients often express concern about pain with such procedures. A topical anesthetic cream formulated with lidocaine/tetracaine 7%7% was approved by the United States Food and Drug Administration in 2006 and recently reintroduced to the market for use during superficial dermatological procedures. A Phase 3 study was conducted to assess the efficacy and safety of lidocaine/tetracaine 7%7% cream versus placebo cream when used to induce local dermal anesthesia during injections with hyaluronic acid. Mean visual analog scale scores significantly favored lidocaine/tetracaine 7%7% cream. A significant percent of subjects also indicated that lidocaine/tetracaine 7%7% cream provided adequate pain relief and that they would use lidocaine/tetracaine 7%7% cream again. Investigators also rated lidocaine/tetracaine 7%7% cream significantly better than placebo cream for providing adequate pain relief and on the assessment of pain scale. Lidocaine/tetracaine 7%7% cream was safe and well tolerated with most subjects reporting no erythema, edema, or blanching. No related adverse events were reported with lidocaine/tetracaine 7%7% cream; one related adverse event of erythema was reported with placebo cream. The results of this study indicate that lidocaine/tetracaine 7%7% cream is efficacious and safe at providing pain relief for soft tissue augmentation with hyaluronic acid.

  1. Localization and identification of structural nonlinearities using cascaded optimization and neural networks

    Science.gov (United States)

    Koyuncu, A.; Cigeroglu, E.; Özgüven, H. N.

    2017-10-01

    In this study, a new approach is proposed for identification of structural nonlinearities by employing cascaded optimization and neural networks. Linear finite element model of the system and frequency response functions measured at arbitrary locations of the system are used in this approach. Using the finite element model, a training data set is created, which appropriately spans the possible nonlinear configurations space of the system. A classification neural network trained on these data sets then localizes and determines the types of all nonlinearities associated with the nonlinear degrees of freedom in the system. A new training data set spanning the parametric space associated with the determined nonlinearities is created to facilitate parametric identification. Utilizing this data set, initially, a feed forward regression neural network is trained, which parametrically identifies the classified nonlinearities. Then, the results obtained are further improved by carrying out an optimization which uses network identified values as starting points. Unlike identification methods available in literature, the proposed approach does not require data collection from the degrees of freedoms where nonlinear elements are attached, and furthermore, it is sufficiently accurate even in the presence of measurement noise. The application of the proposed approach is demonstrated on an example system with nonlinear elements and on a real life experimental setup with a local nonlinearity.

  2. Extreme Associated Functions: Optimally Linking Local Extremes to Large-scale Atmospheric Circulation Structures

    CERN Document Server

    Panja, Debabrata

    2007-01-01

    We present a new statistical method to optimally link local weather extremes to large-scale atmospheric circulation structures. The method is illustrated using July-August daily mean temperature at 2m height (T2m) time-series over the Netherlands and 500 hPa geopotential height (Z500) time-series over the Euroatlantic region of the ECMWF reanalysis dataset (ERA40). The method identifies patterns in the Z500 time-series that optimally describe, in a precise mathematical sense, the relationship with local warm extremes in the Netherlands. Two patterns are identified; the most important one corresponds to a blocking high pressure system leading to subsidence and calm, dry and sunny conditions over the Netherlands. The second one corresponds to a rare, easterly flow regime bringing warm, dry air into the region. The patterns are robust; they are also identified in shorter subsamples of the total dataset. The method is generally applicable and might prove useful in evaluating the performance of climate models in s...

  3. Nonlinear Optimization-Based Device-Free Localization with Outlier Link Rejection

    Directory of Open Access Journals (Sweden)

    Wendong Xiao

    2015-04-01

    Full Text Available Device-free localization (DFL is an emerging wireless technique for estimating the location of target that does not have any attached electronic device. It has found extensive use in Smart City applications such as healthcare at home and hospitals, location-based services at smart spaces, city emergency response and infrastructure security. In DFL, wireless devices are used as sensors that can sense the target by transmitting and receiving wireless signals collaboratively. Many DFL systems are implemented based on received signal strength (RSS measurements and the location of the target is estimated by detecting the changes of the RSS measurements of the wireless links. Due to the uncertainty of the wireless channel, certain links may be seriously polluted and result in erroneous detection. In this paper, we propose a novel nonlinear optimization approach with outlier link rejection (NOOLR for RSS-based DFL. It consists of three key strategies, including: (1 affected link identification by differential RSS detection; (2 outlier link rejection via geometrical positional relationship among links; (3 target location estimation by formulating and solving a nonlinear optimization problem. Experimental results demonstrate that NOOLR is robust to the fluctuation of the wireless signals with superior localization accuracy compared with the existing Radio Tomographic Imaging (RTI approach.

  4. Scalable unit commitment by memory-bounded ant colony optimization with A{sup *} local search

    Energy Technology Data Exchange (ETDEWEB)

    Saber, Ahmed Yousuf; Alshareef, Abdulaziz Mohammed [Department of Electrical and Computer Engineering, King Abdulaziz University, P.O. Box 80204, Jeddah 21589 (Saudi Arabia)

    2008-07-15

    Ant colony optimization (ACO) is successfully applied in optimization problems. Performance of the basic ACO for small problems with moderate dimension and searching space is satisfactory. As the searching space grows exponentially in the large-scale unit commitment problem, the basic ACO is not applicable for the vast size of pheromone matrix of ACO in practical time and physical computer-memory limit. However, memory-bounded methods prune the least-promising nodes to fit the system in computer memory. Therefore, the authors propose memory-bounded ant colony optimization (MACO) in this paper for the scalable (no restriction for system size) unit commitment problem. This MACO intelligently solves the limitation of computer memory, and does not permit the system to grow beyond a bound on memory. In the memory-bounded ACO implementation, A{sup *} heuristic is introduced to increase local searching ability and probabilistic nearest neighbor method is applied to estimate pheromone intensity for the forgotten value. Finally, the benchmark data sets and existing methods are used to show the effectiveness of the proposed method. (author)

  5. Index Fund Optimization Using a Genetic Algorithm and a Heuristic Local Search

    Science.gov (United States)

    Orito, Yukiko; Inoguchi, Manabu; Yamamoto, Hisashi

    It is well known that index funds are popular passively managed portfolios and have been used very extensively for the hedge trading. Index funds consist of a certain number of stocks of listed companies on a stock market such that the fund's return rates follow a similar path to the changing rates of the market indices. However it is hard to make a perfect index fund consisting of all companies included in the given market index. Thus, the index fund optimization can be viewed as a combinatorial optimization for portfolio managements. In this paper, we propose an optimization method that consists of a genetic algorithm and a heuristic local search algorithm to make strong linear association between the fund's return rates and the changing rates of market index. We apply the method to the Tokyo Stock Exchange and make index funds whose return rates follow a similar path to the changing rates of Tokyo Stock Price Index (TOPIX). The results show that our proposal method makes the index funds with strong linear association to the market index by small computing time.

  6. Process planning optimization on turning machine tool using a hybrid genetic algorithm with local search approach

    Directory of Open Access Journals (Sweden)

    Yuliang Su

    2015-04-01

    Full Text Available A turning machine tool is a kind of new type of machine tool that is equipped with more than one spindle and turret. The distinctive simultaneous and parallel processing abilities of turning machine tool increase the complexity of process planning. The operations would not only be sequenced and satisfy precedence constraints, but also should be scheduled with multiple objectives such as minimizing machining cost, maximizing utilization of turning machine tool, and so on. To solve this problem, a hybrid genetic algorithm was proposed to generate optimal process plans based on a mixed 0-1 integer programming model. An operation precedence graph is used to represent precedence constraints and help generate a feasible initial population of hybrid genetic algorithm. Encoding strategy based on data structure was developed to represent process plans digitally in order to form the solution space. In addition, a local search approach for optimizing the assignments of available turrets would be added to incorporate scheduling with process planning. A real-world case is used to prove that the proposed approach could avoid infeasible solutions and effectively generate a global optimal process plan.

  7. Enhanced Differential Evolution Based on Adaptive Mutation and Wrapper Local Search Strategies for Global Optimization Problems

    Directory of Open Access Journals (Sweden)

    Chun-Liang Lu

    2014-12-01

    Full Text Available Differential evolution (DE is a simple, powerful optimization algorithm, which has been widely used in many areas. However, the choices of the best mutation and search strategies are difficult for the specific issues. To alleviate these drawbacks and enhance the performance of DE, in this paper, the hybrid framework based on the adaptive mutation and Wrapper Local Search (WLS schemes, is proposed to improve searching ability to efficiently guide the evolution of the population toward the global optimum. Furthermore, the effective particle encoding representation named Particle Segment Operation-Machine Assignment (PSOMA that we previously published is applied to always produce feasible candidate solutions for solving the Flexible Job-shop Scheduling Problem (FJSP. Experiments were conducted on comprehensive set of complex benchmarks including the unimodal, multimodal and hybrid composition function, to validate performance of the proposed method and to compare with other state-of-the art DE variants such as jDE, JADE, MDE_pBX etc. Meanwhile, the hybrid DE model incorporating PSOMA is used to solve different representative instances based on practical data for multi-objective FJSP verifications. Simulation results indicate that the proposed method performs better for the majority of the single-objective scalable benchmark functions in terms of the solution accuracy and convergence rate. In addition, the wide range of Pareto-optimal solutions and more Gantt chart decision-makings can be provided for the multi-objective FJSP combinatorial optimizations.

  8. The Develoment of Anesthesia.

    Science.gov (United States)

    Davis, Audrey B.

    1982-01-01

    Until the eighteenth century, doctors were reluctant to use chemicals to alleviate pain because they accepted the religious/moral beliefs of their day, claiming that pain was beneficial for the body. Traces technical developments in the control of pain, discussing relationships of anesthesia to social, cultural, and scientific factors and…

  9. The Develoment of Anesthesia.

    Science.gov (United States)

    Davis, Audrey B.

    1982-01-01

    Until the eighteenth century, doctors were reluctant to use chemicals to alleviate pain because they accepted the religious/moral beliefs of their day, claiming that pain was beneficial for the body. Traces technical developments in the control of pain, discussing relationships of anesthesia to social, cultural, and scientific factors and…

  10. Anesthesia for pediatric dentistry.

    Science.gov (United States)

    Saxen, M A; Wilson, S; Paravecchio, R

    1999-04-01

    The administration of anesthesia to young patients creates a unique series of problems for the anesthesiologist. This article details these various problems and tackles the primary challenge facing clinicians in this environment: providing an environment that allows technically complex dental treatment to be delivered without inflicting any adverse psychological impact on the child or physical harm to the child or others.

  11. Locality Aware Optimal Task Scheduling Algorithm for TriBA——A Novel Scalable Architecture

    Institute of Scientific and Technical Information of China (English)

    KHAN Haroon-Ur-Rashid; SHI Feng

    2008-01-01

    An optimal algorithmic approach to task scheduling for,triplet based architecture(TriBA),is proposed in this paper.TriBA is considered to be a high performance,distributed parallel computing architecture.TriBA consists of a 2D grid of small,programmable processing units,each physically connected to its three neighbors.In parallel or distributed environment an efficient assignment of tasks to the processing elements is imperatire to achieve fast job turnaround time.Moreover,the sojourn time experienced by each individual job should be minimized.The arriving jobs are comprised of parallel applications,each consisting of multiple-independent tasks that must be instantaneously assigned to processor queues,as they arrive.The processors indeDendently and concurrently service these tasks.The key scheduling issues is,when some queue backlogs are small,an incoming job should first spread its tasks to those lightly loaded queues in order to take advantage of the parallel processing gain.Our algorithmic approach achieves optimality in task scheduling by assigning consecutive tasks to a triplet of processors exploiting locality in tasks.The experimental results show that tasks allocatian to triplets of processing elements is efficient and optimal.Comparison to well accepted interconnection strategy,2D mesh,is shown to prove the effectiveness of our algorithmic approach for TriBA.Finally we conclude that TriBA can be an efficient interconnection strategy for computations intensive applications,if tasks assignment is carried out optimally using algorithmic approach.

  12. 椎管开放对硬膜外腔局麻药药效动力学的影响%Effect of vertebral canal opening on pharmacodynamics of local anesthesia in epidural space

    Institute of Scientific and Technical Information of China (English)

    邓伟

    2014-01-01

    Objective To investigate the pharmacodynamic changes in local epidural anesthetic and correlated factors before and after epidural space opening during vertebral canal surgery. Methods 120 patients who underwent vertebral canal operation under epidural anesthesia from January 2008 to December 2010 in Anyang City People's Hospital in Henan Provincial were selected. A self control study method was applied to persistently monitor the patients' vital signs〔heart rate variance(HRV),mean arterial pressure(MAP),heart rate(HR),saturation of blood oxygen(SpO2)〕,and the subjective manifestations of patients,the appraisal of surgeon about the surgical local situation(the degree of skeletal muscle relaxation,neural reflex,the ooze blood and so on),the changes in movement (primarily Aαnerve fiber),feeling(primarily Aδnerve fiber),skin temperature(primarily non-myelinated nerve fiber C)within the scope of anesthesia,the dosage of local anesthetic used and the incidence of local anesthetic toxicity were record before and after epidural cavity opening. Results There were no statistical significant differences in vital signs before and after epidural cavity opening in this group of patients. After the opening of epidural space,the local use of anesthetic dosage and the incidence of local anesthetic toxicity were obviously higher than those before the opening〔lidocaine(mg/h):911.23±15.58 vs. 460.19±10.82,ropivacaine(mg/h):13.35±0.19 vs. 5.24±0.17, the incidence of local anesthetic toxicity:67.5%vs. 1.2%,all P<0.01〕,the anesthesia plane(skeletal muscle laxity, feeling,skin temperature)was poorer than that before the opening of epidural space〔the anesthetic plane before the opening was(4.0±1.7),(10.7±1.5),(12.0±1.6)segments respectively,after opening was(2.0±1.8),(10.2±1.3), (12.6±1.9)segments〕,after epidural space opening,the correlations among the three planes(movement sensation disjointed)were worse than those before the epidural space opening

  13. Energy Consumption Forecasting Using Semantic-Based Genetic Programming with Local Search Optimizer

    Directory of Open Access Journals (Sweden)

    Mauro Castelli

    2015-01-01

    Full Text Available Energy consumption forecasting (ECF is an important policy issue in today’s economies. An accurate ECF has great benefits for electric utilities and both negative and positive errors lead to increased operating costs. The paper proposes a semantic based genetic programming framework to address the ECF problem. In particular, we propose a system that finds (quasi-perfect solutions with high probability and that generates models able to produce near optimal predictions also on unseen data. The framework blends a recently developed version of genetic programming that integrates semantic genetic operators with a local search method. The main idea in combining semantic genetic programming and a local searcher is to couple the exploration ability of the former with the exploitation ability of the latter. Experimental results confirm the suitability of the proposed method in predicting the energy consumption. In particular, the system produces a lower error with respect to the existing state-of-the art techniques used on the same dataset. More importantly, this case study has shown that including a local searcher in the geometric semantic genetic programming system can speed up the search process and can result in fitter models that are able to produce an accurate forecasting also on unseen data.

  14. Energy Consumption Forecasting Using Semantic-Based Genetic Programming with Local Search Optimizer.

    Science.gov (United States)

    Castelli, Mauro; Trujillo, Leonardo; Vanneschi, Leonardo

    2015-01-01

    Energy consumption forecasting (ECF) is an important policy issue in today's economies. An accurate ECF has great benefits for electric utilities and both negative and positive errors lead to increased operating costs. The paper proposes a semantic based genetic programming framework to address the ECF problem. In particular, we propose a system that finds (quasi-)perfect solutions with high probability and that generates models able to produce near optimal predictions also on unseen data. The framework blends a recently developed version of genetic programming that integrates semantic genetic operators with a local search method. The main idea in combining semantic genetic programming and a local searcher is to couple the exploration ability of the former with the exploitation ability of the latter. Experimental results confirm the suitability of the proposed method in predicting the energy consumption. In particular, the system produces a lower error with respect to the existing state-of-the art techniques used on the same dataset. More importantly, this case study has shown that including a local searcher in the geometric semantic genetic programming system can speed up the search process and can result in fitter models that are able to produce an accurate forecasting also on unseen data.

  15. Optimal Local Approximation Spaces for Generalized Finite Element Methods with Application to Multiscale Problems

    CERN Document Server

    Babuska, Ivo

    2010-01-01

    The paper addresses a numerical method for solving second order elliptic partial differential equations that describe fields inside heterogeneous media. The scope is general and treats the case of rough coefficients, i.e. coefficients with values in $L^\\infty(\\Omega)$. This class of coefficients includes as examples media with micro-structure as well as media with multiple non-separated length scales. The approach taken here is based on the the generalized finite element method (GFEM) introduced in \\cite{107}, and elaborated in \\cite{102}, \\cite{103} and \\cite{104}. The GFEM is constructed by partitioning the computational domain $\\Omega$ into to a collection of preselected subsets $\\omega_{i},i=1,2,..m$ and constructing finite dimensional approximation spaces $\\Psi_{i}$ over each subset using local information. The notion of the Kolmogorov $n$-width is used to identify the optimal local approximation spaces. These spaces deliver local approximations with errors that decay almost exponentially with the degree...

  16. Energy Consumption Forecasting Using Semantic-Based Genetic Programming with Local Search Optimizer

    Science.gov (United States)

    Vanneschi, Leonardo

    2015-01-01

    Energy consumption forecasting (ECF) is an important policy issue in today's economies. An accurate ECF has great benefits for electric utilities and both negative and positive errors lead to increased operating costs. The paper proposes a semantic based genetic programming framework to address the ECF problem. In particular, we propose a system that finds (quasi-)perfect solutions with high probability and that generates models able to produce near optimal predictions also on unseen data. The framework blends a recently developed version of genetic programming that integrates semantic genetic operators with a local search method. The main idea in combining semantic genetic programming and a local searcher is to couple the exploration ability of the former with the exploitation ability of the latter. Experimental results confirm the suitability of the proposed method in predicting the energy consumption. In particular, the system produces a lower error with respect to the existing state-of-the art techniques used on the same dataset. More importantly, this case study has shown that including a local searcher in the geometric semantic genetic programming system can speed up the search process and can result in fitter models that are able to produce an accurate forecasting also on unseen data. PMID:26106410

  17. An Optimal Parameterization Framework for Infrasonic Tomography of the Stratospheric Winds Using Non-Local Sources

    Science.gov (United States)

    Blom, Philip S.; Marcillo, Omar

    2016-12-01

    A method is developed to apply acoustic tomography methods to a localized network of infrasound arrays with intention of monitoring the atmosphere state in the region around the network using non-local sources without requiring knowledge of the precise source location or non-local atmosphere state. Closely spaced arrays provide a means to estimate phase velocities of signals that can provide limiting bounds on certain characteristics of the atmosphere. Larger spacing between such clusters provide a means to estimate celerity from propagation times along multiple unique stratospherically or thermospherically ducted propagation paths and compute more precise estimates of the atmosphere state. In order to avoid the commonly encountered complex, multi-modal distributions for parametric atmosphere descriptions and to maximize the computational efficiency of the method, an optimal parameterization framework is constructed. This framework identifies the ideal combination of parameters for tomography studies in specific regions of the atmosphere and statistical model selection analysis shows that high quality corrections to the middle atmosphere winds can be obtained using as few as three parameters. Comparison of the resulting estimates for synthetic datasets shows qualitative agreement between the middle atmosphere winds and those estimated from infrasonic travel time observations.

  18. An optimal parametrization framework for infrasonic tomography of the stratospheric winds using non-local sources

    Science.gov (United States)

    Blom, Philip S.; Marcillo, Omar E.

    2017-03-01

    A method is developed to apply acoustic tomography methods to a localized network of infrasound arrays with intention of monitoring the atmosphere state in the region around the network using non-local sources without requiring knowledge of the precise source location or non-local atmosphere state. Closely spaced arrays provide a means to estimate phase velocities of signals that can provide limiting bounds on certain characteristics of the atmosphere. Larger spacing between such clusters provide a means to estimate celerity from propagation times along multiple unique stratospherically or thermospherically ducted propagation paths and compute more precise estimates of the atmosphere state. In order to avoid the commonly encountered complex, multimodal distributions for parametric atmosphere descriptions and to maximize the computational efficiency of the method, an optimal parametrization framework is constructed. This framework identifies the ideal combination of parameters for tomography studies in specific regions of the atmosphere and statistical model selection analysis shows that high quality corrections to the middle atmosphere winds can be obtained using as few as three parameters. Comparison of the resulting estimates for synthetic data sets shows qualitative agreement between the middle atmosphere winds and those estimated from infrasonic traveltime observations.

  19. Application and therapeutic effect of tension - free herniorrhaphy under local anesthesia in recurrent hernia in elderly%局麻下疝修补术在老年复发性腹股沟疝中的应用及疗效

    Institute of Scientific and Technical Information of China (English)

    刘仁胜; 刘小卫

    2011-01-01

    目的 探讨局麻下无张力疝修补术对老年复发性腹股沟疝的疗效.方法 回顾性分析我科2006年至2008年在局麻下行无张力疝修补术的老年复发性腹股沟疝41例患者的临床资料.结果 局部麻醉的效果良好,对患者的生理干扰小.通过腹膜前间隙对肌耻骨孔的增强修补,覆盖了全腹股沟的薄弱区域,有效防止了腹股沟疝的再复发.并且并发症少,随访至今无复发.结论 局麻下行肌耻骨孔的增强修补疗效确切,是老年复发性腹股沟疝切实可行的选择.%Objective To approach the therapeutic effect of tension - free herniorrhaphy under local anesthesia on recurrent hernia in the elderly. Method The clinical data of 48 cases of recurrent hernia in the elderly were analyzed retrospectively, in which the tension - free herniorrhaphy under local anesthesia was applied from 2006 to 2008 in our department. Results Local anesthesia had a satisfactory effect and displayed less disturbance to physiology of the patients. Enhanced restoration of myopectineal orifice through preperitoneal space could cover the weak area of inguinal area and reduce the recurrence of inguinal hernia effectively. Complications were rare and follow - up showed no recurrence up to now. Conclusion Enhanced restoration of myopectineal orifice under local anesthesia has significant efficacy, which would be a feasible selection to recurrent hernias in the elderly.

  20. Radiobiologically optimized couch shift: A new localization paradigm using cone-beam CT for prostate radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yimei, E-mail: yhuang2@hfhs.org; Gardner, Stephen J.; Wen, Ning; Zhao, Bo; Gordon, James; Brown, Stephen; Chetty, Indrin J. [Department of Radiation Oncology, Henry Ford Health System, 2799 W Grand Boulevard, Detroit, Michigan 48202 (United States)

    2015-10-15

    Purpose: To present a novel positioning strategy which optimizes radiation delivery by utilizing radiobiological response knowledge and evaluate its use during prostate external beam radiotherapy. Methods: Five patients with low or intermediate risk prostate cancer were evaluated retrospectively in this IRB-approved study. For each patient, a VMAT plan with one 358° arc was generated on the planning CT (PCT) to deliver 78 Gy in 39 fractions. Five representative pretreatment cone beam CTs (CBCT) were selected for each patient. The CBCT images were registered to PCT by a human observer, which consisted of an initial automated registration with three degrees-of-freedom, followed by manual adjustment for agreement at the prostate/rectal wall interface. To determine the optimal treatment position for each CBCT, a search was performed centering on the observer-matched position (OM-position) utilizing a score function based on radiobiological and dosimetric indices (EUD{sub prostate}, D99{sub prostate}, NTCP{sub rectum}, and NTCP{sub bladder}) for the prostate, rectum, and bladder. We termed the optimal treatment position the radiobiologically optimized couch shift position (ROCS-position). Results: The dosimetric indices, averaged over the five patients’ treatment plans, were (mean ± SD) 79.5 ± 0.3 Gy (EUD{sub prostate}), 78.2 ± 0.4 Gy (D99{sub prostate}), 11.1% ± 2.7% (NTCP{sub rectum}), and 46.9% ± 7.6% (NTCP{sub bladder}). The corresponding values from CBCT at the OM-positions were 79.5 ± 0.6 Gy (EUD{sub prostate}), 77.8 ± 0.7 Gy (D99{sub prostate}), 12.1% ± 5.6% (NTCP{sub rectum}), and 51.6% ± 15.2% (NTCP{sub bladder}), respectively. In comparison, from CBCT at the ROCS-positions, the dosimetric indices were 79.5 ± 0.6 Gy (EUD{sub prostate}), 77.3 ± 0.6 Gy (D99{sub prostate}), 8.0% ± 3.3% (NTCP{sub rectum}), and 46.9% ± 15.7% (NTCP{sub bladder}). Excessive NTCP{sub rectum} was observed on Patient 5 (19.5% ± 6.6%) corresponding to localization at OM

  1. [Regional anesthesia of the airways in difficult tracheal intubation in a conscious patient with spontaneous respiration].

    Science.gov (United States)

    Dziadz'ko, A M

    2002-01-01

    Clinical pattern of anesthesia, hemodynamic and gas exchange states were evaluated in 64 patients with congenital or acquired damage of maxillary-facial region due to tumor or trauma. 51 patients were intubated under locoregional anesthesia of the upper respiratory tract (superior laryngeal nerves, glossopharyngeal nerves, intratracheal anesthesia) by means of blind nasal or oral fiberoptic retrograde and by using laryngeal mask technique. In 12 cases fiberoptic device was used for intubation under local anesthesia by lidocaine solution. There was no airways obstruction in any case. Satisfactory anesthesia in oropharynx, larynx and trachea was reached in all cases, the most profound blockage of airways and lack of pharyngeal and laryngeal reflexes being in patients under locoregional anesthesia. So locoregional anesthesia can be used for awake intubation.

  2. Low dose spinal anesthesia for knee arthroscopy

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-06-01

    Full Text Available Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

  3. Optimal management of prostate cancer with lethal biology--state-of-the-art local therapy.

    Science.gov (United States)

    Chapin, Brian F

    2015-01-01

    Defining prostate cancer with lethal biology based upon clinical criteria is challenging. Locally advanced/High-Grade prostate cancer can be downstaged or even downgraded with cure in up to 60% of patients with primary therapy. However, what is known is that high-grade prostate cancers have a greater potential for recurrence and progression to metastatic disease, which can ultimately result in a patient's death. Patients with clinical features of "high-risk" prostate cancer (cT2c, PSA >20, ≥ Gl 8 on biopsy) are more likely to harbor more aggressive pathologic findings. The optimal management of high-risk prostate cancer is not known as there are not prospective studies comparing surgery to radiation therapy (RT). Retrospective and population-based studies are subject to many biases and attempts to compare surgery and radiation have demonstrated mixed results. Some show equivalent survival outcomes while others showing an advantage of surgery over RT. Local therapy for high-risk disease does appear to be beneficial. Improved outcomes realized with local therapy have been clearly demonstrated by several prospective studies evaluating androgen deprivation therapy (ADT) alone versus ADT plus RT. The combination of local with systemic treatment showed improved disease-specific and overall survival outcomes. Unfortunately, primary ADT for N0M0 prostate cancer is still inappropriately applied in general practice. While the surgical literature is largely retrospective, it too demonstrates that surgery in the setting of high-risk prostate cancer is effective in providing durable disease-specific and overall survivals. [

  4. Optimizing heliostat positions with local search metaheuristics using a ray tracing optical model

    Science.gov (United States)

    Reinholz, Andreas; Husenbeth, Christof; Schwarzbözl, Peter; Buck, Reiner

    2017-06-01

    The life cycle costs of solar tower power plants are mainly determined by the investment costs of its construction. Significant parts of these investment costs are used for the heliostat field. Therefore, an optimized placement of the heliostats gaining the maximal annual power production has a direct impact on the life cycle costs revenue ratio. We present a two level local search method implemented in MATLAB utilizing the Monte Carlo raytracing software STRAL [1] for the evaluation of the annual power output for a specific weighted annual time scheme. The algorithm was applied to a solar tower power plant (PS10) with 624 heliostats. Compared to former work of Buck [2], we were able to improve both runtime of the algorithm and quality of the output solutions significantly. Using the same environment for both algorithms, we were able to reach Buck's best solution with a speed up factor of about 20.

  5. Explanation of how to run the global local optimization code (GLO) to find surface heat flux

    Energy Technology Data Exchange (ETDEWEB)

    Aceves, S; Sahai, V; Stein, W

    1999-03-01

    From the evaluation[1] of the inverse techniques available, it was determined that the Global Local Optimization Code[2] can determine the surface heat flux using known experimental data at various points in the geometry. This code uses a whole domain approach in which an analysis code (such as TOPAZ2D or ABAQUS) can be run to get the appropriate data needed to minimize the heat flux function. This document is a compilation of our notes on how to run this code to find the surface heat flux. First, the code is described and the overall set-up procedure is reviewed. Then, creation of the configuration file is described. A specific configuration file is given with appropriate explanation. Using this information, the reader should be able to run GLO to find the surface heat flux.

  6. SIMULTANEOUS SHAPE AND TOPOLOGY OPTIMIZATION OF TRUSS UNDER LOCAL AND GLOBAL STABILITY CONSTRAINTS

    Institute of Scientific and Technical Information of China (English)

    GuoXu; LiuWei; LiHongyan

    2003-01-01

    A new approach for the solution of truss shape and topology optimization problem sunder local and global stability constraints is proposed. By employing the cross sectional areas of each bar and some shape parameters as topology design variables, the difficulty arising from the jumping of buckling length phenomenon can be easily overcome without the necessity of introducing the overlapping bars into the initial ground structure. Therefore computational efforts can be saved for the solution of this kind of problem. By modifying the elements of the stiffness matrix using Sigmoid function, the continuity of the objective and constraint functions with respect to shape design parameters can be restored to some extent. Some numerical examples demonstrate the effectiveness of the proposed method.

  7. Some aspects of optimization of an invasive microwave antenna for local hyperthermia treatment of cancer.

    Science.gov (United States)

    de Sieyes, D C; Douple, E B; Strohbehn, J W; Trembly, B S

    1981-01-01

    Hyperthermia has emerged as a promising alternative or adjunct to other forms of cancer therapy. In order to utilize hyperthermia in very localized volumes immersed in regions of vital normal tissue, an invasive microwave coaxial monopole antenna has been developed. An experimental approach has been taken to characterize and optimize the electromagnetic properties and heating capabilities of bare and insulated antennas imbedded in tissue equivalent phantoms and dog brain. Four methods have been used to visualize the thermal profiles of the microwave probes: the liquid crystal technique, the gelatin technique, and the direct measurement of temperature with thermistor probes in phantom and dog brain. Among the parameters studied are: antenna impedance, insertion depth, antenna insulation (dielectric constant and thickness), shaft insulation, and frequency.

  8. Optimization modeling of U.S. renewable electricity deployment using local input variables

    Science.gov (United States)

    Bernstein, Adam

    For the past five years, state Renewable Portfolio Standard (RPS) laws have been a primary driver of renewable electricity (RE) deployments in the United States. However, four key trends currently developing: (i) lower natural gas prices, (ii) slower growth in electricity demand, (iii) challenges of system balancing intermittent RE within the U.S. transmission regions, and (iv) fewer economical sites for RE development, may limit the efficacy of RPS laws over the remainder of the current RPS statutes' lifetime. An outsized proportion of U.S. RE build occurs in a small number of favorable locations, increasing the effects of these variables on marginal RE capacity additions. A state-by-state analysis is necessary to study the U.S. electric sector and to generate technology specific generation forecasts. We used LP optimization modeling similar to the National Renewable Energy Laboratory (NREL) Renewable Energy Development System (ReEDS) to forecast RE deployment across the 8 U.S. states with the largest electricity load, and found state-level RE projections to Year 2031 significantly lower than thoseimplied in the Energy Information Administration (EIA) 2013 Annual Energy Outlook forecast. Additionally, the majority of states do not achieve their RPS targets in our forecast. Combined with the tendency of prior research and RE forecasts to focus on larger national and global scale models, we posit that further bottom-up state and local analysis is needed for more accurate policy assessment, forecasting, and ongoing revision of variables as parameter values evolve through time. Current optimization software eliminates much of the need for algorithm coding and programming, allowing for rapid model construction and updating across many customized state and local RE parameters. Further, our results can be tested against the empirical outcomes that will be observed over the coming years, and the forecast deviation from the actuals can be attributed to discrete parameter

  9. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  10. Optimal HP configurations of proteins by combining local search with elastic net algorithm.

    Science.gov (United States)

    Guo, Yu-Zhen; Feng, En-Min; Wang, Yong

    2007-04-10

    The prediction of protein conformation from its amino-acid sequence is one of the most prominent problems in computational biology. But it is NP-hard. Here, we focus on an abstraction widely studied of this problem, the two-dimensional hydrophobic-polar protein folding problem (2D HP PFP). Mathematical optimal model of free energy of protein is established. Native conformations are often sought using stochastic sampling methods, but which are slow. The elastic net (EN) algorithm is one of fast deterministic methods as travelling salesman problem (TSP) strategies. However, it cannot be applied directly to protein folding problem, because of fundamental differences in the two types of problems. In this paper, how the 2D HP protein folding problem can be framed in terms of TSP is shown. Combination of the modified elastic net algorithm and novel local search method is adopted to solve this problem. To our knowledge, this is the first application of EN algorithm to 2D HP model. The results indicate that our approach can find more optimal conformations and is simple to implement, computationally efficient and fast.

  11. Treatment optimization with concurrent SBRT and intracavitary brachytherapy for locally advanced cervical cancer.

    Science.gov (United States)

    Wan, Bin; Lang, Jinyi; Wang, Pei; Ma, C-M

    2016-01-01

    This work is aimed at investigating treatment planning strategies to optimally combine stereotactic body radiation therapy (SBRT) with intracavitary brachytherapy (ICBT) for the treatment of locally advanced cervical cancer. Forty patients (stage IIB - IIIB) previously treated with combined SBRT and ICBT were randomly selected for this retrospective study. All patients were CT- and MR-scanned with a ring applicator in situ. HR-CTV and OARs were contoured according to fused CT and MR images. Several ICBT plans were generated for each patient based on different dose prescription points, and then a matching SBRT plan was generated for each ICBT plan. The dose distribution of each composite plan was analyzed with a focus on the doses received by 90% and 100% of the target volume (D90 and D100), the target volume receiving 100% of the prescription dose (V100%), and the doses received by 2 cc and 40% of the OARs (D2cc and D40). As the distance, d, between the prescription point and the tandem varied within 1.0 and 1.9 cm, the D90, D100 and V100% for the target, as well as D2cc and D40 for the bladder and rectum approached their optimal values for d value between 1.0 and 1.4 cm. When designing a combined ICBT+SBRT plan, one should measure the size of the cervix and set the prescription isodose line 1.0 to 1.4 cm away from the tandem for the ICBT plan first and then optimize the SBRT plan based on the ICBT dose distribution to achieve the best target coverage and critical structures sparing. PACS number: 87.53.jw; 87.55.D. © 2016 The Authors.

  12. [Development and clinical evaluation of an anesthesia information management system].

    Science.gov (United States)

    Feng, Jing-yi; Chen, Hua; Zhu, Sheng-mei

    2010-09-21

    To study the design, implementation and clinical evaluation of an anesthesia information management system. To record, process and store peri-operative patient data automatically, all kinds of bedside monitoring equipments are connected into the system based on information integrating technology; after a statistical analysis of those patient data by data mining technology, patient status can be evaluated automatically based on risk prediction standard and decision support system, and then anesthetist could perform reasonable and safe clinical processes; with clinical processes electronically recorded, standard record tables could be generated, and clinical workflow is optimized, as well. With the system, kinds of patient data could be collected, stored, analyzed and archived, kinds of anesthesia documents could be generated, and patient status could be evaluated to support clinic decision. The anesthesia information management system is useful for improving anesthesia quality, decreasing risk of patient and clinician, and aiding to provide clinical proof.

  13. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  14. Anesthesia for thoracoscopic surgery

    OpenAIRE

    Conacher I

    2007-01-01

    Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therape...

  15. Effects of local anesthesia and flunixin meglumine on the acute cortisol response, behavior, and performance of young dairy calves undergoing surgical castration.

    Science.gov (United States)

    Webster, H B; Morin, D; Jarrell, V; Shipley, C; Brown, L; Green, A; Wallace, R; Constable, P D

    2013-10-01

    This study assessed the effects of flunixin meglumine (FM) and a local anesthetic block (LA) on postcastration performance, plasma cortisol concentration, and behavior in dairy calves. Thirty 2- to 3-mo-old Holstein-Friesian bull calves were allocated to 5 treatments: castration with LA (2% lidocaine injected into the testes and subcutaneously), castration with FM (1.1mg/kg, i.v.), castration with LA+FM, castration without drugs (CC), and sham castration (SC). Castration was performed using a Newberry knife and Henderson castrating tool. Feed intake and body weight gain were recorded for 10d postcastration. Plasma cortisol concentration and behavior frequency and duration were monitored for 8h postcastration. Variables with repeated measures were analyzed using PROC MIXED (SAS Institute Inc., Cary, NC); one-way ANOVA was used for nonrepeated measures. No differences in feed intake or body weight gain were detected among groups. Calves in the CC, LA, and FM groups had transient (<60, <60, and <45 min, respectively) increases in plasma cortisol concentration after castration, with a second increase at 120 min in the LA group, whereas cortisol concentration remained at baseline in the LA+FM and SC groups. Mean cortisol concentrations were lower for calves in the LA+FM and SC groups than in the CC group. The area under the plasma cortisol concentration curve during the first 3h postcastration was greater in CC- and LA-treated calves than in SC controls. Castration without drugs was associated with higher frequencies of crouching and statue standing and less oral activity compared with SC controls. Administering LA alone before castration was associated with higher frequencies of head turning, statue standing, and postural changes, and less feeding behavior compared with SC controls. More leg lifting to groom was seen in LA+FM-treated calves than in SC controls. Calves administered FM alone before castration exhibited less crouching than CC calves, fewer postural shifts

  16. Hi-fidelity multi-scale local processing for visually optimized far-infrared Herschel images

    Science.gov (United States)

    Li Causi, G.; Schisano, E.; Liu, S. J.; Molinari, S.; Di Giorgio, A.

    2016-07-01

    In the context of the "Hi-Gal" multi-band full-plane mapping program for the Galactic Plane, as imaged by the Herschel far-infrared satellite, we have developed a semi-automatic tool which produces high definition, high quality color maps optimized for visual perception of extended features, like bubbles and filaments, against the high background variations. We project the map tiles of three selected bands onto a 3-channel panorama, which spans the central 130 degrees of galactic longitude times 2.8 degrees of galactic latitude, at the pixel scale of 3.2", in cartesian galactic coordinates. Then we process this image piecewise, applying a custom multi-scale local stretching algorithm, enforced by a local multi-scale color balance. Finally, we apply an edge-preserving contrast enhancement to perform an artifact-free details sharpening. Thanks to this tool, we have thus produced a stunning giga-pixel color image of the far-infrared Galactic Plane that we made publicly available with the recent release of the Hi-Gal mosaics and compact source catalog.

  17. Automatic boiling water reactor control rod pattern design using particle swarm optimization algorithm and local search

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Cheng-Der, E-mail: jdwang@iner.gov.tw [Nuclear Engineering Division, Institute of Nuclear Energy Research, No. 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan, ROC (China); Lin, Chaung [National Tsing Hua University, Department of Engineering and System Science, 101, Section 2, Kuang Fu Road, Hsinchu 30013, Taiwan (China)

    2013-02-15

    Highlights: ► The PSO algorithm was adopted to automatically design a BWR CRP. ► The local search procedure was added to improve the result of PSO algorithm. ► The results show that the obtained CRP is the same good as that in the previous work. -- Abstract: This study developed a method for the automatic design of a boiling water reactor (BWR) control rod pattern (CRP) using the particle swarm optimization (PSO) algorithm. The PSO algorithm is more random compared to the rank-based ant system (RAS) that was used to solve the same BWR CRP design problem in the previous work. In addition, the local search procedure was used to make improvements after PSO, by adding the single control rod (CR) effect. The design goal was to obtain the CRP so that the thermal limits and shutdown margin would satisfy the design requirement and the cycle length, which is implicitly controlled by the axial power distribution, would be acceptable. The results showed that the same acceptable CRP found in the previous work could be obtained.

  18. Optimal Solubility of Diclofenac β-Cyclodextrin in Combination with Local Anaesthetics for Mesotherapy Applications

    Directory of Open Access Journals (Sweden)

    Giuseppe Tringali

    2017-01-01

    Full Text Available Because of low injection volume, the recently marketed injectable solution of diclofenac in complex with β-cyclodextrin (Akis®, IBSA Farmaceutici Italia is an ideal candidate for mesotherapy applications. In this study, we investigated the solubility of Akis, 25 and 50 mg/kg, in combination with various local anaesthetics (lidocaine, mepivacaine, bupivacaine, levobupivacaine, and ropivacaine at different concentrations in aqueous vehicles (normal saline, sterile water, or bicarbonate. Final injection mixtures were classified as limpid, turbid, or milky at visual analysis under standardized conditions. We found that (i the use of sterile water for injections or normal saline as vehicles to dilute Akis in combination with whatever local anaesthetic normally results in milky solutions and therefore is not recommended; (ii using bicarbonate, optimal solubility was obtained combining Akis with lidocaine, both 1 and 2%, or mepivacaine, both 1 and 2%, whereas solutions were turbid in combination with bupivacaine, levobupivacaine, or ropivacaine. Thus, we recommend that Akis is used in combination with lidocaine or mepivacaine in a bicarbonate vehicle.

  19. Distributed Self-Organization Of Swarms To Find Globally $\\epsilon$-Optimal Routes To Locally Sensed Targets

    CERN Document Server

    Chattopadhyay, Ishanu

    2011-01-01

    The problem of near-optimal distributed path planning to locally sensed targets is investigated in the context of large swarms. The proposed algorithm uses only information that can be locally queried, and rigorous theoretical results on convergence, robustness, scalability are established, and effect of system parameters such as the agent-level communication radius and agent velocities on global performance is analyzed. The fundamental philosophy of the proposed approach is to percolate local information across the swarm, enabling agents to indirectly access the global context. A gradient emerges, reflecting the performance of agents, computed in a distributed manner via local information exchange between neighboring agents. It is shown that to follow near-optimal routes to a target which can be only sensed locally, and whose location is not known a priori, the agents need to simply move towards its "best" neighbor, where the notion of "best" is obtained by computing the state-specific language measure of an...

  20. Experiences of Modified Kugel Patch under Local Anesthesia in Senile Inguinal Hernia Repair%局麻下改良Kugel补片在老年腹股沟疝修补术中的应用体会

    Institute of Scientific and Technical Information of China (English)

    尚宏清; 贾利猛; 马向涛; 欧云崧; 余力伟

    2011-01-01

    目的 评价改良Kugel补片在老年腹股沟疝无张力修补术中应用的安全可靠性.方法 回顾分析2005年9月至2010年3月,我院对286例老年腹股沟疝患者应用改良Kugel补片在局麻下行324例无张力疝修补术,观察手术时间、住院时间和术后近远期并发症发生率.结果 本组手术时间单侧平均41 min,双侧平均84 min,所有患者均于术后1~5 d痊愈出院,平均住院时间为3.8 d.发生切口明显疼痛3例,阴囊血肿1例.全组未出现缺血性睾丸炎、切口感染、尿潴留等术后并发症.244例(85.3%)获得随访,随访时间3~52个月,无复发.结论 局麻下改良Kugel补片在治疗老年腹股沟疝的临床应用中,具有安全、舒适、恢复快、并发症少、复发率低等优点,值得推广.%Objective To assess the safety and reliability of modified Kugel patch in tension free repair of senire inguinal hernia.Methods By retrospective analysis of the cases from September 2005 to March 2010,it was found that 324 cases of tension free hernia repair were conducted with modified Kugel patch under local anesthesia for 286 cases of senile inguinal hernia in our hospital.The time of operation, time of admission, and the incidence of complications in short - term and long - term after operations were observed.Results The average time of operation in the group was 41min for unilateral repair and was 84min for bilateral repair.All of the patients were discharged after curing in 1 to 5 days after operation,and the average admission time was 3.8 days.There were 3 cases with apparent incision pain and 1 case with scrotum hematoma.There were no postoperative complications as ischemic orchitis, incision infection, urine retention and others in the whole group.244 cases( 85.3% )were under the follow - up visit for 3 to 52 months,with no case of recurrence reported.Conclusion The modified Kugel patch in the repair of senile inguinal hernia under local anesthesia is characterized