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At least 631 records · Page 35Linked to original sources
PubMed2000

Dental safety needles' effectiveness: results of a one-year evaluation.

BACKGROUND: Some government agencies and state legislatures recently have passed regulations mandating the use of safety-enhanced devices, including dental anesthetic safety needles. Little information exists, however, on the efficacy and utility of these types of needles currently on the market. METHODS: The authors evaluated four types of dental safety needles and syringes for clinical acceptability. Two of these devices were deemed unacceptable owing to inherent features identified during the bench test. The remaining two devices were clinically evaluated using an 11-statement survey. Senior dental students completed the survey at one, two, four, five, six and eight weeks from introduction of the devices to a dental school clinic. Junior dental students joined the senior students using one of the devices for the last six months of the evaluation and joined the senior students in completion of a final survey at 52 weeks. RESULTS: The survey results indicated increasing user dissatisfaction with nine of the safety device features evaluated over the 52 weeks. At eight weeks, use of one of the two devices was discontinued owing to poor clinical performance. A review of the blood exposure incident reports that routinely are collected following an exposure incident revealed a small increase in exposures involving anesthetic needles. The sample size was too small to determine statistical significance of the change in injury rate, but it did show that needlesticks continue to occur in spite of the use of safety devices. CONCLUSIONS: None of the safety devices tested successfully passed the clinical evaluation. Continued evaluation is necessary to ensure that effective safety devices are available to dental practitioners. CLINICAL IMPLICATIONS: Evaluators had significant concerns about the usability of dental safety needles and their ability to adapt to using them effectively. Results of a review and bench tests indicate that the devices tested are no safer than traditional anesthetic needles.

Accidents, Occupational↗
PubMed1998

[Accidents with sharp instruments in nurses in a university hospital in Campinas, Sao Paolo].

This study has the objective to evaluate certain aspects of the occurrence of accidents of work with perforative cutting tool in nursing workers of a university hospital. Forty-six workers who had accidental needlesticks and injuries from other sharp objects (from June to/December 1994) were interviewed. The data found are likely to help programs of prevention of accidents with nursing workers.

Accidents, Occupational↗
PubMed1996

Vertical strabismus after cataract surgery.

PURPOSE: To compare anesthesia methods with resultant strabismus patterns in patients with vertical diplopia after cataract surgery. METHODS: The authors analyzed 28 consecutive patients with acquired vertical diplopia after cataract surgery to identify the strabismus pattern. The method of anesthesia administration was available in 21 patients. Three orbital dissections with simulated retrobulbar blocks were performed on cadavers to ascertain the possibility of injuring the vertical rectus muscles at the time of injection. RESULTS: Fifty percent of the involved muscles were overactive, 39 percent were restricted, and 11 percent were paretic. Eleven patients received retrobulbar, and ten received peribulbar anesthesia. The inferior rectus in 17 patients and the superior rectus muscle in 11 were involved. The odds of damaging the inferior rectus, as opposed to the superior rectus muscle, with peribulbar anesthesia was 4.8 times higher than with retrobulbar blocks. Cadaveric dissections showed the likelihood of direct needle injury to either vertical recti with retrobulbar blocks. CONCLUSIONS: In this patient population, permanent vertical strabismus after cataract surgery results more often from overacting or restricted muscles than from primary muscle paresis. Both the superior and inferior recti can be injured with retrobulbar anesthesia, but peribulbar injections affect the inferior rectus muscle more frequently.

Anesthesia, Local↗
PubMed2001

Ocular complications of needle perforations during retrobulbar and peribulbar injections.

As a whole, the complication rate of retrobulbar and peribulbar injections is low, especially if done correctly (see appendix I). Side effects, however, can be extremely serious, and alternative methods such as topical or sub-Tenon's anesthesia should be considered (see appendix II), particularly when evaluating monocular patients with high-risk characteristics.

Anesthesia, Local↗