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Chronic foot and leg ulcers are a common health problem worldwide. A mainstay of chronic ulcer therapy is sharp mechanical wound debridement requiring potent analgesia. In this prospective, controlled, single-centre, crossover design study, patients were assigned to either the administration of topical analgesia with 5% lidocaine/prilocaine cream or the inhalation of an analgesic 50% N2 O/O2 gas premix. Primary outcome parameter was level of pain at maximum wound depth during debridement as measured by a visual analogue scale. Secondary outcomes included level of pain after debridement, overall duration of treatment session, duration and completeness of debridement, and the patient's subjective perception of analgesic quality during debridement. Pain level increased from 0·60/0·94 (first/second debridement; baseline) to 1·76/2·50 (debridement) with 5% lidocaine/prilocaine and from 1·00/1·35 (baseline) to 3·95/3·29 (debridement) with 50% N2 O/O2 gas premix. Patient satisfaction was 90·48%/94·44% (first/second debridement) with topical 5% lidocaine/prilocaine analgesia and 90·48%/76·47% with the inhalation of 50% N2 O/O2 gas premix. Debridement was completed in a significantly higher percentage of 85·71%/88·89% (first/second debridement) with 5% lidocaine/prilocaine than with 50% N2 O/O2 gas premix (42·86%/58·82%) (odds ratio 6·7; P = 0·001). This study provides sound evidence that analgesia with topically administered 5% lidocaine/prilocaine cream is superior to the use of inhaled 50% N2 O/O2 gas premix in chronic leg ulcer debridement.

Cationic alkyl complexes of the rare-earth metals [LnRm(L)n](3–m)+ (R=alkyl; m=1, 2; L=Lewis base) were virtually unknown species until recently. Because of their increased Lewis acidity/electrophilicity they should have considerable potential as homogeneous catalysts in olefin polymerization and in organic transformations. They can be generated by treating the neutral rare-earth metal precursors containing at least two alkyl groups R with suitable Lewis or Bronsted acids in the presence of weakly coordinating anions. Not only monocationic but also dicationic alkyl derivatives have been shown to be accessible. In the context of modeling homogeneous ethylene polymerization using a mixture consisting of LnR3/AlR3/[NMe2HPh][B(C6F5)4], such dications were discovered. Some thermally robust examples of mono- and dicationic alkyl complexes have been structurally characterized as solvent-separated ion pairs. Neutral and monoanionic macrocycles such as crown ethers or aza-crown ethers as well as amidinato, β-diketiminato, and substituted cyclopentadienyl ligands are suitable ancillary ligands to stabilize the cationic alkyl fragments.

I. Introduction 1953II. Overview of Synthesis, Structure, and Properties 1954A. Synthetic Methods 1954B. Ligands and Structures 1955III. Halo Complexes 1956A. General 1956B. Divalent Halo Complexes 1956C. Trivalent Halo Complexes 1957IV. Chalcogenido Complexes 1958A. General 1958B. Divalent Chalcogenido Complexes 1958C. Trivalent Chalcogenido Complexes 1959V. Pnicogenido Complexes 1960A. General 1960B. Divalent Amido and Phosphido Complexes 1960C. Trivalent Pnicogenido Complexes 19611. Bis(amido) Complexes 19612. Mixed Halo and Chalcogenido Complexes 1962VI. Hydrocarbyl and Silyl Complexes 1963A. General 1963B. Divalent Complexes 19631. Metallacarbaboranes 19632. Bimetallic Naphthalene Complexes 19643. Silyl Complexes 1964C. Bis(Hydrocarbyls) 19641. Bis(alkyl), Bis(aryl), and Anionic Tris(alkyl)Complexes19642. Allyl and Anionic Tris(allyl) Complexes 19653. Metallacyclopentenes 19654. Metallacarbaboranes 19655. Fullerides 1966D. Hydrocarbyl Complexes with Rare-EarthMetal to Chlorine, Oxygen, and NitrogenBonds19661. Aryloxo, Silylamido, and AmidinatoComplexes19662. Linked Pnicogenido CyclopentadienylComplexes1966VII. Hydrido Complexes 1968A. General 1968B. Complexes with a [Ln(