Abstract:
BACKGROUND:Lidocaine is used to alleviate procedural pain but paradoxically increases pain during injection. Pain perception can be modulated by non-noxious stimuli such as temperature or touch according to the gate control theory of pain. We postulated that lidocaine dripped onto the skin prior to injection would cool or add the sensation of touch at the skin surface to reduce pain perception from the procedure. METHODS:A randomized clinical trial of patients referred to the procedure service from February 2011 through March 2015 was conducted. All patients received 1% subcutaneous lidocaine injection. Patients randomized to the intervention group had approximately 1 to 2 ml of lidocaine squirted onto the skin surface prior to subcutaneous lidocaine injection. Patients were blinded to the details of the intervention and were surveyed by a blinded investigator to document the primary outcome (severity of pain from the procedure) using a visual analog scale. RESULTS:A total of 481 patients provided consent and were randomized to treatment. There was a significant improvement in the primary outcome of procedural pain (control, 16.6 ± 24.8 mm vs 12.2 ± 19.4 mm; P = .03) with the intervention group as assessed by using the visual analog scale score. Pain scores were primarily improved for peripherally inserted central catheters (control, 18.8 ± 25.6 mm vs 12.2 ± 18.2 mm; P = .02) upon subgroup analysis. CONCLUSIONS:Bedside procedures are exceedingly common. Data regarding the severity of procedural pain and strategies to mitigate it are important for the informed consent process and patient satisfaction. Overall, pain reported from common bedside procedures is low, but pain can be further reduced with the addition of lidocaine onto the skin surface to modulate pain perception. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT01330134; URL: www.clinicaltrials.gov.
journal_name
Chestjournal_title
Chestauthors
Patel BK,Wendlandt BN,Wolfe KS,Patel SB,Doman ER,Pohlman AS,Hall JB,Kress JPdoi
10.1016/j.chest.2018.04.018subject
Has Abstractpub_date
2018-10-01 00:00:00pages
773-780issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(18)30630-5journal_volume
154pub_type
杂志文章,随机对照试验相关文献
CHEST文献大全abstract::A study of 26 men with bronchogenic cancer demonstrated high serum calcitonin levels in 62 percent (16). Levels were particularly high in patients with small-cell cancer and adenocarcinoma. Two varieties of hypercalcitonemia have been encountered: (1) ectopic hypercalcitonemia, in which the hormone is secreted by the ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.4.495
更新日期:1976-04-01 00:00:00
abstract::Fondaparinux, a selective inhibitor of factor Xa, is the first of a new class of antithrombotic compounds, the synthetic pentasaccharides. Its benefit-to-risk ratio in preventing venous thromboembolism after major orthopedic surgery was investigated in four randomized, double-blind international phase III trials in pa...
journal_title:Chest
pub_type: 杂志文章,评审
doi:
更新日期:2003-12-01 00:00:00
abstract:INTRODUCTION:CD14 is a cell surface glycoprotein expressed mainly on mature monocytes and macrophages. Soluble CD14 (sCD14) is present in normal plasma and is found increased in serum of patients with septicemia, polytrauma, and sarcoidosis. In active sarcoidosis, increased levels of sCD14 in BAL supernatant have been ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.6.1614
更新日期:1995-12-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether an association exists between aortic calcification viewed on plain chest radiography and coronary artery disease. METHODS:Retrospective review of all chest radiographs obtained from consecutive patients undergoing coronary angiography at a primary cardiac center during 1999. Plain...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.5.1468
更新日期:2002-05-01 00:00:00
abstract::A 26-year-old woman presented with abnormal findings on a chest radiograph. She had no significant history other than a fever 4 months prior to presentation that had resolved without a definite cause identified. She denied cough, shortness of breath, chest pain, history of smoking, environmental exposures, or prior pr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2015.08.023
更新日期:2016-03-01 00:00:00
abstract::Clotting abnormalities are well-recognized complications that occur with high frequency in patients suffering from underlying malignant diseases. New and highly sensitive molecular markers of hemostasis, thrombin-antithrombin III complex (TAT III), D-dimer fragments (DD), and plasmin-alpha 2-antiplasmin complex (PIC) ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.1.196
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Peripherally inserted central venous catheters (PICCs) are now widely used for intermediate and long-term access in current-day health care, especially in the inpatient setting, where they are increasingly supplanting conventional central venous catheters (CVCs) placed percutaneously into the internal jugula...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.128.2.489
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To study the effect of intravenous (i.v.) terbutaline on potassium (K) and magnesium (Mg) distribution, ECG changes, and prevalence of ventricular ectopic beats in healthy subjects. DESIGN:Randomized double-blind, placebo-controlled crossover. Subjects received either placebo or terbutaline (bolus, 0.25 mg; ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.106.6.1654
更新日期:1994-12-01 00:00:00
abstract:STUDY OBJECTIVES:We set out to determine whether there is a difference in postoperative pain and recovery after the patient undergoes the axillary muscle-sparing incision (ie, muscle-sparing thoracotomy [MT]) vs the modified posterolateral incision (ie, posterolateral thoracotomy [PT]). DESIGN:Analysis of a database o...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.128.4.2664
更新日期:2005-10-01 00:00:00
abstract::A prospective evaluation of 74 human immunodeficiency virus (HIV)-infected patients with cardiopulmonary complaints revealed six patients (8.1 percent) with pulmonary hypertension with elevated right ventricular systolic over right atrial pressure of 58 +/- 8 mm Hg (range, 49 to 66 mm Hg), as documented by Doppler ech...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.100.5.1268
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:The hypoxia test can be performed to identify potential hypoxia that might occur in an at-risk individual during air travel. In 2004, the British Thoracic Society increased the hypoxia test cutoff guideline from 85 to 90% in young children. The aim of this study was to investigate how well the cutoff values ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-1198
更新日期:2008-04-01 00:00:00
abstract::Increased blood lactate concentration (hyperlactatemia) and lactic acidosis (hyperlactatemia and serum pH < 7.35) are common in patients with severe sepsis or septic shock and are associated with significant morbidity and mortality. In some patients, most of the lactate that is produced in shock states is due to inade...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.15-1703
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The majority of community-acquired pneumonia (CAP) patients (about 80%) will be treated as outpatients, because therapy with a single agent will work. For the remaining 20% of patients requiring hospitalization, there is some growing debate regarding the efficacy of different management approaches. For hospi...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.128.2.940
更新日期:2005-08-01 00:00:00
abstract:STUDY OBJECTIVES:To investigate the roles of human alpha-defensin (HAD), human beta-defensin (HBD)-1, and HBD-2, novel antimicrobial peptides, in patients with Mycobacterium avium-intracellulare infection (MAI). PATIENTS:The study included 25 patients (10 men) with MAI who visited our hospital between June 1998 and Au...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.4.1131
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Individual studies have reported widely variable rates for VTE and bleeding among hospitalized patients with coronavirus disease 2019 (COVID-19). RESEARCH QUESTION:What is the incidence of VTE and bleeding among hospitalized patients with COVID-19? METHODS:In this systematic review and meta-analysis, 15 st...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.11.005
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:To examine the effect of preoperative smoking behavior on postoperative pulmonary complications. DESIGN:Prospective cohort study. SETTING:The Veterans Administration Medical Center, Syracuse, NY. PARTICIPANTS:Patients scheduled for noncardiac elective surgery (n=410). MEASUREMENTS AND RESULTS:Smoking stat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.4.883
更新日期:1998-04-01 00:00:00
abstract::Actinomyces israelii is a rare cause of pericarditis. Infection spreads to pericardium from an intrathoracic focus. Branching gram-positive filaments are seen on microscopic examination of clinical specimens. Cultures should be performed under anaerobic conditions. Both surgical drainage and antibiotics (penicillin) a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.5.680
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:Pulmonary arterial hypertension (PAH) is a progressive disease with high rates of morbidity and mortality. Current therapies improve symptoms, functional capacity, and, in select cases, survival. Little is known about patient factors that may predict the likelihood of patient-important, clinically relevant r...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.14-0263
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Sleep-disordered breathing (SDB) may promote an increase in cardiac workload early after acute myocardial infarction (AMI). We tested the hypothesis that in the early phase after AMI, SDB is associated with increased 24-h arterial BP, heart rate (HR), and, thus, cardiac workload. METHODS:In this prospective...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-1930
更新日期:2013-05-01 00:00:00
abstract::Chronic thromboembolic pulmonary hypertension (CT-E PH) is a rare and aberrant outcome of acute pulmonary embolism. Because it has become a potentially curable form of pulmonary hypertension, the frequency of recognized cases has increased. We report a case series of 72 patients with CT-E PH evaluated in our instituti...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.1_supplement.52s
更新日期:1995-01-01 00:00:00
abstract::Among 1,700 primary tumors of the lung, there were 53 cases of bronchial adenoma (3.1 percent); 38 (72 percent) of the 53 were typical carcinoids, and the remaining 15 were of a higher grade of malignant neoplasm. There was a slight predominance of female patients, and the age of greatest incidence was between 30 and ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.77.1.81
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.032
更新日期:2020-05-01 00:00:00
abstract::Thirty-three patients who were to undergo diagnostic fiberoptic bronchoscopy were studied. Pulmonary function tests were performed before the procedure, after topical lidocaine anesthesia, and immediately and four hours after bronchoscopy. Nine patients received aerosolized isoproterenol (Isuprel) before the topical a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.5.516
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:Patients with sarcoidosis frequently complain of fatigue, even when sarcoidosis has come into clinical remission. The primary aim of this study was to assess the severity of fatigue in patients with sarcoidosis in clinical remission and to characterize it according to the international criteria for chronic f...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.10-2629
更新日期:2011-08-01 00:00:00
abstract:STUDY OBJECTIVES:Obstructive sleep apnea (OSA) is characterized by recurrent apnea during sleep that may compromise oxidative balance. Oxidative stress is increased in the blood and in the airways of OSA patients. DESIGN:The aim of this study was to investigate whether oxidative stress is determined by nocturnal apnea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.124.4.1386
更新日期:2003-10-01 00:00:00
abstract::In this study we determine the prevalence and type of arrhythmias that occur during postural drainage and chest percussion (PDP) of critically ill patients, and identify those patients who are most at risk of developing them. We monitored the vital signs and ECGs of 72 ICU patients during their initial PDP treatment. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.6.1836
更新日期:1992-12-01 00:00:00
abstract::The most examined tumor markers in lung cancer patients are CEA, hormonal peptides, and some neurogenic enzymes in small cell carcinoma. Calcitonin, ACTH, ADH, CEA, neurophysin, oxytocin, beta-endorphin, neuron-specific enolase, and CK BB are elevated in serum specimens in 25-75% of cases of small cell carcinoma. The ...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.89.4_supplement.219s
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD. METHODS:Patients with idiopathic pulm...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2019.04.016
更新日期:2019-11-01 00:00:00
abstract::Klippel-Trenaunay syndrome (KTS) is a congenital disorder characterized by a triad of cutaneous vascular nevi, soft tissue or bony hypertrophy, and varicose veins or venous malformations involving one or more extremities. An incidence of venous thromboembolism of up to 22% has been reported in this disorder. Also repo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.5.1520
更新日期:2000-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine how the volume and severity of emphysema measured by CT morphometry (CTM) before and after lung volume reduction surgery (LVRS) relates to the functional status of patients after LVRS. DESIGN:A histologically validated CT algorithm was used to quantify the volume and severity of emphysema ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.118.5.1240
更新日期:2000-11-01 00:00:00