Home > Search Results

Results: 1 to 20 of 29

Use of adrenaline with lidocaine for surgery on fingers and toes

Review question: We reviewed the evidence on the use of adrenaline with lidocaine for surgery on fingers and toes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The safety and efficacy of epinephrine in hand surgery: a systematic review of the literature and international survey

Bibliographic details: Shridharani SM, Manson PN, Magarakis M, Broyles JM, Whitaker IS, Rodriguez ED.  The safety and efficacy of epinephrine in hand surgery: a systematic review of the literature and international survey. European Journal of Plastic Surgery 2014; 37(4): 183-188

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy and safety of bupivacaine versus lidocaine in dental treatments: a meta-analysis of randomised controlled trials

The objective of this study was to assess the efficacy and safety of bupivacaine compared with lidocaine in local anaesthesia in dental treatment. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and the World Health Organisation (WHO) International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing bupivacaine with lidocaine in terms of efficacy and safety. Sixteen studies were included, of which nine had low, six had moderate and one had high risk of bias. In comparison with 2% lidocaine plus 1:100,000 adrenaline, 0.5% bupivacaine plus 1:200,000 adrenaline showed a higher success rate in inflamed pulp (P = 0.03) but a lower success rate in vital pulp (P < 0.00001), a lower percentage of patients using postoperative analgesics (P < 0.00001), a longer onset times of pulpal anaesthesia and a longer duration of pulpal anaesthesia (P < 0.00001). In comparison with 2% lidocaine plus 1:80,000 adrenaline, 0.75% bupivacaine plus 1:200,000 adrenaline had same level of success rate (P = 0.29), and was better in postoperative pain control (P = 0.001) while 0.75% levobupivacaine had same level of postoperative pain control (P = 0.16); 0.5% levobupivacaine had higher success rate (P = 0.04) and was better in postoperative pain control (P = 0.001) than 2% lidocaine. There was no statistically significance in adverse events between two groups. Given the efficacy and safety, the bupivacaine group is better than the lidocaine group in dental operations that take a relatively long time, especially in endodontic treatments or where there is a need for postoperative pain management.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy and safety of mepivacaine compared with lidocaine in local anaesthesia in dentistry: a meta-analysis of randomised controlled trials

The objective of the study was to assess the efficacy and safety of mepivacaine compared with lidocaine used in local anaesthesia in dentistry. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure and WHO International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing mepivacaine with lidocaine in terms of efficacy and safety. Twenty-eight studies were included, of which 15 had low risk of bias and 13 had moderate risk of bias. In comparison with 2% lidocaine with 1:100,000 adrenaline, 3% mepivacaine showed a lower success rate (P = 0.05), a shorter onset time of pulpal anaesthesia (P = 0.0005), inferior pain control during injection phase and superior inhibition of heart rate increase (P < 0.0001). In contrast, 2% mepivacaine with 1:100,000 adrenaline gave a higher success rate (P < 0.00001), a similar onset time of pulpal anaesthesia (P = 0.34) and superior pain control during injection phase (P < 0.0001); 2% mepivacaine with 1:20,000 levonordefrin had the same success rate (P = 0.69) and similar onset time of pulpal anaesthesia (P = 0.90). In addition, 3% mepivacaine had shorter onset time (P = 0.004), same level of success rate (P = 0.28) and similar pain control during injection and postinjection compared with 2% lidocaine with 1:50,000 adrenaline. Given the efficacy and safety of the two solutions, 2% mepivacaine with vasoconstrictors is better than 2% lidocaine with vasoconstrictors in dental treatment. Meanwhile, 3% plain mepivacaine is better for patients with cardiac diseases.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Sedation in Children and Young People: Sedation for Diagnostic and Therapeutic Procedures in Children and Young People [Internet]

Many children present to hospitals and dental clinics needing effective sedation or anaesthesia for painful or distressing diagnostic or therapeutic procedures. There are many sedation techniques available but there is insufficient guidance on which techniques are effective and what resources are required to deliver them safely. Sedation is not always effective enough and will occasionally require the procedure to be delayed until the child can be anaesthetised perhaps in another healthcare setting or on another day. Consequently sedation failure is both distressing for the child and has major NHS cost implications. Excessive doses of sedation can cause unintended loss of consciousness and dangerous hypoxia. In comparison, planned anaesthesia is effective, but may have resource implications. The need for sedation or anaesthesia will depend upon the type of procedure. Some types of procedures are very common and healthcare providers and practitioners need to understand whether sedation or anaesthesia is the most cost effective method of managing them

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: December 2010
Show search results within this document

The Use of the Electromotive Drug Administration System in Patients with Overactive Bladder: A Review of the Clinical Effectiveness, Safety, and Cost-Effectiveness [Internet]

Overactive bladder (OAB) is a urological condition characterized by frequent urination, the need to urinate leading to disruption of sleep (nocturia), and urinating unintentionally with or without urge incontinence. OAB is often associated with overactivity of the bladder detrusor muscle, which represents the most common underlying idiopathic or neurogenic dysfunction. It has been estimated that about one in six adults (17%) have OAB, and the prevalence of OAB increases with age. Approximately 10% of children have symptoms that are severe enough to warrant a diagnosis of OAB. Treatment for OAB includes behavioral modifications, pelvic floor rehabilitation, pharmacological agents (e.g., oral medication, intravesical instillation), electrical stimulation, or reconstructive surgery. Intravesical instillation is a local drug delivery system though a catheter into the bladder that is widely used to treat bladder cancer and other conditions. However, some substances are not readily absorbed through the low permeability of the intact urothelium leading to limited effectiveness of the treatment.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 24, 2014
Show search results within this document

Depression in Adults with a Chronic Physical Health Problem: Treatment and Management

This clinical guideline was commissioned by NICE and developed by the National Collaborating Centre for Mental Health. It sets out clear, evidenceand consensus-based recommendations for healthcare staff on how to treat and manage depression in adults with a chronic physical health problem.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2010
Show search results within this document

Assessment and Management of Acute Pain in Adult Medical Inpatients: A Systematic Review [Internet]

Poor pain management in surgical settings is known to be associated with slower recovery, greater morbidity, longer lengths of stay, lower patient satisfaction, and higher costs of care, suggesting that optimal pain care in these settings is of utmost importance in promoting acute illness management, recovery, and adaptation. VA/DoD Clinical Practice Guidelines have been developed for the management of acute post-operative pain, although the basis for many of the recommendations was by expert consensus rather than empirical evidence.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: April 2008
Show search results within this document

The Management of Inadvertent Perioperative Hypothermia in Adults [Internet]

Inadvertent perioperative hypothermia is a common but preventable complication of perioperative procedures, which is associated with poor outcomes for patients. Inadvertent perioperative hypothermia should be distinguished from the deliberate induction of hypothermia for medical reasons, which is not covered by this guideline.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: April 2008

Interventions for Atypical Facial Pain: A Review of Clinical Effectiveness and Guidelines [Internet]

The purpose of this report is to review the available published literature relating to pharmacological and non-pharmacological interventions for the treatment of atypical facial pain (AFP) in adults.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 1, 2016
Show search results within this document

Pain Management Interventions for Hip Fracture [Internet]

To review and synthesize the evidence on pain management interventions in nonpathological hip fracture patients following low-energy trauma. Outcomes include pain management (short and long term), mortality, functional status, pain medication use, mental status, health-related quality of life, quality of sleep, ability to participate in rehabilitation, return to pre-fracture living arrangements, health services utilization, and adverse effects.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2011
Show search results within this document

Pain relief for women with pre‐cancerous changes of the cervix (cervical intraepithelial neoplasia (CIN)) undergoing outpatient treatment

Treatment for CIN is usually undertaken in an outpatient colposcopy clinic to remove the pre‐cancerous cells from the cervix (lower part of the womb). It commonly involves lifting the cells off the cervix with electrically heated wire (diathermy) or laser, or destroying the abnormal cells with freezing methods (cryotherapy). This is potentially a painful procedure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Ketorolac for Pain Management: A Review of the Clinical Evidence [Internet]

Non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in the pain management in various clinical conditions such as headaches, menstrual disorders, postoperative pain, spinal and soft tissue pain, rheumatoid arthritis (RA), osteoarthritis (OA), and ankylosing spondylitis (AS) by blocking cyclooxygenase (COX) enzymes that are needed to produce prostaglandin.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: June 30, 2014
Show search results within this document

Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

The guideline is intended to cover the care of healthy women with uncomplicated pregnancies entering labour at low risk of developing intrapartum complications. In addition, recommendations are included that address the care of women who start labour as ‘low risk’ but who go on to develop complications. These include the care of women with prelabour rupture of membranes at term, care of the woman and baby when meconium is present, indications for continuous cardiotocography, interpretation of cardiotocography traces, and management of retained placenta and postpartum haemorrhage. Aspects of intrapartum care for women at risk of developing intrapartum complications are covered by a range of guidelines on specific conditions (see section 1.8) and a further guideline is planned on intrapartum care of women ‘at high risk’ of complications during pregnancy and the intrapartum period.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2014
Show search results within this document

Acute Heart Failure: Diagnosing and Managing Acute Heart Failure in Adults

The need for this guideline was identified as the NICE guidelines on chronic heart failure were being updated. We recognised at this time that there were important aspects of the diagnosis and management of acute heart failure that were not being addressed by the chronic heart failure guideline, which focussed on long term management rather than the immediate care of someone who is acutely unwell as a result of heart failure. The aim of this guideline is to provide guidance to the NHS on the diagnosis and management of acute heart failure.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: October 2014

Type 1 Diabetes in Adults: Diagnosis and Management

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

Drug Misuse: Opioid Detoxification

The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2008

Drug Class Review: Quick-relief Medications for Asthma: Final Report Update 1 [Internet]

Asthma is a chronic inflammatory disorder of the airways. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, cough, and other symptoms. Asthma medications fall into 2 general classes: medications for long-term control and medications for quick relief of airflow obstruction and symptoms. Medications for quick relief of bronchoconstriction and acute symptoms include short-acting beta2-agonists and anticholinergics. The purpose of this review is to compare the benefits and harms of short-acting beta2-agonists and ipratropium bromide used for quick relief of asthma symptoms.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
Show search results within this document

Interventions for adult Eustachian tube dysfunction: a systematic review

This systematic review found insufficient evidence to draw conclusions about the effectiveness of any intervention for adults with Eustachian tube dysfunction (ETD). The quality of the evidence was generally poor. Evidence was insufficient to allow recommendation of a trial of any particular intervention. Further research is needed to establish a definition of ETD, its relation to broader middle ear ventilation problems and clear diagnostic criteria.

Health Technology Assessment - NIHR Journals Library.

Version: July 2014
Show search results within this document

Advanced Breast Cancer: Diagnosis and Treatment

Breast cancer is the most common cancer for women in England and Wales, with about 37,000 new cases diagnosed and 11,000 deaths recorded in England and Wales each year. In men breast cancer is rare, with about 270 cases diagnosed, and 70 deaths in England and Wales each year. Of these new cases in women and men, around 10% are diagnosed in the advanced stages, when the tumour has spread significantly within the breast or to other organs of the body. In addition, there is a significant number of women who have been previously treated with curative intent who subsequently develop either a local recurrence or metastases. Over recent years there have been important developments in the investigation and management of these patients including new chemotherapy, and biological and hormonal agents. There is some evidence of practice variation across the country and of patchy availability of certain treatments and procedures. A clinical guideline will help to address these issues and offer guidance on best practice.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: February 2009
Show search results within this document

Systematic Reviews in PubMed

See all (33)...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...