Analgesia and hypnosis are two separate entities and should result in distinct assessment and management for patients admitted to an intensive care unit (ICU). Those patients are exposed to moderate-severe pain and they are likely to remember pain as one bothersome experience. Any cause of patient discomfort is sought with the priority given to pain and adequate analgesia. Assessing pain must rely upon the use of clinical scoring systems, although these instruments are still underused in ICU.
OBJECTIVE: To review the pharmacology and mechanisms by which local anesthetics cause allergic reactions. Recommendations concerning appropriate use of local anesthetics and alternative therapies in patients with documented local anesthetic allergies are given. DATA SOURCE: A MEDLINE search of English-language literature identified pertinent clinical studies, case reports, and reviews. The periods of review were Med1, 1990-present, and Med2, 1985-1989, using the MeSH terms drug hypersensitivity and anesthetics. References from the selected studies, case reports, and reviews were reviewed.
PURPOSE: To evaluate the effect of preoperative visits on patients' psychology, physiology, and behavior during the perioperative period of eye surgery under local anesthesia, with the aim of enhancing patients' cooperation with the surgery and improving their degree of satisfaction. METHODS: A total of 240 patients scheduled to undergo eye surgery between August and October 2013 were randomly divided into an observation (n = 120) and a control (n = 120) group. Patients in the observation group attended preoperative visits with nurses and received conventional nursing care.
Thirty-five patients who were referred for endodontic therapy were used in a study involving the use of a meditative state for hypnotic induction. Induction was by the use of relaxation, and the silent repetition of a simple word while the patient's eyes were closed. Deepening of hypnosis was by suggestion of whole-body numbness or "glove" anesthesia, orally directed. Supplemental local anesthesia was used in some cases. The method proved to be rapid, easily learned, and well accepted.
Thirty-four endodontic patients completed dental anxiety questionnaires and had saliva samples taken prior to and at the conclusion of their initial endodontic treatment. Pain and anxiety were managed with local anesthesia, nitrous oxide--oxygen psychosedation, hypnosis, and meditation, either alone or in combination. For most patients, by the conclusion of the treatment, anxiety had decreased, salivary volume had increased, and salivary protein was reduced.
Special Care in Dentistry: Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
Occasionally, a dental patient presents his/her dentist with a history of hypersensitivity to local anesthetic agents. The symptoms may include immediate reactions to the injection procedure (dizziness, shortness of breath, tachycardia, etc), or delayed reactions to the anesthetic (swelling, urticaria, etc). Although the true incidence of local anesthetic allergy is low, such a history often involves the patient's anxiety regarding the use of the drug in question, and the dentist's apprehension to treat the "problematic" patient.