Monday, June 30, 2014
Tuesday, June 24, 2014
Delayed onset of Local Anaesthesia.
This young person of 30 years undergone dental treatment sometime back and had complained of unbearable pain during the procedure.
When another dental treatment was needed , it was referred to me for possible anaesthesia support with adminstration of Gen Anaesthetic during dental treatment ( root canaling )
Before that the patient was called to the hospital anaesthesia department.
He was adminstered local anaesthetic subcutaneously in various concentrations of Lignocaine 1 %, Lignocaine 2 % , Sesorcaine 0.5% in the forearm of both hands they were marked. After an interval of of 5 mins touch and pin prick test and thermal response with ice cube was done on all injection sites and compared to non injection sites. There was hardly no change in perception of above sensations.
The tests were repeated after 15 mins and 20 mins and 30 mins when about 20-25 % pain
differentiation was observed. Thinking that most probably he will need Gen Anaesth for the procedure later, I let him go home.
As he was an educated person, he was sent home and was asked to do the test on himself with a needle Lo... the person called from home after 4 hours to say that after about 1 and 1/2 hrrs from the injectiopn, he felt obliteration of touch sensation and no pain on needle prick . So the onset was very very delayed.
With counselling and assurance and discussion with dental surgeon. the procedure was done under local anaesthesia using 1 % lignocaine but after an waiting period of about more 1 hour. He felt no pain and the procedure was uneventful. Other routine investigations were within normal limit.
Later on we had suggested a nerve conduction test but he did not report.
When another dental treatment was needed , it was referred to me for possible anaesthesia support with adminstration of Gen Anaesthetic during dental treatment ( root canaling )
Before that the patient was called to the hospital anaesthesia department.
He was adminstered local anaesthetic subcutaneously in various concentrations of Lignocaine 1 %, Lignocaine 2 % , Sesorcaine 0.5% in the forearm of both hands they were marked. After an interval of of 5 mins touch and pin prick test and thermal response with ice cube was done on all injection sites and compared to non injection sites. There was hardly no change in perception of above sensations.
The tests were repeated after 15 mins and 20 mins and 30 mins when about 20-25 % pain
differentiation was observed. Thinking that most probably he will need Gen Anaesth for the procedure later, I let him go home.
As he was an educated person, he was sent home and was asked to do the test on himself with a needle Lo... the person called from home after 4 hours to say that after about 1 and 1/2 hrrs from the injectiopn, he felt obliteration of touch sensation and no pain on needle prick . So the onset was very very delayed.
With counselling and assurance and discussion with dental surgeon. the procedure was done under local anaesthesia using 1 % lignocaine but after an waiting period of about more 1 hour. He felt no pain and the procedure was uneventful. Other routine investigations were within normal limit.
Later on we had suggested a nerve conduction test but he did not report.
BURN from Defibrillator
A young patient of 28 years had some kind of dysrythmia and was on a pace maker. The earlier pacemakers were not intelligent enough to detect a VF and deliveer DC shocks. After oseveral syncopal attacks he was admitted to ICU and was waiting for a new pacemaker with defibrillator./ In the CCU he suffered repeated attacks of VF and arrested several times. While in ICU received DCshock several times.( 18 occasions )
The sisters in ICU gets panic while the patient goes to VF. In the process of application of jelly correct placement of PADS were not meticulously followed . In the process he had several burn injury to the chest wall. The author was witnessed one such event.
The patient finally placed a pacemaker with defibrillator with medication.( Ameodartone). he was discharged. But he survived the ordeal.
Also published
J of Evolution Med. Dent Sci./ Vol 5 /Issue 83 /Oct.17,2017
The sisters in ICU gets panic while the patient goes to VF. In the process of application of jelly correct placement of PADS were not meticulously followed . In the process he had several burn injury to the chest wall. The author was witnessed one such event.
The patient finally placed a pacemaker with defibrillator with medication.( Ameodartone). he was discharged. But he survived the ordeal.
Also published
J of Evolution Med. Dent Sci./ Vol 5 /Issue 83 /Oct.17,2017
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