Lidocaine Research Articles

Comparison of Efficacy of 0.5% Ropivacaine Versus 2% Lignocaine Hydrochloride with Adrenaline (1:80,000) in Surgical Removal of Impacted Mandibular Third Molars with Emphasis on Depth of Anesthesia- Prospective, Randomized, Split Mouth Study

Comparison of Efficacy of 0.5% Ropivacaine Versus 2% Lignocaine Hydrochloride with Adrenaline (1:80,000) in Surgical Removal of Impacted Mandibular Third Molars with Emphasis on Depth of Anesthesia- Prospective, Randomized, Split Mouth Study

TLC vs. HPLC: A green comparison for veterinary drug analysis

This work describes two analytical methods for determining lidocaine (LD) and oxytetracycline (OTC) in veterinary dosage form: a traditional Thin-Layer Chromatography (TLC) method and a more environmentally friendly Reversed-Phase High-Performance Liquid Chromatography (RP-HPLC) method.Initially, the TLC method was used due to its speed, simplicity, and accuracy. It successfully separated LD and OTC in veterinary dosage forms with a linearity range of 0.5–11.0 µg/band for LD and 4.0–34.0 µg/band for OTC. However, TLC proved to be inadequate for resolving the binary mixture in the presence of toxic lidocaine impurity (2,6-dimethylaniline) (DMA), and was less environmentally friendly.Consequently, an RP-HPLC method was developed using a C18 column and a mobile phase consisting of ethanol and phosphate buffer (pH 7) in a 70:30 ratio, with a flow rate of 1.0 mL/min. This method effectively separated OTC, LD and DMA, using a PDA detector at wavelengths of 272, 232, and 210 nm and with retention times of 1.529, 2.77, and 3.581 min for OTC, DMA, and LD respectively. The RP-HPLC method showed linearity ranges of 270.0–972.0 µg/mL for OTC, 0.5–25.0 µg/mL for DMA, and 5.0–18.0 µg/mL for LD.Both methods were validated for linearity, precision, accuracy, robustness, detection limit, and quantitation limit. The greenness of each method was evaluated using NEMI, Eco-scale, and Agree tools, with results demonstrating the RP-HPLC method as the more environmentally sustainable method.

Sub-Tenon's anesthesia in equine cataract surgery and vitrectomy: a retrospective case series (2018-2022).

A retrospective data analysis was performed on 17 eyes from 13 horses which underwent a sub-Tenon's injection to facilitate phacoemulsification or pars plana vitrectomy under general anesthesia between 2018 and 2022. All procedures were performed by the same veterinary ophthalmologist. Seven eyes received a sub-Tenon's dose of 7 ml lidocaine (XylocainÒ, 2 % lidocaine hydrochloride, Germany, Aspen Germany GmbH), and 10 eyes received 7 ml mepivacaine (MepinaestÒ purum 2 %, mepivacaine hydrochloride, Switzerland, Gebro Pharma GmbH). Statistical analysis compared onset and duration of globe centralization and pupil mydriasis between the two groups. Intraoperative and postoperative complications were also assessed. Mepivacaine had a significantly later onset of action regarding globe centration and mydriasis (8,9 minutes vs. 6 minutes), but also a significantly longer duration of globe centration than lidocaine (31,5 minutes vs. 15,6 minutes). There were no statistically relevant differences between solutions regarding duration of pupil dilation (40,4 minutes for 2 % lidocaine vs. 69,2 minutes for 2 % mepivacaine). Chemosis occurred in all 17 eyes. Surgical complications included corneal epithelial defects (5), retinal detachment (5), lens opacification (5), temporary blindness during recovery (3) and glaucoma (2). Sub-Tenon's anesthesia is a feasible alternative to systemic neuromuscular blockade and retrobulbar block anesthesia for surgical procedures on the equine globe. A controlled prospective in vivo study is needed to further evaluate effects and risks.

Assessing Tramadol Hydrochloride as an Alternative to Lignocaine Hydrochloride in Dental Implant Procedures: A Randomized Trial.

To evaluate tramadol hydrochloride, an atypical opioid with potential analgesic properties, as a viable alternative to lignocaine hydrochloride in supraperiosteal anesthesia for dental implants. A split-mouth, double-blind, randomized controlled trial was conducted in patients requiring maxillary dental implants. Patients meeting inclusion criteria received either 5% tramadol hydrochloride with adrenaline or 2% lignocaine hydrochloride with adrenaline via supraperiosteal infiltration. Onset, duration of anesthesia, visual analog scale (VAS) pain scores, and adverse effects were recorded. Forty patients were included, with a mean age of 39.35 years, 62.5% male. No significant differences were observed in VAS pain scores between tramadol (2.08 ± 1.328) and lignocaine (2.05 ± 1.260) groups (p = 0.931). Onset of anesthesia showed no significant difference between the tramadol (128.00 ± 18.207 seconds) and lignocaine (128.30 ± 18.287 seconds) groups (p = 0.736). The duration of anesthesia was comparable between tramadol (59 ± 12.092 minutes) and lignocaine (59.90 ± 11.705 minutes) groups (p = 0.0736). Adverse effects included nausea in two tramadol and one lignocaine patient. Tramadol hydrochloride demonstrated comparable local anesthetic efficacy to lignocaine hydrochloride in dental implant surgery Clinical significance: Both drugs provided effective pain control with similar onset and duration of anesthesia. Tramadol may offer an alternative for patients with lignocaine contraindications, although further studies are warranted to validate its safety and efficacy in dental procedures. How to cite this article: Parlawar AN, Mundada BP. Assessing Tramadol Hydrochloride as an Alternative to Lignocaine Hydrochloride in Dental Implant Procedures: A Randomized Trial. J Contemp Dent Pract 2024;25(7):639-644.

Defining critical quality attributes and composition parameters for burn wound dressings: Antibiotic-anesthetic films as a model

The management of wounds primarily revolves around pain relief, effective infection control and the promotion of tissue regeneration to prevent complications like chronic skin wounds. While polymeric bioactive films are innovative alternatives to conventional wound dressings, there exists a dearth of guidance regarding their quality control. This underscores the imperative need to establish precise critical quality attributes, a task undertaken within this study using an antibiotic-anesthetic film as a model. The aim was to establish the influence of critical composition and process parameters and optimize the formula.First, the quality target product profile was defined, and critical quality attributes were identified. Our material selection included ciprofloxacin hydrochloride (an antimicrobial), lidocaine hydrochloride (an anesthetic), as well as excipients, such as sodium alginate, sodium hyaluronate, carbomer and glycerol. The critical components were identified through a risk assessment matrix, and their influence on film composition was determined by experimental verification using Design-Expert® software. A full factorial design was employed to assess the effects of sodium hyaluronate, carbomer and glycerol (as independent variables) on transparency, homogeneity, folding capacity and handling. Following this, an optimized formulation was achieved and subjected to further characterization.These optimized antibiotic-anesthetic films exhibited uniform micro-distribution of components, ensuring dosage uniformity. Both ciprofloxacin hydrochloride and lidocaine hydrochloride displayed sustained release profiles, suggesting potential therapeutic benefits for skin wounds. Furthermore, the resistance and elongation properties were similar to those of human skin.Utilizing a QbD approach, we successfully developed an optimized antibiotic-anesthetic film that adhered to the essential critical quality attributes. This films exhibits potential utility as a wound dressing. The findings presented in this study establish a fundamental framework for delineating the critical quality attributes of dressing films and refining their formulation to optimize wound treatment.

Impact of Carbon Source on Bacterial Cellulose Network Architecture and Prolonged Lidocaine Release.

The biosynthesis of bacterial cellulose (BC) is significantly influenced by the type of carbon source available in the growth medium, which in turn dictates the material's final properties. This study systematically investigates the effects of five carbon sources-raffinose (C18H32O16), sucrose (C12H22O11), glucose (C6H12O6), arabinose (C5H10O5), and glycerol (C3H8O3)-on BC production by Komagataeibacter hansenii. The varying molecular weights and structural characteristics of these carbon sources provide a framework for examining their influence on BC yield, fiber morphology, and network properties. BC production was monitored through daily measurements of optical density and pH levels in the fermentation media from day 1 to day 14, providing valuable insights into bacterial growth kinetics and cellulose synthesis rates. Scanning electron microscopy (SEM) was used to elucidate fibril diameter and pore size distribution. Wide-angle X-ray scattering (WAXS) provided a detailed assessment of crystallinity. Selected BC pellicles were further processed via freeze-drying to produce a foam-like material that maximally preserves the natural three-dimensional structure of BC, facilitating the incorporation and release of lidocaine hydrochloride (5%), a widely used local anesthetic. The lidocaine-loaded BC foams exhibited a sustained and controlled release profile over 14 days in simulated body fluid, highlighting the importance of the role of carbon source selection in shaping the BC network architecture and its impact on drug release profile. These results highlight the versatility and sustainability of BC as a platform for wound healing and drug delivery applications. The tunable properties of BC networks provide opportunities for optimizing therapeutic delivery and improving wound care outcomes, positioning BC as an effective material for enhanced wound management strategies.

Effectiveness and Safety of IPN-20-SENSE LIDOCAINE for Lip Volume Augmentation and/or Redefinition (SMILE Study): A Non-inferiority Randomized Double-Blinded Controlled Study.

Hyaluronic acid (HA) is a widely used dermal filler for lip augmentation. IPN-20-SENSE LIDOCAINE (Laboratoires VIVACY) is a monophasic gel consisting of cross-linked HA and includes lidocaine hydrochloride for the reduction of injection-associated pain. The SMILE study was designed to assess the non-inferiority of IPN-20-SENSE LIDOCAINE compared to HA-RK-Lido in improving aesthetic lip appearance. The secondary objectives were to evaluate the effectiveness and safety of IPN-20-SENSE LIDOCAINE against the chosen similar active control device. This was a prospective, multicenter, double-blinded, randomized active controlled parallel group study undertaken in two investigational sites between May 2021 and July 2022 (14 months). The primary endpoint of this study was the proportion of subjects reporting an improvement on the Global Aesthetic Improvement Scale (GAIS) 3 months after treatment initiation. Regarding the primary endpoint, the difference between the treatment arms in the proportion of improved subjects was +7.0[-2.2;17.7]. The lower limit of this 90%CI, being above the non-inferiority margin of -15 and below zero, demonstrated the non-inferiority of IPN-20-SENSE LIDOCAINE vs. HA-RK-Lido. The secondary outcomes reported by subjects and the blinded live evaluators supported this result. All injection site reactions and device-related adverse events reported in this study were expected, already described and were mostly mild and transient. The study demonstrated the non-inferiority of IPN-20-SENSE LIDOCAINE to HA-RK-Lido in the aesthetic improvement of the lips. The effect of both treatments decreased over time. Nonetheless, aesthetic improvement was sustained longer in the IPN-20-SENSE LIDOCAINE arm. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

POLYMER BIOCOMPOSITES IN THE FORM OF HYDROGEL USED FOR THE TREATMENT OF PRESSURE SORES

This paper presents research related to the development of hydrogel polymer biocomposites (chitosan and alginate) with an analgesic medication (lidocaine hydrochloride). The pharmaceutical availability of lidocaine hydrochloride from the hydrogel preparations was evaluated for transdermal systems in accordance with the Polish Pharmacopoeia, XI Edition. The rheological tests showed that these preparations had the characteristics of non-Newtonian, pseudoplastic liquids, for which the viscosity decreases as the shear rate increases. The developed hydrogel preparations showed bacteriostatic and bactericidal effects against both Escherichia coli and Staphylococcus aureus. The release of lidocaine hydrochloride from the tested hydrogel was a complex process that followed first-order kinetics. The rate of release could be influenced by appropriate selection of the composition of the biocomposite.

Laser‐scribed graphene toward scalable fabrication of electrochemical paper-based devices for lidocaine detection in forensic and pharmaceutical samples

Lidocaine (LID), a tertiary amine drug, is widely used as a local anesthetic for topical anesthesia and also presents antiarrhythmic and analgesic properties. Given its use can induce a temporary loss of sensory, motor, and autonomic function, it has been associated with criminal instances of drug-facilitated sexual assault. Herein, we manufactured an electrochemical paper-based analytical device (ePAD) using the laser-scribed graphene (LSG) technique for LID detection in pharmaceutical and forensic applications. The paper-based devices were characterized by scanning electron microscopy (SEM) and Raman spectroscopy, confirming the porosity and graphene-derived nature of the LSG material. In addition, to enhance the electrocatalytic properties, the LSG electrode was modified with a nanocomposite based on the mixture of multi-walled carbon nanotubes (MWCNT) and poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS). Electrochemical characterizations of the non-modified and MWCNT/PEDOT:PSS-modified electrodes by impedance spectroscopy (EIS), cyclic voltammetry (CV), and differential pulse voltammetry (DPV), revealed the enhancement of the electrochemical properties of the modified electrode, providing higher detectability for LID detection. An analytical curve was built using DPV technique and exhibited a linear response in the concentration range of 31 to 248 µmol L−1 LID. The limits of detection (LOD) and quantification (LOQ) of the method were 0.72 µmol L−1 and 2.39 µmol L−1, respectively. The manufacturing reproducibility of the method was assessed by testing 8 sensors from different batches and provided a relative standard deviation (RSD) of 4.92 % (n = 8). The developed sensor was applied to LID determination in a commercial anesthetic sample and, as proof of the applicability of potential use in crime scenes of drug-facilitating crimes, we analyzed spiked LID in alcoholic drinks (vodka and tequila samples). The recovery percentages ranged from 79 % to 109 %, highlighting the practical use of our portable method for in-field analysis. In addition, four seized cocaine samples containing LID were successfully analyzed to demonstrate the potential use as a LID screening tool in street drug samples.

Effectiveness of topical bupivacaine versus topical lidocaine/adrenaline mixture for post-adenotonsillectomy pain management

BackgroundThis study aims to compare the topical administration of bupivacaine hydrochloride and lidocaine hydrochloride with epinephrine in alleviating post-tonsillectomy pain. Post-tonsillectomy pain has remained a challenge to both patient and doctors, and local anaesthetic agents applied to the tonsillar fossae post-operatively look promising.MethodsOne hundred and twenty ASA I or II children aged 2–15 years of consenting parents undergoing adenoidectomy and/or tonsillectomy were enrolled in the study. This was a randomized double-blind study in which the children were allocated into either of two groups to receive 5 ml of 0.125% bupivacaine or equal volume of lidocaine plus 1:200,000 adrenaline-soaked swab applied directly on the tonsillar floor within the fossae and/or nasopharynx after haemostasis was secured for 5 min before discontinuation of anaesthesia.ResultsPatients in the bupivacaine group had better extubating condition (p = 0.0001). There was no difference in the time to eye opening in both groups (p-value 0.316). Patients in the lidocaine group had a time to first analgesic request between 1 and 6 h, whereas in the bupivacaine group, about 25 patients (44% of the group) had a time to first analgesic request that exceeded 6 h (6–10 h). The only complication recorded in both groups following oral feeds was vomiting, and there was no difference in both groups (p = 0.968). Overall parental satisfaction was better with bupivacaine group (p = 0.00001).ConclusionTopical application of bupivacaine was associated with better extubation conditions and parental satisfaction when compared to topical lidocaine plus adrenaline while both demonstrated similar time to eye opening, analgesic request, haemodynamic parameters and incidence of complications.

Adsorption of Ciprofloxacin and Lidocaine by Non-Fibrous Raw Mg-Clays: The Role of Composition and Texture

This study evaluated non-fibrous Mg-clays as potential adsorbents of emerging contaminants (ECs) from water. The materials were characterized, and their textural and structural properties were related to their ability to remove two model EC molecules: ciprofloxacin (CPX) and lidocaine (LID). The results showed that Ad-6 and Ad-7 are mixed-layer kerolite/stevensite, while Ad-5 and Ad-8 are mainly composed of smectite minerals like stevensite and saponite, respectively. Ad-8 exhibited the highest CPX-adsorption capacity (0.91 mmol·g−1 clay), likely due to its saponite content. Mixed-layer materials also performed well, with Ad-6 and Ad-7 achieving an adsorption capacity of 0.8 and 0.55 mmol·g−1 clay, respectively. Adsorption studies suggested that CPX is adsorbed through ion exchange in materials with high smectite content (Ad-8 and Ad-5), while interstratified materials showed enhanced retention due to kerolite presence, which improves their porous structures. Similar findings were observed for LID, indicating a cationic-exchange mechanism for LID adsorption in all the materials and suggesting that the molecular size of the EC could regulate the removal capacity of these materials. This work showed that the studied Mg-clays could be effectively used for the removal of pharmaceutical pollutants, expanding their commercial possibilities.

Effectiveness of Lignocaine Tramadol Hydrochloride Combination in Bier’s Block on Post-Operative Analgesia

Background: Bier’s block has been most commonly used for hand and wrist surgery. Though it reduces the potential complication of general anaesthesia, significant post-operative pain is very common just after tourniquet release. Many adjuvants have been used so far with local anaesthetic to produce a dense block and to provide adequate post–operative analgesia. Of them, Tramadol Hydrochloride was used very successfully as it has got less potential side effects. This study was done to see the effect of Tramadol Hydrochloride in Bier’s block for post-operative analgesia after tourniquet release. Methods: This study was carried out in the Department of Anaesthesiology, Bangladesh Medical College Hospital, Dhaka, during the period of July ’2011 to march ’2012. A total sixty patients aged 20-60 years of ASA-1 and ASA-2 undergoing hand and wrist surgery of less than 40-minute duration were enrolled for the study. The effectiveness of combination of Lignocaine and Tramadol Hydrochloride as an anaesthetic solution in Bier’s block was assessed in terms of reduction of tourniquet pain, quality of anaesthesia, the time of first analgesic demand, and the amount of total analgesic needed in post-operative 24-hours period. Patients in control group (Gr-L) received 40 ml of 0.5% Lignocaine and patients in trial group (Gr-LT) received 38 ml of Lignocaine with 2ml (100mg) of Tramadol Hydrochloride as an anaesthetic solution. Patients were observed post-operatively for 24 hours. Pain was assessed in terms of VAS. Results: Tourniquet pain was significantly less in Gr-LT (p<0.000). Post-operative analgesia was also significantly prolonged in Gr-LT (109.61±12.32 min) than in Gr-L (75.8±9.30 min). The number of total analgesic demand in post-operative 24 hours period was also significantly reduced in Gr-LT (P<0.000).Conclusion: The Lignocaine and Tramadol Hydrochloride mixture in Bier’s block provides adequate post-operative analgesia and causes less analgesic demand in post-operative period.

Assessing α-Bisabolol as a Transmucosal Permeation Enhancer of Buccal Local Anesthetics.

Needle-free buccal anesthesia improves dental treatment outcomes for both patients and dentists. In this study, we report on an assessment of the enhancement effects of α-bisabolol on the in vitro transmucosal permeation of prilocaine hydrochloride (PCl) and lidocaine hydrochloride (LCl) from needleless buccal films. We also evaluated the mechanical properties of the film, which consisted of Methocel™ K100 LV as the film-forming polymer (3% m·m-1), PEG 400 as a cosolvent (15% m·m-1 based on drug loading), α-bisabolol (15 and 30% m·m-1 based on drug loading), and the drugs combined at a 1:1 ratio (15 mg·unit-1). The porcine esophageal epithelium was used as a membrane barrier, and artificial saliva was the release medium. After a 1 h experiment at 25 ± 2 °C, α-bisabolol significantly decreased, rather than enhanced, the permeation fluxes (five-fold), permeability coefficients (seven-fold), and retentions (two-fold) of both PCl and LCl through the epithelium, regardless of the concentration. Moreover, the resistance and flexibility of the films markedly decreased compared to those without α-bisabolol. Therefore, under the experimental conditions, using α-bisabolol as a buccal permeation enhancer for the hydrophilic local anesthetics PCl and LCl from buccal films is not feasible.

Evaluation of lignocaine HCl as a therapeutic and diagnostic tool in myofascial pain dysfunction syndrome and internal derangement

Background: Myofascial pain syndrome MPS is one of the most common causes of chronic musculoskeletal pain. It clinically presents with hypersensitive points in the muscle called “trigger points”. Most of the time it remains undiagnosed/undertreated and this leads to severity in symptoms. Deactivation/elimination of trigger points (TrPs) remains the cornerstone of myofascial pain dysfunction syndrome (MPDS) management. The most commonly employed techniques clinically are dry needling of the TrP, local anesthetics or saline injections into TrP, spray and stretch, and ultrasound/electrogalvanic stimulation. Although peripheral nerve blocks are widely used for chronic pain management, their role in myofascial pain dysfunction syndrome is not yet well established. Our study aims to demonstrate the role of mandibular nerve block using lignocaine hydrochloride in the management of MPDS. Materials and Method: Our study is a single-centered randomized control trial performed to evaluate the diagnostic and therapeutic role of mandibular nerve block in treating myofascial pain dysfunction syndrome. A total of 20 subjects fulfilling the inclusion criteria were enrolled in the study. Clinical parameters (pain, mouth opening, and mandibular deviation) were assessed at each follow-up appointment. Result: All of our patients had significant pain relief at the end of 1 month (P < 0.001), and a substantial improvement in mouth opening is also noted (P < 0.001). There was a significant improvement in deviation immediately after nerve block, and further gradual improvement was observed during each follow-up. Conclusion: Our study confirmed the role of mandibular nerve block in myofascial pain management. The diagnostic value of mandibular nerve block in differentiating MPDS from internal derangement is also highlighted.

Comparing the Efficacy of 8.4% and 7.5% Buffered Lidocaine during Surgical Removal of Impacted Mandibular Third Molar- A Split Mouth Double Blinded Randomized Controlled Study.

Conventional injection technique with adrenaline during removal of impacted third molar of mandible had proportionally increased pain during administration with slow onset of action and shorter duration of anesthesia. The purpose of this study was to compare the effective nature of 8.4% and 7.5% buffered lidocaine hydrochloride during surgical removal of mandibular impacted third molar. This prospective crossover study included 50 patients requiring bilateral removal of impacted mandibular third molars. Group I included 50 impacted mandibular third molars that were administered with 8.4% buffered lidocaine hydrochloride and group II included 50 impacted mandibular third molars were administered with 7.5% buffered lidocaine hydrochloride. The outcome variables were pain on injection, time of onset of anesthesia, and duration of action of anesthesia. The above parameters were recorded by the investigator and statistically analyzed through Chi-square test using SPSS software. Patients in group I had mild pain (1.02) and patients in group II (5.74) had moderate pain with a statistical significance of p< 0.05 for group I respectively. The mean onset of action of anesthesia in group I was 0.08 seconds and 0.59 seconds in group II (p< 0.05). The duration of anesthesia was 342.51 minutes from group I and 122.06 minutes in group II (p< 0.05) respectively. Lidocaine hydrochloride buffered with 8.4 % sodium bicarbonate was found to be more effective in reduction of pain during injection, also had a faster onset of action and longer duration of the action of anesthesia when compared to 7.5% buffered lidocaine hydrochloride.

Technique description and outcome evaluation of Thoroughbred racehorses following soft palate thermocautery performed under standing sedation.

Palatal dysfunction (PD), which encompasses palatal instability (PI) and intermittent dorsal displacement of the soft palate, is the most common performance-limiting upper respiratory tract obstruction in young Thoroughbred racehorses. Soft palate thermocautery (SPT) performed under general anaesthesia is a routinely performed procedure for PD in some countries, but the procedure for and outcome of SPT performed under standing sedation has not been published. (1) To describe a technique for SPT performed under standing sedation; and (2) to assess post-operative performance in horses compared to controls using the Racing Post rating (RPR), British Horseracing Authority official rating (OR), Performance Index and Earnings. Retrospective case series. Medical records were reviewed for all horses that had SPT performed under standing sedation following topical and local infusion of lidocaine hydrochloride into the rostral soft palate, and that were identified to have PI by overground endoscopy. Two matched controls were identified for each case. The median RPR, OR, Performance Index and Earnings for the three pre-operative and three post-operative races were compared. No significant differences were identified between the SPT (n=23) and Control groups (n=46) for baseline characteristics or outcomes. Retrospective study design, small sample size. No significant differences in racing performance were identified between horses that had SPT performed under standing sedation and controls.

Internet of things-based smart medical waste management system

Smart medical waste management is significant during the ongoing COVID-19 pandemic. This research presents a smart medical waste management system with real-time monitoring of medical waste data and an end-user application. The functional and technical design of a smart trolley by integrating various sensors for authenticated automatic lid opening and closing, waste level, weight, and storage time monitoring are discussed. Subsequently, the implementation of a cloud server and web application that provide automatic notifications to stakeholders are also presented. The users can monitor the entire process to take actions and approvals whenever necessary. The experiments are conducted to test the functionalities of the smart trolley and web application prototype. The results showed that the sensing system is efficient and avoids manual checking by sending necessary notifications. Healthcare institutions can adopt the proposed system for medical waste transfer to ensure process transparency, worker safety, and environmental cleanliness.

A validated HPTLC method for quantification of a new combination containing Lidocaine HCl and Diltiazem HCl

Regulators approve newer medications and medication combinations for the treatment of various disorders. For the treatment of anal fissures, a novel combination of currently available medications, such as lidocaine HCl and diltiazem HCl, has been approved. The current work represents high-performance thin layer chromatographic method to estimate the amounts of lidocaine hydrochloride and diltiazem hydrochloride in a combined gel dosage form called Crema-L gel (2% W/W of lidocaine and 2% W/W of diltiazem hydrochloride). This method has been validated. The mobile phase in this method consisted of a mixture of toluene, methanol, ethyl acetate (7:2: 1% v/v/v) and two drops of ammonia. The stationary phase was pre-coated aluminium sheet with silica gel G60 F254 (10 × 10 cm, 0.2 mm layer thickness). The drugs’ resolved peaks were found at the Rf values of 0.59 for Lidocaine HCl and 0.48 for Diltiazem HCl. The overlay UV spectra of the two medications were used to determine the analytical wavelength and at 220 nm, both drugs showed appreciable absorbance. The concentration range of 400–1200 ng/band was determined to be the linear approach for both lidocaine HCl and diltiazem HCl, as indicated by their respective correlation coefficients (r2) of 0.9987 and 0.9980. The technique for simultaneously estimating lidocaine hydrochloride and diltiazem hydrochloride in bulk and pharmaceutical dosage form was shown to be robust, accurate, precise, and repeatable.Graphical

Cupric ion coordination-mediated molecularly imprinted electrochemical sensor for the recognition and ratiometric detection of lidocaine

Molecularly imprinted polymers (MIPs) have been widely used as artificial recognition elements in sensing applications. However, their electrochemical sensing performance is generally hampered by limited affinity and uncontrolled condition change. In this work, a novel MIP electrochemical sensor based on metal coordination interaction was prepared and used for the recognition and ratiometric detection of lidocaine (LC). The sensor was constructed by electrodepositing Cu-coordinated MIP on biomass carbon modified glassy carbon electrode. Herein, Cu2+ ions acted as anchor for the immobilization of LC during the synthesis process, enabling the orderly formation of molecular recognition sites. Reversely, the metal coordination between Cu2+ ions and LC molecules facilitated the recognition of LC. Moreover, the doped cupric ions in the polymer film could provide a reference signal for subsequent ratiometric strategy. Thus the resulting sensor exhibited high selectivity, sensitivity, satisfactory reproducibility, and anti-interference ability. Under the selected conditions, the peak current ratio of LC and cupric ion was linear to LC concentration in the range of 0.008–2.5 μmol L−1 (R2 = 0.9951), and the limit of detection was 1.9 nmol L−1 (S/N = 3). The practical feasibility of the sensor was evaluated by detecting human serum and pharmaceutical samples, and satisfactory outcomes were obtained.

Effective Treatment of Methotrexate Induced Oral Mucositis With a Morphine Mouthwash Solution: A Case Report.

Introduction: Methotrexate (MTX) is a common medication used to treat rheumatoid arthritis (RA). MTX inhibits rapid cell turnover throughout the body which can lead to significant side effects. Patients who present with oral lesions may have suffered severe acute toxicity from MTX. Supportive pain treatment includes magic mouthwash solution and/or oral viscous lidocaine to manage pain and allow for healing. We report a case of MTX induced oral mucositis that did not respond to magic mouthwash but did improve with a morphine mouthwash solution. Case: A 67-year-old female with RA presented with worsening oral lesions over 2weeks. She reported non-compliance with folic acid for 2weeks while on MTX. Physical exam revealed ulcerating oral lesions on the mucous membranes consistent with mucositis. Pain treatment was initiated with magic mouthwash, but her pain was not well controlled after 24hours, and still unable to swallow. An oral morphine mouthwash solution was initiated, and patient reported improved pain control over the next 48hours. She was on the morphine mouthwash for 6days during which improvement in the lesions was noted. Discussion: Pain management is imperative for oral mucositis. When traditional therapies do not provide adequate control, morphine mouthwash can be considered. It is a safer alternative to systemic opioids and topical opioids may influence cell proliferation and migration, which can positively impact healing of oral lesions. Conclusion: A morphine mouthwash solution can provide effective pain management for oral mucositis lesions in patients who do not respond adequately to magic mouthwash.