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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

982
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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The inhibitory effect of intravenous lidocaine infusion on tinnitus after translabyrinthine removal of vestibular

David M Baguley1, Stephen Jones, Ingrid Wilkins

  • 1Department of Neuro-Otology, Addenbrooke's Hospital, Cambridge, UK. dmb29@cam.ac.uk

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|March 29, 2005
PubMed
Summary
This summary is machine-generated.

Intravenous lidocaine infusion temporarily reduced tinnitus loudness, pitch, and distress in patients who had their cochlear nerve severed. This suggests lidocaine acts on the central auditory pathway to alleviate tinnitus.

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Area of Science:

  • Neurology
  • Otolaryngology
  • Pharmacology

Background:

  • Intravenous lidocaine offers transient tinnitus relief, but its action site remains debated.
  • Proposed sites include the cochlea, cochlear nerve, and central auditory pathways.

Purpose of the Study:

  • To investigate the central auditory pathway as the site of action for lidocaine's tinnitus-inhibiting effects.
  • To assess lidocaine's efficacy in patients with severed cochlear nerves due to vestibular schwannoma surgery.

Main Methods:

  • A double-blind, placebo-controlled, crossover study was conducted at a university hospital.
  • Sixteen patients with post-surgical tinnitus after vestibular schwannoma removal received intravenous lidocaine or placebo.
  • Tinnitus intensity, pitch, and distress were measured using visual analogue scales before and after infusions.

Main Results:

  • Lidocaine infusion significantly reduced tinnitus loudness, pitch, and distress compared to placebo at 5 minutes post-infusion (p < 0.05).
  • No significant differences were observed at 20 minutes post-infusion, indicating a short-lasting effect.
  • These findings suggest a transient, central mechanism of action for lidocaine in tinnitus management.

Conclusions:

  • Intravenous lidocaine demonstrates a statistically significant, albeit short-lived, inhibitory effect on tinnitus in patients with surgically sectioned cochlear nerves.
  • The observed effect strongly implicates the central auditory pathway as the primary site of action for lidocaine's tinnitus suppression.
  • This research provides crucial insights for developing novel tinnitus-targeting therapies.