By using stereospecific reactions we prepared two homological series of diastereomeric + cis- and + trans-N,N-dimethyl-2-(2- alkoxyphenylcarbamoyloxy)cyclohexylmethyl-ammonium chlorides with number of carbons in the alkoxy group varying from one to eight. Structure of the prepared compounds was proved by NMR and IR spectroscopy. The principal physico-chemical characteristics, including partition coefficients, were obtained and relative local anesthetic activity was measured using a surface in vivo model. It was found that (1) for both cis- and trans-isomers there is a parabolic relationship between log activity and molecular lipophilicity (as measured by TLC RM and log P values), (2) all drugs prepared for this study use hydrophobic pathway to block inactivated channels, and (3) there is no strict requirement for precise disposition of the functional groups responsible for receptor binding, probably due to conformational flexibility of the sodium channel protein.
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Medicine (Baltimore)
January 2025
Department of Cardiovascular Surgery, Eskisehir Osmangazi University Medical Faculty, Eskişehir, Türkiye.
This study assesses the effect of carotid sinus blockade applied with a local anesthetic on hemodynamic parameters during carotid endarterectomy (CEA) operations performed under general anesthesia. The medical records of patients who underwent CEA under general anesthesia between January 2020 and December 2022, were retrospectively reviewed. It was recorded whether the patients received carotid sinus block with 2 mL of 2% prilocaine.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Shanxi Provincial Integrated TCM and WM Hospital, Taiyuan, China.
Rationale: Local anesthesia is a widely used technique for emergency wound closure, with lidocaine among the most commonly employed local anesthetics. Allergic reactions to lidocaine are rare, with anaphylaxis being even more uncommon.
Patient Concerns And Diagnosis: This report describes a 72-year-old male patient who presented with a right foot injury and underwent wound suturing under lidocaine local anesthesia.
J Endourol
January 2025
Urological Research Network, Miami Lakes, Florida, USA.
Focal therapy (FT) is an emerging option for intermediate-risk prostate cancer (IR-PCa). Transperineal MRI fusion laser ablation of PCa (TPFLA) is a novel FT technique with limited data reported. We conducted a phase I clinical trial evaluating the safety, feasibility, and 1-year oncologic results for patients with IR-PCa treated with TPFLA in an office setting.
View Article and Find Full Text PDFJ Int Med Res
January 2025
Department of Anesthesiology and Pain Medicine, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).
Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.
J Pers Med
December 2024
Department of Orthopaedics and Traumatology, Universita' Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
: The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has revolutionized outpatient hand surgery, enabling procedures such as carpal tunnel release and trigger finger release without a tourniquet. Its benefits include patient cooperation during surgery, especially for tendon repairs. However, WALANT has limitations, including a steep learning curve, longer operative preparation time, and risks such as digital ischemia and adrenaline-induced cardiac ischemia.
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