لیدوکایین

Sore throat and hoarseness are common and unpleasant postoperative complications. Local use of rosemary and lidocaine is considered among anesthesiologists for their anti-inflammatory effects. In this study, we compare the impacts of these substances on Sore throat and hoarseness.

This was a randomized, double-blind clinical trial study conducted on 90 patients undergoing endotracheal intubation. Patients were randomly divided into three equal groups, Lidocaine gargle, Rosemary gargle, and control group, in which the tube cuff was filled with air till pressure reached under 30 cm H2O. Sore throat severity was assessed based on VAS (Visual Analogue Scale), and hoarseness severity was assessed based on the GRBAS scale immediately after extubation, within every 15 minutes in recovery and every 2 hours until 6 hours, then 12 and 24 hours after extubation.

The findings of this study showed that there is a significant relationship between the severity of sore throat in different study groups at all times of study. Examining the trend of changes in the average severity of sore throat showed that this relationship was significant from the 30th minute (P = 0.009) until 24 hours after the operation (P < 0.001). Also, the results of this study showed that the severity of hoarseness between the study groups decreased significantly at all times of the study. Examining the trend of changes showed that this significant relationship remains from the 30th minute (P = 0.041) to the last measurement time (24 hours after the operation) (P < 0.001).

The findings of this study showed that the use of lidocaine and rosemary significantly reduces the severity of both sore throat and hoarseness from the 30th minute to at least 24 hours after intubation. Also, the effect of lidocaine on reducing sore throat and hoarseness is greater than that of rosemary.

Cataract surgery is the most common surgery in the world. The prevalence of age-related cataract increases with age, and its prevalence increases with each decade of age after forty years. Various drugs are used to control analgesia and hemodynamics in patients undergoing cataract surgery. The purpose of this study is to compare dexmedetomidine and 2% lidocaine in the control of analgesia and hemodynamic changes in cataract surgery with local anesthesia.

In this double-blind clinical trial study, 52 patients with anesthesia class I and II underwent cataract surgery. Patients were randomly assigned to two groups: lidocaine (three cc) and dexmedomedin (five μg/kg + lidocaine). The information collection checklist in this study included: age, gender, history of aspirin use, systolic and diastolic blood pressure, heart rate, intraocular pressure, postoperative complications, and postoperative pain.

 The Mann-Whitney U test showed that the Dex-Metomedin group had less pain than the Lidocaine group in the first hour after the intervention (P=0.012). Two hours after the intervention, the dexmedemodin group had less pain than the lidocaine group (P=0.001). In the investigation of IOP after retrobulbar block in the dexmedetomidine group, we saw a significant increase in IOP from 16.56±3.12 to 17.96±2.68 mmHg compared to before the block (P=0.001). In the lidocaine group, we also saw a significant increase in IOP from 16.18±3.66 to 19.66±4.67 mm Hg compared to before the block (P=0.001). Before and after retrobulbar block, there was no significant difference between the two groups (P=0.694 and P=0.108, respectively). To investigate the effect of these interventions more precisely, the amount of IOP pressure change was also compared between the two groups, and we saw a greater increase in the lidocaine group than in the dexmedetomidine group (P=0.002).

The results of the present study showed that dexmedetomidine + lidocaine in retrobulbar form compared to lidocaine was able to control the pain level of patients after surgery and systolic and diastolic blood pressure during surgery. It is suggested to use this drug as local anesthesia in cataract surgery.

Tonsils are lymphoid tissues of the body's defense system that surround the pharynx and prevent the entry of microbes through inhalation. Tonsillectomy is the final treatment for enlarged tonsils and is one of the most common procedures in the ear, throat and nose. To prevent and improve postoperative complications, various methods are used, including lidocaine and dexmedetomidine injections. The aim of this study was to compare the effects of intravenous infusions of lidocaine and dexmedetomidine on the rate and severity of immediate complications after tonsillectomy surgery.

This study was conducted as a prospective, triple-blind, randomized clinical trial on 96 patients who were candidates for tonsillectomy under general anesthesia at Al-Zahra Hospital, Isfahan, Iran. The patients had informed consents and met the conditions to enter the study. 30 minutes before induction of anesthesia, patients were randomly assigned to one of three groups receiving lidocaine, dexmedetomidine, or placebo. All patients were examined for intraoperative bleeding, laryngospasm in the first 2 hours after the operation, and laryngitis in the first 24 hours after the operation. SPSS version 26 software was used for statistical analysis.

The findings of this research indicated that at 45, 75 and, 90 minutes after recovery, the mean score of pain and at 15-90 minutes in terms of anxiety was significantly different from the rest in at least one of the three groups (P<0.05). Systolic blood pressure (SBP) and arterial oxygen blood pressure in minutes 30 to 90, as well as Diastolic blood pressure (DBP) in minutes 60, 75 and 90, showed a significant difference between the three studied groups (P<0.05). There was no significant difference between the incidences of laryngospasm in the groups. However, there was a significant difference between the incidences of bronchospasm in all three groups. In terms of factors such as cough and nausea, no significant differences were observed in the studied groups. However, the average amount of bleeding in surgery, the recovery time and, the first time to tolerate liquids and solids in at least one group were significantly different from the others.

Overall, both dexmedetomidine and lidocaine are effective in reducing heart rate, SBP, Per Os (PO), and bleeding, and also increase arterial oxygen pressure, while respiratory rate, laryngospasm, bronchospasm, cough, nausea and extubation time were not significantly different between the three study groups.

A smooth endotracheal intubation minimizes hemodynamic changes. We assessed the effect of ketamine and lidocaine on Diastolic blood pressure (DBP) Systolic blood pressure (SBP), heart rate (HR), Mean arterial pressure (MAP) and, oxygen saturation (SpO2) changes after endotracheal intubation compared to a control group.

In this randomized, triple-blind clinical trial (IRCT20200825048515N56) approved by the Medical Ethics Committee of the Isfahan University of Medical Sciences (IR.MUI.MED.REC.1400.721) 90 patients aged 18-65 years as candidates for surgery under general anesthesia at Alzahra Hospital in Isfahan were included between December 2022 and February 2023. They were randomly allocated to the ketamine hydrochloride (ketamine) (0.5 mg/kg), lidocaine hydrochloride 2% (Lignodic)          (0.5 mg/kg), and control groups. The subjects, age, height, weight, gender, Body mass index (BMI) and clinical information, such as mean blood pressure, HR, SBP, DBP, MAP, and, oxygen saturation 1, 3, 5 and 10 minutes following endotracheal intubation, recovery stay and, extubation time were noted and analyzed by repeated measure analysis using SPSS version 28. The significance level in all analyses was considered less than 0.05.

Ninety candidates for electroconvulsive therapy (ECT) were randomly assigned to three groups of 30: one group receiving lidocaine hydrochloride, one receiving ketamine hydrochloride, and the other a control group. Overall, 60 cases (66.7%) were male and 30 cases (33.3%) were female.
Both lidocaine and ketamine effectively reduce hemodynamic changes during endotracheal intubation, but lidocaine potentially has greater benefits in terms of improving oxygenation and reducing heart rate variability, as well as reducing recovery time during anesthesia. No significant difference was detected between the two studied groups regarding diastolic blood pressure, systolic blood pressure, heart rate, mean arterial pressure changes, recovery stay, extubation time, and laryngoscopy grade.

Based on the findings in this study, lidocaine offered more desirable hemodynamic stability than ketamine and resulted in fewer hemodynamic disturbances. Also, in the case of persistent hypertension or tachycardia. This was not observed in any of the groups.

To reduce the pain caused by propofol injection, a wide range of medicinal and non-pharmacological methods have been investigated.

This double-blind randomized clinical trial study was conducted on 60 patients who were candidates for elective surgery referred to Peymaniyeh Hospital in Jahrom city. Patients were divided into two groups A: lidocaine 2% at a dose of 1 mg/kg and group B: ephedrine at a dose of 70 micrograms/kg using a random number table. Lidocaine and ephedrine were injected within 5 seconds, and after 30 seconds, propofol 1% in the amount of 3 ml (equivalent to 30 mg) was injected into the corresponding vein at a rate of 0.5 ml per second. After the injection, the patient was clearly asked about pain or discomfort at the injection site, and the answer was yes or no, and if there was pain, its severity was recorded in the questionnaire based on verbal descriptions.

Comparing the pain caused by propofol injection in the lidocaine and ephedrine groups, using the chi-square test, showed that the frequency of pain in the ephedrine group (33.3%) was not significant compared to the lidocaine group (16.7%). (p=0.20).

In the present study, both ephedrine and lidocaine drugs significantly reduced the pain caused by propofol injection, but the scale of this difference between the two groups was not significant. Therefore, these two drugs can be widely used depending on the condition of the patient in reducing pain during propofol injection.

Loss of sensation in ​​the part of the body is called local anesthesia. Local anesthetics (LAs) can treat pain in specific areas of the body by blocking sodium channels. They have also been introduced in several studies as antimicrobial agents. In the present study, special attention has been paid to their role as antimicrobial agents and their effects in treatment.By means of several databases, related key words for antimicrobial agents were searched until the end of 2021. Initially, by restricting the search, unrelated and duplicate studies were eliminated, and after reviewing the appropriate abstracts and complete texts,, they were appended to the present study.This study is focusing on the antimicrobial application of LAs , their interfering with various agents in combination with them, the mechanism of action, and the structural dependence on the antimicrobial effects . The following results have been perceived:1- Structure, concentration, duration of exposure, type of microorganism and temperature affect the antimicrobial activity.2. Compounds such as opioids, antibiotics, etc. can be combined with them and affect the antimicrobial properties.3- Lidocaine has been studied the most and has been effective in prevention and treatment.4- Due to their antimicrobial activity, they can be used in the clinic to prevent infection at the surgical site.

Due to the need to prevention of postoperative pain after mastoidectomy-tympanoplasty, the present study was performed to evaluate the preemptive effect of adding morphine to topical lidocaine on postoperative pain intensity.

In this double-blind clinical trial study, 80 patients who were candidates for elective mastoidectomy- tympanoplasty surgery were randomly divided into two groups of 40; the first group underwent local anesthesia with lidocaine, and the second group underwent local anesthesia with lidocaine with morphine. Patients were evaluated for hemodynamic parameters, postoperative pain intensity during surgery and recovery and 24 hours after surgery, and the findings were compared between the two groups.

Evaluation of patients' pain intensity in recovery and ward showed that at the time of patients' recovery and two hours after surgery, the intervention group had a lower intensity; but in 12 and 24 hours after surgery, no significant difference was seen between the two groups. In the intragroup study, pain intensity significantly reduced in both groups, but the rate of pain reduction in the intervention group was significantly higher. The trend of changes in hemodynamic parameters during surgery and length stay in recovery was not significantly different between the two groups.

Addition of morphine to topical lidocaine reduces the postoperative mastoidectomy-tympanoplasty surgery, while topical use of this drug has no effect on patients' hemodynamics, longer recovery, and extubating time.

Due to the high sensitivity, eye surgeries should have the least irritating reactions after anesthesia. On the other hand, due to the fact that the laryngeal mask is less irritated, using this device is always a good choice in cataract surgery. Postoperative stimulation the present study was designed to compare the two methods of using Lubricant gel, lidocaine gel during laryngeal mask airway (LMA) on hemodynamic symptoms and anesthesia reactions in patients undergoing cataract surgery.

This randomized double-blind clinical trial study was performed on 120 patients undergoing cataract surgery. Patients were randomly divided into 60 equal groups of lidocaine gel and lubricant gel. Systolic and diastolic blood pressure, heart rate and arterial oxygen saturation before and immediately after induction 5 minutes after surgery 15 minutes after surgery, 30 minutes after surgery and were calculated in recovery. Episodes of cough, sore throat, nausea and vomiting in recovery, 2, 6, 12 and 24 hours after surgery were also recorded in the ophthalmology department.

The findings of the present study indicated that the groups were not significantly different in terms of demographic characteristics. There was no significant difference between cough, nausea and heart rate and oxygen saturation rate of arterial blood 30 minutes after surgery and recovery in the airway of the laryngeal mask after its exit, but in sore throat and saturation of arterial blood hemoglobin there is a significant difference. The intensity of sore throat in the lidocaine group decreased and the oxygen saturation of arterial blood increased in the 15 minutes after surgery in the lidocaine group.

The results showed that in general, the use of lidocaine could be effective in reducing the severity of sore throat after surgery compared to lubricant, although no significant difference was observed between other variables; it is recommended in future studies in surgery and Caesar with more facilitators for LMA.

Different medicines are utilized in giving nerve block. The different drugs are usually discussed concerning efficacy and persistence of pain relief. The present study aimed to compare the use of lidocaine alone with granisetron/lidocaine combination in terms of the efficacy and persistence of the analgesic effect, in the axillary block used in patients requiring elbow or below elbow surgery.

A double-blind randomized clinical trial was performed on 90 patients who were candidates for elbow surgery. In this regard, an ultrasonography-guided axillary block was performed by a linear transducer using a short-axis in-plane technique. The first group was given lidocaine, whereas the second group received granisetron/lidocaine combination. First, five mg/kg of lidocaine %0.5 was diluted to 40 ccs with 0.9% saline. In the first group, 40ml of lidocaine solution was injected after dipping the syringe in epinephrine. In the second group, 2 mg of granisetron was injected simultaneous with lidocaine solution.

In total, 90 patients entered the study and were divided into two equal groups of 45. The mean age of the patients was 34.48±9.0 years (18-58 years). 61 (67.8%) participants were male and 29 (32.2%) female. The onset time of sensory and motor block in the second group (granisetron/lidocaine combination) was significantly lower, compared to the lidocaine -alone group . Moreover, the continuity of sensory and motor block was significantly higher in the second group. Furthermore, the first analgesic requirement time was significantly lower in the granisetron/lidocaine combination group, compared to the lidocaine- alone group (P<0.001).

The concomitant use of granisetron with lidocaine improved all pain indicators and  also led to faster and more continuous sensory and motor blocks .

Appropriate analgesia after surgery helps patients feel more comfortable and increase the mobility of them. The purpose of this study was to compare the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia.

This double blinded, randomized clinical trial study was done on 60 patients undergoing elective inguinal hernia under general anesthesia. Subjects were randomly assigned into three groups including control, Ketamine and Lidocaine groups. Subjects in Ketamine group were received infiltration of subcutaneous Ketamine 0.5 mg/kg/bw after closure of surgical incision. Subjects in Lidocaine group were received infiltration of subcutaneous Lidocaine 1 mg/kg/bw at the time of wound suturing. Subjects in control group did not receive Ketamine and Lidocaine. The visual analogue scale (VAS) of pain and vital signs were continuously assessed. If VAS≥3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. The complications, including hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded.

The mean VAS at 1, 2 hours after surgery were significantly lower in the Ketamine and Lidocaine group in compared to control group (P<0.05). No significant adverse effect was observed in the Ketamine group.

For reduction of pain, administration of subcutaneous Ketamine is recommended due to no adverse effect and anti analgesic effect of Ketamine is similar to Lidocaine.

Rapid Sequence Induction and Intubation (RSII) is used when the patient is at high risk of pulmonary aspiration of gastric contents. Various side effects of succinylcholine such as sore throat, fasciculation, and myalgia led us to search for a solution to mitigate succinylcholine’s complications. The goal of this study was, therefore, to determine if the Intravenous (IV) administration of lidocaine can affect the incidence of succinylcholine-based sore throat, myalgia, and fasciculation following an appendectomy.

A clinical trial was performed in 2016 on 90 patients (aged 15-70) who were referred to Shahid Mohammadi Hospital (Bandar Abbas, Iran) for an appendectomy. Patients were randomly divided into two groups. Patients’ demographic information (e.g. age, weight, and gender) were recorded. Participants in the first and second groups received lidocaine and normal saline (NSS), respectively, immediately following RSII and shortly before succinylcholine administration. Patients were asked to survey them in terms of any sore throat, myalgia, and fasciculation symptoms. Data were analyzed using IBM SPSS Statistics 23.0, and descriptive and inferential statistics.

Fifty-five percent of the participants were male and forty-five percent were female. The mean age at the group receiving normal saline was three years more than that of the group receiving lidocaine. The incidence of sore throat was considerably lower in patients receiving lidocaine. The incidence of myalgia was nearly equal in both groups. And the rate of mild fasciculation incidence was higher in the group receiving lidocaine, while patients receiving normal saline experienced a higher rate of severe fasciculation incidence.

The use of lidocaine has no significant effect on the incidence of succinylcholine side effects such as the intensity of sore throat, myalgia, and fasciculation.

One of the most important issues in pediatric dentistry is pain control during treatment. The inferior alveolar nerve block has some limitations as a conventional technique for the anesthesia of mandibular permanent molars, necessitating the use of alternative techniques, one of which is the infiltration technique. The aim of this study was to compare the efficacy of inferior alveolar dental nerve block using lidocaine with infiltration technique with articaine in mandibular first permanent molar anesthesia in children 8−11 year of age. In this randomized cross-over clinical trial on 42 children 8−11 year of age both mandibular first permanent molars were restored. Block or infiltration injection was selected randomly. Patient's behavior was registered in two steps of injection and restoration using the SEM scores. For comparison of the two sides, Wilcoxon signed rank test and SPSS 20 were used (α = 0.05). Based on the results, the infiltration technique resulted in a decrease in all the three SEM scores compared to block injection (p value < 0.05). There was no significant difference in the efficacy of these two anesthetic techniques (p value > 0.05). It appears that infiltration technique with articaine is a better alternative for block technique with lidocaine in the restoration of the mandibular first permanent molars.

Injection is common in almost all patients. Considering the limited study in this field, this research was conducted for comparison of articaine and lidocaine on pain during inferior alveolar nerve block on patients referred to the facial and maxillofacial surgery department of Islamic Azad University dentistry in Tehran, 2017.
Methods and Materials: A randomized, single blind split-blind clinical trial was conducted. All patients requiring double-sided jaw injection were studied. Each side of the jaw was randomly assigned to control (lidocaine 2%) and case (Articaine 4%). An injection was performed for each person and the pain level during injection was measured with a 10-point VAS scale, in which zero means as no pain and ten as most pain, with a patient questionnaire. Then, in the next week, injection was performed on the other side of the jaw and the pain was recorded through the above. The solutions used were lidocaine 2% with epinephrine 1/80000, manufactured by the Pharmaceutical Company and Articaine 4% with epinephrine 1/100000, made of septodent factory in France. The needle used was 27-gauge long-shaft manufactured by the NRK factory in Iran. Each cartridge was injected during 60 seconds and was performed by one person on both sides of the anesthetic. Finally the results were evaluated by MANN_U_WHITNEY test.
This study were conducted on 20 subjects (40 specimens) with lidocaine (1.9± 0.85) and articaine (1.1±0.71), respectively. The pain was 0.8 scale or 42% lower than that of lidocaine.(p Articaine seems to have less pain during inferior alveolar nerve block.

Many surgical operations require tracheal intubation for anesthetizing the patients. Intubation and extubation are usually associated with complications in patients. Reducing these complications increases surgical efficiency and also patient satisfaction with surgery. Analgesics are used to reduce these complications. Therefore, the present research was conducted to compare the effects of Lidocaine and pethidine on reducing post-extubation complications in patients referred to operating theatres in Peymaniyeh Hospital in Jahrom.

This clinical trial was carried out on 210 patients who were randomly put into the pethidine, Lidocaine, and control groups. After the surgical procedures and before removing the endotracheal tube, the first group received 20 mg of pethidine, the second group 2ml of Lidocaine, and the third group did not receive any drug. Post-extubation complications such as sore throat, coughing, nausea and vomiting, straining, laryngospasm, transient hypoxemia, and strained voice were compared. The information was analyzed using SPSS 11.5 and descriptive statistical tests (mean and percentage) and inferential statistical tests (chi-square, t-test, ANOVA, etc.)

Patients who received pethidine suffered less straining (p=0.032) and sore throat (p=0.046), but there were no significant differences between the two experimental groups in laryngospasm, transient hypoxemia, nausea and vomiting, coughing, and strained voice. The Lidocaine and the control groups did not differ significantly in post-extubation complications (p>0.05). Furthermore, a larger number of the patients in the pethidine group developed sore throat compared to the Lidocaine group (p=0.049).

Although pethidine was more effective in reducing pain than Lidocaine, yet it did not decrease many of the complications. Therefore, the best method is to concurrently use low doses of both pethidine and Lidocaine.

Pain control is essential to the behavioral management of children in pediatric dentistry. Effective anesthesia plays a key role in this regard, especially in pulp therapy. In order to achieve successful anesthesia, the type of analgesics and injection techniques should be considered. The present study aimed to compare the anesthetic efficacy of articaine infiltration and lidocaine inferior alveolar nerve block in the pulp therapy of lower primary molars.
This randomized, crossover, triple-blind clinical trial was conducted on 64 children aged 4-10 years, who required the bilateral pulp therapy of the lower primary molars. Subjects were randomly divided into two groups. Treatment was performed for two sessions, and one lower primary molar was treated in each session. In the first treatment session, subjects in group A were injected with lidocaine inferior alveolar nerve block, and in the second session, they were injected with articaine infiltration. In group B, all the procedures were similar to group A. In the first treatment session, subjects in group B were injected with articaine infiltration, and in the second session, they were injected with lidocaine inferior alveolar nerve block. Pain intensity was measured upon the initiation of the pulp exposure using the visual analogue scale (VAS). Data analysis was performed by crossover analysis, paired t-test, and independent two-sample t-test.
During the study period, mean pain intensity in the children treated by lidocaine inferior alveolar nerve block was significantly lower compared to those treated by articaine infiltration. However, the two techniques had no statistically significant difference in the children aged 4-6 years and the treatment of the first primary molars.
According to the results, lidocaine inferior alveolar nerve block has higher anesthetic efficacy in the pulp therapy of the lower primary molars compared to articaine infiltration. On the other hand, articaine infiltration could be a proper alternative to lidocaine inferior alveolar nerve block in the children aged 4-6 years and the treatment of the first primary molars considering its greater ease and lower risk.

Sore throat is a common and unpleasant complication of anesthesia which often occurs after the extubation. This study was conducted to compare the effects of two pharyngeal packing methods (wet pack with saline and wet pack with 1% of Lidocaine) on postoperative sore throat after the nasal surgery.
Sixty patients aged between 18-70 years with ASA I-II-III who were candidates for elective nasal surgery and categorized in two groups were enrolled in this double-blind randomized clinical trial. In the first group dampened gauze with 10 cc/kg was used for pharyngeal packing. Patients underwent general anesthesia with a similar method and after intubation, pharyngeal pack was placed with Magill forceps and in the end of operation before extubation was removed. Amount of sore throat, coughing, odynophagia, hoarseness, laryngeal spasm, nausea, and vomiting were assessed and compared after the extubation.
There weren’t any significant differences between groups in term of weight, height, sex, age, duration of surgery, and type of surgery (p=0.194). Also there wasn’t significant difference in sore throat between the lidocaine and placebo group.
There wasn’t any significant difference in sore throat between two groups of Lidocaine and placebo.

In general anesthesia, patients’ coughing during and after recovery is an important clinical problem with a prevalence of 15% to 45%. This study aimed to evaluate the effects of alkalinized lidocaine or lidocaine alone into the tracheal tube cuff on post-extubation cough in lumbar laminectomy surgery with general anesthesia.
Ninety patients scheduled for lumbar laminectomy in prone position were enrolled in this randomized double-blind prospective study. After tracheal intubation, the tracheal tube cuff was filled with either an alkalinized 2% lidocaine solution or lidocaine alone or 0.9% saline. A logistic regression comprising the two factors was used for analysis. The incidence of sore throat reported by patients and cough 0, 10 and 30 minutes at recovery after extubation.
Intracuff alkalinized 2% lidocaine was superior to lidocaine alone and saline in blunting emergence coughing 10 and 30 minutes at recovery after extubation (P = 0.035- P= 0.005). The incidence of sore throat was significantly lower in the alkalinized 2% lidocaine group at the recovery at 10 and 30 min after extubation(p = 0.001).
The present study showed that the intracuff alkalinized 2% lidocaine was superior to lidocaine alone or saline in decreasing the incidence of emergence coughing and sore throat during the recovery room after extubation.

Nowadays some local combinations such as lidocaine prilocaine cream (EMLA) are used to reduce pain in small surgeries. So the aim of this study was to compare the efficacy of EMLA cream and lidocaine injection to reduce pain during episiotomy repair.
This randomized clinical trial was conducted on 46 primiparous women with normal pregnancy and gestational age of more than 37 weeks, who referred for normal vaginal delivery. They randomly divided into two groups. In one group, 5 g of EMLA cream was applied to perineal mediolateral incision before and after delivery for episiotomy incision and for its repair. Lidocaine 2% was used in another group, too. The two groups were compared in terms of the characteristics of patients, the pain during repairing based on the Visual Analogue Scale (VAS) and satisfaction with repairing method.
The mean (SD) duration of episiotomy repair and pain during repairing was 26±10 and 4.2±2.3 cm, respectively and only 8 people (19%) were in need of further analgesia. Forty women (97%) were partially or fully satisfied with their episiotomy repair. No infection was found at the episiotomy site. Comparing the two groups of EMLA and lidocaine, there was no difference between the two groups in terms of the demographic characteristics, labor characteristics, duration of episiotomy repair, need for further analgesia, pain on the VAS and satisfaction with the repair method.
The use of EMLA cream at the site of episiotomy incision in primiparous women with normal vaginal delivery can induce a level of analgesia equal to that of lidocaine.

Cardiovascular stability after induction of general anesthesia is the major advantage of Etomidate. The incidence of pain on injection is a side effect of using Etomidate.The purpose of this study is to compare the efficacy of Lidocaine versus Magnesium sulfate on pain associated with intravenous administration of Etomidate .
In this clinical trial study, 99 patients undergoing elective surgery aged 18-60 years were divided into 3 groups: group 1 (control) without medication, group 2 received 30 mg of lidocaine 1% and group 3 received 2.48 mMol of magnesium sulfate. After 3 minutes, 0.2mg/kg etomidate was injected. The severity of injection pain was immediately evaluated and recorded using the scale of Ambesh et al. Data were analyzed using ANOVA, Tukey and Kruskal-Wallis tests by SPSS software version 9.0.
The incidence of pain in group I (control), regardless of the intensity of pain, was 66/67%; in group II (lidocaine) 63/60% and in group III (magnesium sulfate) 45/45%, respectively. Pain in group II (receiving lidocaine) was lower than in group I (control) (p=0.030) and also lower in Group III (receiving magnesium sulfate) as compared to group I (control) (p=0.015). In terms of pain at the injection site after receiving lidocaine and magnesium sulfate, no significant differences were observed between groups II and III (p=0.325).
Patients receiving lidocaine and magnesium sulfate had less pain on injection with etomidate compared to the control group. But the pain in the magnesium sulfate group was lower in the lidocaine group.

A 27 year old woman with ASA class 1 and with 12 weaks pregnancy was scheduled for circlage of cervix. Spinal anesthesia was selected and induced with spinal needle No:25 and 100 mg (2ml) lidocaine 5% in sitting position .After 2 days , the patient sensed lumbar pain with radiation in her left foot. The pain was sever and coexisted with paresthesia and continued for 1 month and then suppressed slowly. Neurologic exam, EMG and NCV Were normal.