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Local Anesthetics: Common Agents and Their Applications

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...

Local Anesthetics: Pharmacokinetics

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

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Updated: Jun 9, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Psoriasis and anesthetic considerations.

Amir Baluch¹, Arushi Kak, Omar Saleh

¹Jackson Memorial Hospital/University of Miami, Miami, Florida, USA.

Middle East Journal of Anaesthesiology

|September 1, 2010

Summary

This summary is machine-generated.

Psoriasis is a chronic skin condition requiring careful anesthetic management due to potential complications. Anesthesiologists must consider disease severity and patient medications for safe surgical procedures.

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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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Area of Science:

Dermatology and Anesthesiology
Immunology and Pharmacology

Background:

Psoriasis is a chronic, debilitating integumentary condition with potential fatal complications like congestive heart failure.
The chronic and variable nature of psoriasis necessitates careful patient handling, particularly in surgical settings.

Purpose of the Study:

To highlight the critical considerations for anesthesiologists managing patients with psoriasis.
To emphasize the need for preparedness regarding anesthetic complications associated with psoriasis and its treatments.

Main Methods:

Review of existing literature on psoriasis management and anesthetic implications.
Analysis of factors influencing anesthetic choices in psoriatic patients, including disease severity and medication interactions.

Main Results:

Psoriasis management involves various mechanisms, including keratinocyte differentiation, immunosuppression, steroid therapy, and oxygen radicals, but no definitive cure exists.
Anesthetic management requires careful consideration of disease severity, regional anesthesia placement, and potential complications from psoriatic medications.

Conclusions:

Anesthesiologists must be vigilant and prepared when managing psoriasis patients due to the chronic, variable nature of the disease and potential anesthetic risks.
While dermatologists typically manage psoriasis, anesthesiologists play a crucial role in ensuring patient safety during surgical interventions.