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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

1.0K
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...
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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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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...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

2.0K
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...
2.0K
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

1.5K
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...
1.5K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

1.0K
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...
1.0K
Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

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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...
4.9K

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Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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Local anesthetic systemic toxicity.

David M Dickerson1, Jeffrey L Apfelbaum2

  • 1Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois ddickerson@dacc.uchicago.edu.

Aesthetic Surgery Journal
|July 17, 2014
PubMed
Summary
This summary is machine-generated.

Local anesthetic systemic toxicity (LAST) is a rare but serious complication of local anesthesia. This review proposes a practical management method for LAST, aiding clinicians in recognition and treatment.

Keywords:
acute painambulatory surgerybupivacaine toxicitylipid emulsionlocal anesthetic toxicity

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Toxicology

Background:

  • Local anesthetic systemic toxicity (LAST) is a rare but severe complication associated with local anesthesia administration.
  • Prompt recognition and effective treatment of LAST are crucial for patient safety and improved outcomes.
  • Clinicians require clear guidelines for managing this potentially devastating event.

Purpose of the Study:

  • To review the existing literature on the mechanisms, treatment strategies, and preventive measures for LAST.
  • To develop and propose a practical, systematic approach for the clinical management of LAST.
  • To enhance the preparedness of healthcare providers in handling LAST emergencies.

Main Methods:

  • Comprehensive literature search on local anesthetic systemic toxicity.
  • Analysis of studies detailing LAST mechanisms, clinical presentations, and therapeutic interventions.
  • Synthesis of evidence to formulate a practical management protocol.

Main Results:

  • LAST can manifest with diverse neurological and cardiovascular signs.
  • Early recognition and prompt intervention significantly improve patient prognosis.
  • Management involves supportive care, seizure control, and lipid emulsion therapy.

Conclusions:

  • A structured approach to LAST management is essential for clinicians.
  • Understanding LAST mechanisms aids in effective prevention and treatment.
  • This review provides a practical framework to guide the clinical care of patients experiencing LAST.