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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

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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.
One of the advantages of...
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Angle Closure Glaucoma: Treatment01:28

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Cranial Nerves: Types Part I01:14

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Cranial nerves are responsible for transmitting motor and sensory information between the brain and various parts of the body. There are twelve pairs of cranial nerves, with the first six being essential in sensory perception, motor control, and autonomic functions related to the head and neck.
Olfactory Nerve (Cranial Nerve I)
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Local Anesthetics: Common Agents and Their Applications01:23

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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 Surface, Infiltration, and Conduction Block Anesthesia01:30

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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...
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Lagophthalmos after v2 maxillary nerve block.

Amit A Shah1, Srdjan S Nedeljkovic

  • 1From the *Department of Anesthesiology, Yale-New Haven Hospital, New Haven, Connecticut, and †Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

A & a Case Reports
|January 23, 2015
PubMed
Summary

A rare complication of percutaneous maxillary nerve blocks is temporary eye closure inability (lagophthalmos). This may result from local anesthetic affecting facial nerve branches, necessitating careful volume consideration and awareness for patient safety.

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Neurology

Background:

  • Percutaneous maxillary nerve blockade is a procedure used for pain management.
  • Potential complications, though rare, require thorough understanding and reporting.

Purpose of the Study:

  • To report a previously undescribed complication of percutaneous maxillary nerve blockade.
  • To highlight the potential for temporary lagophthalmos following the procedure.

Main Methods:

  • A patient undergoing percutaneous maxillary nerve blockade received lidocaine for local anesthesia.
  • Following fluoroscopic confirmation, methylprednisolone and bupivacaine were administered.
  • The patient developed ipsilateral lagophthalmos post-procedure.

Main Results:

  • The patient experienced an inability to close the ipsilateral eye (lagophthalmos).
  • Symptoms resolved spontaneously within 40 minutes.
  • The complication was attributed to the local anesthetic's effect on zygomatic branches of the facial nerve.

Conclusions:

  • Consideration of smaller local anesthetic volumes for subcutaneous infiltration during maxillary blocks is advised.
  • Awareness of this potential complication is crucial for both clinicians and patients.
  • Management may involve artificial tears or eye patching to prevent corneal injury.