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Local Anesthetics: Adverse Effects

Local Anesthetics: Adverse Effects

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.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...

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.

General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

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...

Local Anesthetics: Mechanism of Action

Local Anesthetics: Mechanism of Action

Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...

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...

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Related Experiment Video

Updated: May 19, 2026

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Published on: May 12, 2018

Anesthetic neurotoxicity.

Ansgar M Brambrink¹, Andrea Orfanakis, Jeffrey R Kirsch

¹Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. brambrin@ohsu.edu

Anesthesiology Clinics

|August 21, 2012

Summary

Concerns about anesthesia

Area of Science:

Neuroscience
Anesthesiology
Gerontology

Background:

Growing concerns exist regarding potential toxic effects of anesthesia on the brains of young and elderly individuals.
While evidence for anesthetic neurotoxicity in the developing brain is substantial, mechanisms remain unclear, and human risk is debated.
Postoperative cognitive dysfunction in the elderly is controversial, with ongoing debate regarding its timeline, severity, and persistence.

Purpose of the Study:

To address the mounting concerns regarding anesthetic neurotoxicity in pediatric and geriatric populations.
To highlight the need for further research into the mechanisms and clinical implications of anesthesia's effects on the brain.
To underscore the current lack of sufficient evidence to guide clinical practice changes for these patient groups.

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Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Published on: January 13, 2018

Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons

Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons

Published on: February 5, 2015

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Last Updated: May 19, 2026

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

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Published on: May 12, 2018

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Published on: January 13, 2018

Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons

Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons

Published on: February 5, 2015

Main Methods:

Review of existing experimental evidence on anesthetic effects in developing brains.
Analysis of the ongoing debate and controversies surrounding postoperative cognitive deterioration in the elderly.
Identification of knowledge gaps and areas requiring well-designed research.

Main Results:

Experimental evidence for anesthetic neurotoxicity in the developing brain is strong, but human risk and mechanisms require further investigation.
The phenomenon of postoperative cognitive deterioration in the elderly is not well-defined, with significant debate on its characteristics.
Current evidence is insufficient to warrant changes in clinical anesthesia practice for either young or elderly patients.

Conclusions:

Further well-designed research is crucial to understand and address the potential neurotoxic effects of anesthesia in vulnerable populations.
Clarifying the risks and mechanisms associated with anesthesia in the young and elderly is imperative for patient safety.
Robust scientific inquiry is needed to guide evidence-based clinical practice in anesthesiology.