Evaluating the Preemptive Analgesic Effect of Photo-biomodulation Therapy on Pain Perception During Local Anesthesia Injection in Children: A Split-mouth Triple-blind Randomized Controlled Clinical Trial.

To evaluate the impact of photobiomodulation therapy (PBMT) on injection pain perception and compare it with a topical oral anesthetic gel. A total of 30 patients of 6 to 9 years-old seeking pulpotomy treatment of maxillary secondary primary molars of both sides were considered for this split-mouth triple-blind randomized clinical trial. On one side of the maxilla, the low-level laser (diode laser, 808 nm, 250 mW; 16.25 J; 32.5 J cm-2 ) was irradiated upon the buccal gingiva of the tooth, while a Benzocaine 20% topical anesthetic gel was applied on the other side. A gel with the same taste (strawberry) was applied for the placebo. The Wong-Baker Faces Pain Rating Scale was used to evaluate the injection pain and postoperation pain at two timestamps, 1 h and 24 h after treatment. Patients' heart rate was also evaluated. Paired t, Wilcoxon signed-rank test, McNemar and Friedman tests were used for statistical analyses. Results demonstrated that PBMT could significantly decrease the injection pain perception and heart rate alternations compared to the topical anesthetic gels (P = 0.000). However, no significant differences were documented between the two methods concerning the 1-h (P = 0.26) and 24-h (P = 1.00) postoperation pain. PBMT can be an effective nonpharmacological technique for controlling injection pain.

Differential effects of anesthetics on electrical properties of the rainbow trout (Oncorhynchus mykiss) heart.

We compared electrocardiographic signals in hatchery-reared, non-spinally-transected, immature rainbow trout (Oncorhynchus mykiss Walbaum) under clove oil (25 ppm), tricaine methanesulfonate (tricaine, 60 ppm), and benzocaine (108 ppm) general anesthesia (35 min, 14 degrees C). For all 3 anesthetics, the mean heart rate (HR) and QRS amplitude did not differ, and QRS duration and QT interval were independent of HR. Heart rate variability (HRV) was significantly (4-fold, P=0.032) higher under benzocaine than under clove oil and tricaine, but did not differ between clove oil and tricaine. QRS duration differed between groups (P<0.001, F=121); benzocaine anesthesia resulted in longer QRS complexes compared to clove oil (P<0.001) and tricaine (P<0.001) anesthesia, and QRS complexes under clove oil were longer than those under tricaine (P<0.001). High HRV and QRS amplitude variation with benzocaine were associated with HR oscillations as anesthetic exposure time increased, and suggest benzocaine toxicity which may influence cardiac function studies. Similar clove oil and tricaine ECG patterns suggest comparable autonomic effects, and maintenance of myocardial excitability. Given its low cost, ease of use, and similar ECG profiles to tricaine, clove oil is a viable alternative for studies of cardiac function in anesthetized rainbow trout.

Preparation and evaluation of bioadhesive benzocaine gels for enhanced local anesthetic effects.

This study was performed to develop new enhanced anesthetic benzocaine gels with a suitable bioadhesive property for local anesthetic effects. As the concentration of benzocaine in the HPMC gels increased up to 15%, the permeation of drug increased, thereafter slightly increased. The activation energy of drug permeation was 11.29 kcal/mol. Bioadhesive forces were also measured. The permeation rate of drug through the skin was studied using various enhancers, such as glycols, non-ionic surfactants or fatty acids. Among the enhancers used, diethylene glycol showed the most enhancing effects. Analgesic activity was examined using a tail-flick analgesimeter. According to the rat tail-flick test, the value of AUEC (0 - 360min) of 15% benzocaine gels containing diethylene glycol was 4662 +/- 200 s min, while that of gels without diethylene glycol was 3353 +/- 132 s min, showing about 1.39-fold increase in analgesic activity. Fifteen percentage of benzocaine gels containing diethylene glycol showed the most enhanced, prolonged analgesic effects, showing the maximum anesthetic effects at 240 min, while the gels without diethylene glycol showed maximum effect at 180 min.

Prevención de reacciones farmacológicas adversas (RFA) y molestias postoperatorias utilizando la técnica de anestesia local a los nervios dentarios posteriores / Prevention of adverse pharmacological reactions and postoperative discomforts using the technique of local anesthesia to posterior dental nerves

La odontología, como disciplina del campo de la salud, debe enfrentar el hecho de que posee como ambiente y como experiencia diversos estímulos que promueven una respuesta natural de ansiedad. Todo lo que se pueda hacer para evitar el dolor o la ansiedad al paciente durante o después del tratamiento dental, además de un control adecuado de los fármacos que se utilizan, principalmente los anestésicos locales, va a traer como resultado un paciente tranquilo y más cooperador, y por lo tanto se le puede brindar una mejor atención y tratamiento. Por medio de la técnica de anestesia local a los nervios dentarios que se les aplicó a 79 pacientes, 75 por ciento del sexo femenino y 25 por ciento del sexo masculino que acudieron al Servicio de Cirugía Bucal de la Facultad de Odontología de la UANL para la remoción quirúrgica de uno de sus terceros molares superiores, al 90 por ciento de esos pacientes se les evitó la punción palatina y por lo tanto menos riesgo de que se presentara una respuesta farmacológica adversa (RFA), además de menos molestias posoperatorias por la infiltración del anestésico local

Practice tip. Which cerumenolytic?

AIM: To test the in vitro dispersion of ear wax by four commonly used cerumenolytics. METHOD: Equal parts of the same piece of ear wax were covered with 10 mL of each preparation and observed for up to 30 days. RESULTS: Sodium bicarbonate and Waxsol dispersed wax within 2 hours, Cerumol was much slower and olive oil had no effect. CONCLUSIONS: The cheapest and most effective cerumenolytic is a solution of sodium bicarbonate.

The effect of formulation on the antimicrobial activity of cetylpyridinium chloride in candy based lozenges.

PURPOSE: The purpose of this investigation was to determine the influence on the antimicrobial activity of cetylpyridinium chloride of the various components of the formulation of each of six candy based lozenges. METHODS: In vivo activity was investigated using six volunteers by determining the reduction in colony forming units recoverable from the oropharynx after sucking each lozenge separately on different days. In vitro determinations investigated the relative activity of aqueous solutions of the lozenges, the effect on activity of additional active ingredients, pH and lozenge base ingredients against separate inocula of each of the test organisms Staphylococcus aureus, Streptococcus pyogenes and Candida albicans. RESULTS: Both in vivo and in vitro results showed that the pH of the dissolved lozenge solution was the single most influential readily adjustable formulation parameter which significantly influenced the activity of cetylpyridinium chloride activity in candy based lozenges. CONCLUSIONS: Lozenges containing cetylpyridinium chloride as the active ingredient should be formulated at a pH greater than 5.5.

An in vitro study to determine efficacy of different wax-dispersing agents.

An in vitro study was performed to compare the relative efficacy of a number of aqueous- and organic-based wax-dispersing preparations. Water, which was originally intended to be a control, surprisingly proved to be the most effective, whilst olive oil appeared to be almost totally ineffective as a wax dispersant. In view of the relatively high cost of commercially available preparations, these results have significant clinical potential.

The mechanism of ceruminolysis.

In a previous study comparing the efficacy of a selection of commonly used ceruminolytics, the authors noted that aqueous-based preparations, and in particular solutions of sodium bicarbonate, were more effective in disintegrating cerumen than most organic-based preparations. In that study, the authors also observed that not only had the wax truly disintegrated following exposure to the aqueous-based preparations, but also that a marked degree of swelling of the wax spheres had occurred with these preparations. In this paper the mechanism of ceruminolysis was investigated by means of a number of commonly available histological techniques. Our findings show that desquamated sheets of corneocytes are the major constituent of cerumen plugs and provide the structural framework of the wax bolus. Ceruminolytics work by hydrating the keratin cells of these sheets of desquamated stratum corneum and subsequently inducing keratolysis, with disintegration of the wax.

Penile desensitization does not affect postcopulatory genital autogrooming in rats: evidence for central motor patterning.

Postcopulatory genital autogrooming was studied in rats following desensitization of the glans penis due to topical application of an anesthetic ointment or to surgical transection of the dorsal penile nerve. These treatments sharply reduced the number of mounts resulting in intromission, but genital autogrooming was largely unaffected. The probability and duration of genital grooming were sensitive to the mount bout status of the copulatory event. The probability of autogrooming was higher, and the duration longer, after mounts that ended mount bouts and after intromissions, than after mounts that were incorporated within a mount bout. These findings suggest that the apparently compulsive genital autogrooming within a copulatory context is not regulated by afferent impulses from the penis, but may largely reflect central motor programing.

Effects of nasopharyngeal cocaine or pharyngeal benzocaine on esophageal motility.

The esophageal effect of topical anesthetics applied to the nasopharynx was evaluated. Eight healthy volunteers underwent an esophageal motility study after each of the following: no anesthesia, 5% cocaine solution applied to the nasopharynx, and 20% benzocaine spray applied to the pharynx. Upper esophageal sphincter relaxation was prolonged after use of the 5% cocaine solution. No other significant effects on esophageal motility or pressures were noted.

Dual effect of local anesthetics on the function of excitable rod outer segment disk membrane.

The effects of local anesthetics and a divalent cation, Ca2+, on the function of rhodopsin were estimated from the measurements of light-induced proton uptake. The light-induced proton uptake by rhodopsin in the rod outer segment disk membrane was enhanced at lower pH (4) but depressed at higher pHs (6 to 8) by the tertiary amine local anesthetics lidocaine, bupivacaine, tetracaine, and dibucaine. The order of local anesthetic-induced depression of the proton uptake followed that of their clinical anesthetic potencies. The depression of the proton uptake versus the concentration of the uncharged form of local anesthetic nearly describes the same curve for small and large dose of added anesthetic. Furthermore, a neutral local anesthetic, benzocaine, depressed the proton uptake at all pHs between 4 and 7. These results indicate that the depression of the proton uptake is due to the effect of only the uncharged form. It is hypothesized that the uncharged form of local anesthetics interacts hydrophobically with the rhodopsin in the disk membrane. The dual effect of local anesthetics on the proton uptake, on the other hand, suggests that the activation of the function of rhodopsin may be caused by the charged form. There was no significant change in the light-induced proton uptake by rhodopsin when 1 mM of Ca2+ was introduced into the disk membrane at varying pHs in the absence or presence of local anesthetics. This fact indicates that Ca2+ ion does not influence the diprotonating process of metarhodopsin; neither does it interfere with the local anesthetic-induced changes in the rhodopsin molecule.

A multicentric clinical trial comparing Otocerol with Cerumol as cerumenolytics.

Fifteen general practitioners conducted a randomized, double-blind comparative trial of two cerumenolytics, namely, Otocerol and Cerumol. A total of 106 patients were entered into the study (fifty-three in each group). Otocerol was shown to be marginally better than Cerumol in all parameters evaluated.

Evaluation of cryogenine on rat paw thermal oedema and rat isolated uterus.

1. Significant inhibition of oedema formation caused by thermal injury was observed for calcium carbaspirin, phenylbutazone, hydrocortisone, cryogenine and indomethacin when given daily beginning 2 days prior to thermal exposure and afterwards. Several anti-inflammatory drugs, including cryogenine, failed to reduce thermal oedema significantly when given as single doses 1 h prior to the thermal injury.2. Kinetic experiments on the rat isolated uterus demonstrated that cryogenine, chlorpromazine, and flufenamic acid were, in part, competitive inhibitors of synthetic bradykinin, while indomethacin and tetrabenazine showed only non-competitive antagonism.