Following the successful synthesis of 2:3-Benzo-l,l-dimethyl-l-silacyelohex-2-ene and its 4-bromo derivative, attempts were made to prepare further derivatives. The syntheses of 2:3-Benzo-4-cyano-l,l-dimethyl-l-silacyclohex-2-ene and 2:3-Benzo-4-hydroxy-l,l-dimethyl-l-silacyclohex-2-ene were attempted via substitution reactions under various conditions. Attempts to prepare the 4-cyano compound were in vain, while the 4-hydroxy compound was readily prepared, on the strength of infrared analyses. The 4-hydroxy compound, however, presented a problem in characterization, as attempts to produce several derivatives of the compound were unsuccessful. Attempts were also made to improve the methods of synthesis and the yields of various intermediate compounds. / Pharmaceutical Sciences, Faculty of / Graduate

Artifacts caused by regional anesthesia can influence image interpretation of ultrasound and nuclear scintigraphy. Perineural and intrasynovial anesthesia is commonly performed prior to magnetic resonance imaging (MRI); and the effects on MR images, if any, is unknown. The objectives of this prospective, randomized, blinded experiment were to determine if perineural and intrasynovial anesthesia of structures in the equine foot cause iatrogenic changes detectable with MRI. A baseline MRI of both front feet was performed on 15 horses 2 to 6 days prior to mepivacaine injection adjacent to the lateral and medial palmar digital nerves (PDN), and into the podotrochlear bursa (PB), digital flexor tendon sheath (DFTS), and distal interphalangeal joint (DIPJ) of one randomly assigned forelimb. MRI was repeated at 24 and 72 hours post-injection; then qualitative and quantitative assessments of MRI findings were performed. The results of this study showed MRI findings associated with the PDN, PB and DIPJ at 24 and 72 hours after mepivacaine injection did not alter significantly from those at baseline. Compared to baseline, a significant increase in synovial fluid volume of the DFTS was detected with MRI at 24 and 72 hours post-injection. Therefore, perineural anesthesia of the PDN and intrasynovial anesthesia of the PB or DIPJ did not interfere with the interpretation of MRI examinations performed at 24 or 72 hours after injection. However, intrasynovial anesthesia of the DFTS caused an iatrogenic increase in synovial fluid, which was detectable on MRI for at least 72 hours. Although a definite time frame for resolution of DFTS distension was not determined, we recommend waiting greater than 3 days between intrasynovial anesthesia of the DFTS and evaluation with MRI. / Equine Guelph

The utilization of intranasal local anesthetic agents has become a prevalent approach in nasal endoscopy procedures, aimed at enhancing patient comfort and optimizing procedural outcomes. This comprehensive literature review seeks to evaluate the benefits and risks associated with the use of intranasal anesthetics prior to nasal endoscopy. A total of twenty-eight studies published within the last three decades were meticulously examined and incorporated in this literature review. The majority of the reviewed studies overwhelmingly demonstrated no significant reduction in patient discomfort or pain during nasal endoscopy with the use of intranasal anesthetics. However, it is noteworthy that two of the included studies highlighted the potential benefits of masking agents to mitigate the bitter taste associated with anesthetic agents, leading to increased analgesic properties during the endoscopic procedure. Conversely, three of the reviewed studies indicated that intranasal anesthetic usage positively impacted the ease of the procedure for the endoscopist, resulting in improved visualization of the nasal cavity and higher-quality images. Interestingly, the choice of specific anesthetic agents, such as cocaine, tetracaine, lidocaine, or co-phenylcaine, did not appear to play a substantial role in the reported outcomes across the studies. In contrast, the method, timing, and decision-making process regarding the application of intranasal anesthetics emerged as crucial factors that influenced the observed outcomes and potential side effects. The variations in these factors yielded diverse results among the studies, emphasizing the significance of careful consideration and standardized protocols in the administration of intranasal anesthetics. Overall, while the reviewed studies generally did not demonstrate significant benefits in terms of reducing patient discomfort or pain, there were notable improvements in the ease of procedure for the endoscopist with intranasal anesthetic usage. Furthermore, the choice of anesthetic agent alone did not significantly impact the outcomes. However, the methodology, timing, and decision-making were shown to be important factors in achieving desirable results. Further research is warranted to explore optimal approaches for intranasal anesthetic administration, including the development of effective masking agents and standardized protocols. It is crucial for further research to assess the utilization of intranasal anesthetics to ensure patient comfort, procedural efficacy, and safety during nasal endoscopy procedures.

Intravenous cannulation of pediatric patients is a common procedure in emergency departments. It is a useful tool to facilitate medical investigations and drug administration. However, the pain induced by the procedure can lead to patient distress and bother the nursing and medical procedures afterwards. There are many kinds of topical anesthesia but no relevant evidence-based guideline for their use is available for the emergency departments. This dissertation synthesizes the available evidence in the literature to establish an evidence-based guideline for the use of topical anesthesia to reduce pain caused by pediatric intravenous cannulation in an emergency department. The communication, implementation and evaluation plan are also developed. A systematic literature review was conducted from 30th August to 2nd September, 2011. A number of electronic databases, including PubMed, CINAHL Plus and Embase were searched. Thirteen eligible randomized controlled trials were identified. They were integrated into a table of evidence and were critically appraised by the SIGN Methodology Checklist. After synthesis of evidence, it is suggested that needleless anesthesia with apparatus assistance significantly reduced pain as early as in five minutes. Patients should however be observed for two hours after the administration of anesthesia for signs of adverse effects. The implementation potential, in terms of the transferability, feasibility and cost-benefit ratio, was examined. Among the anesthesia devices, the Jet lidocaine device has satisfactory transferability, feasibility and cost-benefit ratio. The evidence is then translated into a practice guideline with the recommendations scored based on the “SIGN 50: A guideline developer’s handbook”. A fourteen-month implementation plan,including a communication plan, a pilot study and an evaluation plan is developed. The communication phase lasts for three months and the stakeholders including the Chief of Service, Department Operation Manager, Advanced Practice Nurses, frontline healthcare professionals and the pharmacy department are identified. The pilot plan lasts for ten weeks, which includes a two-week training period, a three-week observational period for baseline measurement, a three-week intervention period and an eight-week amendment period. The pilot study collects data regarding the pain level at baseline and identifies unanticipated problems in the guideline. Amendments would be made accordingly and the revised guideline would be sent for ethical approval before the implementation phase. In the evaluation plan, the primary outcome for the innovation is the level of pain. The secondary outcomes are the admission rate and length of hospital stay. Other outcomes are the satisfaction of healthcare professionals, utilization rate and cost. It is expected that the cannulation pain, admission rate and length of hospital stay would be lower with the application of topical anesthesia. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (M.S.)--University of Michigan, 1979.

Thesis (M.S.)--University of Michigan, 1979.

Thesis (M.S.)--University of Michigan, 1953.

A anestesia local, utilizada como procedimento de rotina em Odontologia para permitir a realizaÃÃo de um tratamento indolor, por si jà apresenta algum grau de dor/desconforto ao paciente, contribuindo para aumentar o medo e a ansiedade no tratamento odontolÃgico em crianÃas e adultos. Este trabalho teve como objetivo avaliar a reaÃÃo do paciente durante a anestesia local com seringa convencional e com um dispositivo que controla a punÃÃo inicial da agulha. Para tanto a amostra foi composta por 57 crianÃas, entre nove e 13 anos de idade, de ambos os gÃneros, dividida por randomizaÃÃo em dois grupos: G1 e G2, de acordo com o dispositivo utilizado na primeira sessÃo: seringa convencional ou dispositivo com controle da punÃÃo inicial da agulha. A tÃcnica anestÃsica utilizada foi a anestesia infiltrativa terminal no sulco vestibular da maxila. O mesmo operador, odontopediatra, anestesiou todas as crianÃas com os dois dispositivos perfazendo um total de 114 sessÃes anestÃsicas, sendo cada crianÃa seu prÃprio controle. Ao final da segunda sessÃo anestÃsica solicitou-se que a crianÃa escolhesse o dispositivo de preferÃncia. A avaliaÃÃo foi realizada utilizando-se os seguintes mÃtodos: Dental Subscale of the Childrenâs Fear Survey Schedule CFSS-DS, mÃdia da frequÃncia de batimentos cardÃacos atravÃs do uso de um oxÃmetro de pulso, Escala Comportamental de Frankl, Escala de Ansiedade Facial, Escala AnÃloga Visual e Escala SOM (Som, Olhos e Movimentos), em quatro momentos do atendimento odontolÃgico, previamente determinados: sala de espera (SE), cadeira odontolÃgica (CO), inÃcio da anestesia (IA) e final da anestesia (FA). De acordo com os resultados 72% da amostra demonstrou baixo nÃvel de ansiedade (CFSS-DS) e predominÃncia do comportamento definitivamente positivo (Escala de Frankl) em todos os momentos avaliados (SE, CO, IA e FA) com os dois dispositivos. NÃo houve diferenÃa estatisticamente significante (P> 0,05) nas mÃdias de dor relatadas pelas crianÃas entre os dois dispositivos testados. No entanto, houve alta correlaÃÃo entre dor e ansiedade relatadas pela crianÃa (P< 0,0001) e entre a ansiedade relatada e a dor observada pela escala SOM (P=0,003). Apesar de nÃo ter sido estatisticamente significante, houve maior preferÃncia das crianÃas pelo dispositivo com controle da punÃÃo inicial da agulha. Concluiu-se assim que a utilizaÃÃo do dispositivo com controle da punÃÃo inicial da agulha nÃo promoveu diferenÃa na reaÃÃo entre as crianÃas do presente estudo em relaÃÃo à seringa convencional, quanto à dor/desconforto e à ansiedade.

O medo e a ansiedade durante os tratamentos odontolÃgicos estÃo na maioria das vezes relacionados à dor do procedimento da anestesia local odontolÃgica. Considerando que existem muitos estudos sobre a atuaÃÃo da vibraÃÃo na analgesia, esta dissertaÃÃo teve por objetivo comparar as reaÃÃes apresentadas por crianÃas ao serem anestesiadas com um dispositivo de anestesia local odontolÃgica que produzia microvibraÃÃes durante o procedimento anestÃsico. Trinta crianÃas, sendo 15 do sexo feminino e 15 do sexo masculino, com idade entre sete e 12 anos submeteram-se a duas sessÃes anestÃsicas, e cada paciente recebeu dois tipos de anestesia: com e sem vibraÃÃo. Um sà pesquisador, odontopediatra, realizou os procedimentos anestÃsicos, que foram filmados e consistiram de anestesias terminais infiltrativas, na regiÃo posterior da maxila. Em razÃo do carÃter multidimensional do medo, ansiedade e dor, utilizou-se uma combinaÃÃo de testes avaliÃ-los, como: O Teste do Medo da CrianÃa (Child Fear Survey Schedule â Dental Subscale â CFSS-DS), Escala de Ansiedade Facial (Facial Anxiety Scale â FAS), Escala Som, Olhos e Movimento (Sound, Eyes and Motor â SEM), Escala Visual AnalÃga â Visual Analogue Scale (VAS) e Escala Frankl. Aplicou-se as escalas em momentos prederteminados, os quais ocorreram antes e apÃs o procedimento anestÃsico. ApÃs a segunda sessÃo anestÃsica, buscou-se saber a preferÃncia das crianÃas quanto ao uso ou nÃo de vibraÃÃo e verificou-se que 90% das crianÃas preferiram a anestesia utilizando-se vibraÃÃo. Houve diferenÃa estatisticamente significante na Escala Visual AnÃloga â Visual Analogue Scale (VAS) na comparaÃÃo das mÃdias (p = 0,04) para um critÃrio de seleÃÃo a um nÃvel de significÃncia de 5%. Dessa forma, conclui-se que o uso da vibraÃÃo pareceu exercer influÃncia positiva sobre a percepÃÃo das crianÃas durante o procedimento de anestesia local, pois a maioria dos participantes da pesquisa optou pelo dispositivo com emprego da vibraÃÃo, atrelando ao fato de que foi verificado que a anestesia local com vibraÃÃo provoca menos dor, segundo a diferenÃa estatisticamente significante da Escala Visual AnÃloga. / The fear and anxiety during dental treatments are often related to pain regarding local dental anesthetic procedures. As there are many studies about the effect of vibration on pain analgesia, this thesis aimed to compare whether children anesthetized with a dental anesthetic device that produced micro-vibrations during the anesthetic procedure would behave differently when compared to the regular procedure. Thirty children, aged between 7 and 12 years underwent two sessions of local dental anesthesia each, with and without the vibration device. A single researcher, pediatric dentist, managed the anesthetic procedures that consisted of maxillary infiltration anesthesia and which were recorded on video. Due to the multidimensional nature of fear, anxiety and pain, multiple tests were used to evaluate them, such as Child Fear Survey Schedule â Dental Subscale â CFSS-DS, Facial Anxiety Scale â FAS , the SEM Scale Sound, Eyes and Motor, the Visual Analogue Scale (VAS) and the Frankl Scale. The scales were applied twice, before and after anesthesia. After the second anesthetic session, the preference of the children regarding the use or not of vibration was assessed and it was found that 90% of children preferred anesthesia using vibration. There was a statistically significant difference considering the Visual Analogue Scale (VAS) in the comparison of means (p = 0,04) considering a significance level of 5%. As a result, we concluded that the use of vibration seemed to result in a positive influence on the perception of the children regarding the anesthetic procedure, as almost the totality opted by the device with vibration, which lead us to the conclusion that the use of vibration resulted in a less painful local dental anesthesia.

Orientadores: Francisco Carlos Groppo, Eneida de Paula, Maria Cristina Volpato / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T12:43:33Z (GMT). No. of bitstreams: 1 Baroni_DanielaBelisario_M.pdf: 989272 bytes, checksum: e1ed096aa94fb3480d6dfbd684b19f7a (MD5) Previous issue date: 2010 / Mestrado / Farmacologia, Anestesiologia e Terapeutica / Mestre em Odontologia