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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 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...

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...

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: Chemistry and Structure-Activity Relationship

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...

Inhalational Anesthetics: Overview

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...

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Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Published on: July 23, 2020

Types of office-based anesthetics.

Laurence M Hausman¹, Elisha J Dickstein, Meg A Rosenblatt

¹Mount Sinai School of Medicine, New York, NY, USA. laurence.hausman@mountsinai.org

The Mount Sinai Journal of Medicine, New York

|January 13, 2012

Summary

This summary is machine-generated.

Advances in anesthesia and surgical techniques have enabled safe office-based procedures. Careful patient and procedure selection, alongside pain management, are crucial for successful outpatient surgery.

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Area of Science:

Anesthesiology
Surgical Innovation
Outpatient Care

Background:

Significant evolution in surgical and anesthetic practices over recent decades.
Development of newer anesthetics with improved safety, fewer hemodynamic effects, and rapid clearance.
Advancement of minimally invasive surgical techniques reducing perioperative patient discomfort.

Purpose of the Study:

To examine the growth and safety of office-based surgery and anesthesia.
To highlight the critical factors for successful outpatient procedures.
To emphasize the importance of patient selection and pain management in office settings.

Main Methods:

Review of anesthetic and surgical advancements.
Analysis of safety profiles of various anesthesia types (local, MAC, general, regional) in office settings.
Discussion of essential considerations for patient and procedure selection.

Main Results:

Newer anesthetics and less invasive surgeries support the expansion of office-based procedures.
Local, monitored anesthesia care (MAC), general, and regional anesthesia have been safely administered in private offices.
Proper patient and procedure selection is paramount due to the remote nature of private surgical offices.

Conclusions:

Office-based surgery and anesthesia are safe and growing, driven by medical advancements.
Meticulous patient and procedure selection are essential for safety in office-based settings.
Anesthesiologists must ensure all office locations meet stringent safety standards for surgical procedures.